This article provides an overview of the psychological issues of facial plastic surgery patients. It begins with a review of the research on the preoperative psychological characteristics of cosmetic surgery patients. Results from the studies assessing postoperative changes in psychological status are reviewed. The psychological issues of specific patient groups, including adolescents and male patients, are discussed. Individuals who undergo plastic surgical procedures as a result of craniofacial anomalies or facial injuries often face a myriad of psychosocial challenges. These issues are outlined in brief. The article concludes with a discussion of two psychiatric conditions, body dysmorphic disorder and posttraumatic stress disorder, that may be frequently encountered by facial plastic surgeons.