Body Dysmorphic Disorder and Plastic Surgery
The last eight years have seen a boom in cosmetic plastic surgery procedures. Patients of all ages, races, and genders have come into plastic surgeons’ offices in the search for self-improvement. There is a small, but real, subset of patients that are looking for more than what a plastic surgeon can deliver. These patients have body dysmorphic disorder. In short, this is a disorder of perception. Patients with this disorder typically have had multiple procedures in the past, are looking for changes to features that do not seem to need changes, and are very distressed over slight imperfections.
Body dysmorphic disorder is described by a set of characteristics and symptoms:
- Preoccupation with physical appearance
- Strong belief that one has an abnormality in their appearance that makes them ugly
- Frequently examining yourself in the mirror or avoiding mirrors altogether
- Believing that others take notice of your appearance in a negative way
- Frequent cosmetic procedures with little satisfaction
- Excessive grooming
- Feeling extremely self-conscious
- Refusing to appear in pictures
- Skin picking
- Comparing your appearance with that of others
- Avoiding social situations
- Wearing excessive makeup or clothing to camouflage perceived flaws
As a plastic surgeon, it is our responsibility to identify these characteristics in prospective patients. We can all look at people in the media and question whether some of them don’t have an underlying body dysmporphia. It is irresponsible as a plastic surgeon to recognize these traits in a prospective patient and still proceed to operate. They will never be completely satisfied with the results and may even be more unhappy.