Cosmetic Surgery is No Cure for Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) has been getting a lot of attention in the media recently.  The condition, which drives people to constantly alter their appearance in a desire to be perfect, is oftentimes linked to plastic surgery. But do BDD sufferers actually benefit emotionally by undergoing plastic surgery? A new study’s says ‘no’. Despite these findings, there are surgeons who still provide requested surgeries to BDD sufferers.

The study, which was recently published in the Annals of Plastic Surgery, was spearheaded by Katharine A. Phillips, MD, is the director of the body image program at Rhode Island Hospital. Phillips defines BDD as “a psychiatric disorder characterized by preoccupation with an imagined or slight defect in appearance which causes clinically significant distress or functional impairment. A majority of these individuals believe they have an actual deformity that can be corrected by cosmetic treatments to fix these perceived defects rather than seeking psychiatric intervention."

Phillips co-authored the study with Canice Crerand, PhD, of the Children’s Hospital of Philadelphia. The researchers reported that previous studies showed BDD to be relatively common among individuals who underwent plastic surgery, accounting for roughly 7-8% American plastic surgery patients. The duo retrospectively studied 200 individuals with BDD. Of the group, 31% sought and 21% received surgical or minimally invasive treatments to remedy their BDD symptoms.

The study found that almost all of the individuals still experienced BDD symptoms, while some even developed new appearance fixations. The researchers also surveyed 265 cosmetic surgeons, of which 65% reported treating patients with BDD symptoms. Only one percent of the reported cases that were treated resulted in symptom improvement.

The most common surgical procedures among the patients were rhinoplasty and breast augmentation, while the most popular non-invasive treatments were dermal fillers and microdermabrasion. Three-quarters of all the desired procedures involved the face, and more than a third of the patients studied underwent numerous different treatments.

In the long-term, only 25% of patients with BDD showed a more positive appraisal of their treated body parts. Not only that, only two percent of treated patients saw a lasting improvement of their overall BDD symptoms.   

Of the patients who sough treatment, 20% did not receive a procedure. Surprisingly, patients with BDD were turned down more often due inability to pay for a procedure than they were for their symptoms. Thirty percent of patients could not undergo their procedure due to financing, while 26% were refused treatment by a doctor. The researchers also found that surgeons were significantly less likely to refuse a cosmetic treatment than other procedures, such as dermatological, dental or otherwise.

"This suggests that many surgeons were not aware of the patient's BDD or do not consider BDD a contraindication to treatment,” says Phillips.  “In a survey of 265 cosmetic surgeons, only 30 percent believed that BDD was always a contraindication to surgery."

While some cases of body dysmorphic disorder are easy to recognize, other cases are not so clear-cut. This study is an indicator that there should be more training and sensitivity in the aesthetic plastic surgery industry to the symptoms of BDD.  While most patients have a healthy desire to simply enhance their features, the crippling symptoms of BDD could be the motive for patients to undergo cosmetic surgery.