Review articleBody dysmorphic disorder and appearance enhancing medical treatments
Section snippets
The popularity of appearance enhancing medical treatments
According the American Society of Plastic Surgeons, 10.9 million cosmetic surgical and minimally invasive treatments were performed in 2006 (ASPS, 2007). Just under 2 million of these treatments were traditional cosmetic surgical procedures such as liposuction, breast augmentation, and rhinoplasty. The vast majority, over 9.1 million, were minimally invasive procedures such as Botox® injections and chemical peels. The number of all of these procedures has increased by 48% since 2000 and over
Psychological aspects of cosmetic surgery
Surprising to many individuals, there is a large literature on the psychological aspects of cosmetic surgery (Crerand, Cash, & Whitaker, 2006; Sarwer, in press; Sarwer & Crerand, 2004; Sarwer, Didie, & Gibbons, 2006). Research in this area dates back almost 50 years to the pioneering work of plastic surgeons and psychiatrists at Johns Hopkins University. Early studies in this area relied heavily on unstructured clinical interviews performed by psychoanalytically trained psychiatrists. Perhaps
Descriptive and diagnostic issues
Case reports in the cosmetic surgery and dermatology literatures describing symptoms consistent with body dysmorphic disorder (BDD) appeared prior to the disorder's inclusion in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Descriptions of “minimal deformity” and “insatiable” patients were reported in the cosmetic surgery literature in the 1960s (Edgerton, Jacobson, & Meyer, 1960; Knorr, Edgerton, & Hoopes, 1967). Case reports of “dysmorphophobia” and “dermatological
Cosmetic surgery patients
Over the past decade, a number of studies have investigated the rate of BDD among persons who present for cosmetic surgery (see Table 1). The first study in this area found that 7% of patients met diagnostic criteria for the disorder (Sarwer, Wadden, et al., 1998). International studies, which typically relied upon clinical interviews, reported slightly higher rates of BDD (Ishigooka et al., 1998; Vargel & Ulusahin, 2001; Vindigni et al., 2002). However, methodological limitations, such as
The effect of appearance enhancing medical treatments on BDD
The efficacy of cosmetic surgery or other appearance enhancing treatments on BDD has yet to be formally investigated. A randomized controlled trial of this issue would face a number of methodological and ethical challenges. Therefore, our understanding of the effect of appearance enhancing treatments on BDD is gleaned from clinical reports and retrospective studies (Crerand et al., 2005; Phillips, Grant, et al., 2001; Veale et al., 1996).
These studies indicate that appearance enhancing
Directions for future research
Over the past decade, much has been learned about the relationship between BDD and appearance enhancing medical procedures. The rate of BDD in cosmetic surgical and dermatology populations has been well-established, and the frequency with which BDD patients seek and receive cosmetic treatments has been documented. Despite these advances, additional research is needed to further investigate BDD among persons who present for appearance enhancing treatments. Future studies are needed to identify
References (91)
- et al.
Body dysmorphic disorder in a sample of cosmetic surgery applicants
European Psychiatry
(2003) - et al.
Dysmorphic concern symptoms and personality disorders: A clinical investigation in patients seeking cosmetic surgery
Psychiatry Research
(2006) - et al.
Body dysmorphic disorder symptoms among patients with acne vulgaris
Journal of the American Academy of Dermatology
(2007) - et al.
Non-psychiatric medical treatment of body dysmorphic disorder
Psychosomatics
(2005) - et al.
Dysmorphophobia: Recent developments of interest to the maxillofacial surgeon
British Journal of Oral and Maxillofacial Surgery
(1996) - et al.
Surgical-psychiatric study of patients seeking plastic (cosmetic) surgery: Ninety-eight consecutive patients with minimal deformity
British Journal of Plastic Surgery
(1960) - et al.
Body dysmorphic disorder in adult orthodontic patients
American Journal of Orthodontics and Dentofacial Orthopedics
(2006) - et al.
Exposure, response prevention, and cognitive therapy in the treatment of body dysmorphic disorder
Behavior Therapy
(1993) - et al.
Rate of body dysmorphic disorder in dermatology patients
Journal of American Academy of Dermatology
(2000) - et al.
Surgical and nonpsychiatric medical treatment of patients with body dysmorphic disorder
Psychosomatics
(2001)
Awareness and identification of body dysmorphic disorder by aesthetic surgeons: Results of a survey of American Society for Aesthetic Plastic Surgery members
Aesthetic Surgery Journal
Body image and cosmetic medical treatments
Body Image: An International Journal of Research
Body image and obesity in adulthood
Psychiatric Clinics of North America
The psychology of cosmetic surgery: A review and reconceptualization
Clinical Psychology Review
Body image dissatisfaction in women seeking rhytidectomy or blepharoplasty
Aesthetic Surgery Journal
Obesity and body image
Body Image: An International Journal of Research
Body dysmorphic disorder in patients with acne
Comprehensive Psychiatry
Cosmetic rhinoplasty in body dysmorphic disorder
The British Association of Plastic Surgeons
Cognitive behavior group therapy for body dysmorphic disorder: A case series
Behaviour Research Therapy
Clinical and subclinical body dysmorphic disorder
European Archives of Psychiatry and Clinical Neuroscience
Prospective analysis of the outcome of subpectoral breast augmentation: Sensory changes, muscle function, and body image
Plastic and Reconstructive Surgery
Measuring outcomes in plastic surgery: Body image and quality of life in abdominoplasty patients
Plastic and Reconstructive Surgery
Mortality among augmentation mammoplasty patients
Epidemiology
Mortality rates among augmentation mammoplasty patients: An update
Epidemiology
Women's psychosocial outcomes of breast augmentation with silicone gel-filled implants: A 2-year prospective study
Plastic and Reconstructive Surgery
Correlated of dysmorphic concern in people seeking cosmetic enhancement
Australian and New Zealand Journal of Psychiatry
Dermatological non-disease: A common and potentially fatal disturbance of cutaneous body image
British Journal of Dermatology
Body dysmorphic disorder
Dermatologic Clinics
Cosmetic surgery of the face
Body dysmorphic disorder and cosmetic surgery
Plastic and Reconstructive Surgery
Rate of body dysmorphic disorder among patients seeking facial cosmetic procedures
Psychiatric Annals
Psychological assessment of patients requesting orthognathic surgery and the relevance of body dysmorphic disorder
British Journal of Orthodontics
Mental disorders in dental practice: A case report of body dysmorphic disorder
Special Care in Dentistry
Factors which influence the decision to undergo cosmetic breast augmentation surgery
Journal of Women's Health
A screening questionnaire for body dysmorphic disorder in a cosmetic dermatologic surgery practice
Dermatologic Surgery
Professional and legal considerations in cosmetic surgery
Psychosocial issues and their relevance to the cosmetic surgery patient
Botulinophilia: Contraindication for therapy with botulinum toxin
International Journal of Clinical Pharmacology and Therapeutics
Body dysmorphic disorder: Diagnosis and treatment
General Dentistry
Clomipramine vs desipramine crossover trial in body dysmorphic disorder: Selective efficacy of a serotonin reuptake inhibitor in imagined ugliness
Archives of General Psychiatry
Treatment of body-dysmorphic disorder with serotonin reuptake blockers
American Journal of Psychiatry
A review of psychosocial outcomes for patients seeking cosmetic surgery
Plastic and Reconstructive Surgery
Demographic features of patients seeking cosmetic surgery
Psychiatry and Clinical Neuroscience
Mortality and suicide among Danish women with cosmetic breast implants
Archives of Internal Medicine
Cited by (112)
Psychology of facial aesthetics
2021, Aesthetic Surgery of the Facial SkeletonPatient-reported outcome measures in external and endonasal functional septorhinoplasty – A propensity score matching study
2021, American Journal of Otolaryngology - Head and Neck Medicine and SurgeryApplication of a transdiagnostic treatment for emotional disorders to body dysmorphic disorder: A randomized controlled trial
2019, Journal of Affective DisordersPerfectionism and Baldness Distress in Men: The Mediating Effect of Aging Anxiety
2024, European Journal of Psychology OpenSurgical Rhinoplasty in Mild Forms of Body Dysmorphic Disorder: Safety, Protocols, and Long-Term Outcomes
2024, Facial Plastic Surgery