January 12, 2004

By: Nicole Sims
Website: http://www.1st-in-cosmetics.com

Cosmetic surgeons should screen patients for body dysmorphia

Cosmetic surgeons should screen their patients to filter out those suffering from body dysmorphic disorder – a distorted self-image and preoccupation with imagined or minor defects.

Five per cent of people who undergo cosmetic surgery have BDD. They spend £10 million a year on their surgery but because of their condition, eight out of 10 of them are dissatisfied with the result. In extreme cases, cosmetic surgery patients kill their doctors – most just transfer their dissatisfaction to another area of their body and start all over again.

Dr David Veale, a consultant psychiatrist at the Royal Free and University College Medical School, told delegates that the BDD was under-diagnosed, partly because people were ashamed of the condition.

He has conducted a study, soon to be published, comparing 16 people with BDD at psychiatric outpatients who crave nose surgery (rhinoplasty) with 23 ‘normal’ people who have undergone rhinoplasty. He found that people with BDD were younger (around 25 compared to 40 for the control group), more depressed and anxious and more likely to believe that rhinoplasty would radically alter their lives.

They were far more likely to try to alter the way their looked, such as hiding behind their hair or hands, sticking their chin out or wearing distracting jewellery or body piercing. They were also more likely to embark on DIY surgery with scissors or pliers.

A simple questionnaire would quickly identify those patients with BDD, said Dr Veale. Questions would focus on whether the patient was depressed, abused drugs or alcohol, had social phobias or obsessive compulsive disorder, how often they thought about their appearance and how such a preoccupation affected their life.

“BDD is not just about being dissatisfied with your appearance,” said Dr Veale. “It’s a major preoccupation. It’s on their mind all day and it affects every aspect of their lives. It affects their ability to get work, it handicaps intimacy and they avoid social situations. They are constantly looking at themselves and constantly comparing themselves with others.”

Dr Veale found that BDD was sometimes triggered by a particular incident in childhood or puberty. A third said their symptoms started after an episode of bullying or teasing at school, 22 % said it was prompted by seeing themselves in a mirror - “My whole face and body was out of proportion” one patient said – 11% said it began after being sexually abused and 17% felt their BDD was triggered by just becoming more self-conscious of their appearance, usually at puberty.

Strangely Dr Veale’s research has discovered that one in five people with BDD were either trained in or worked in art and design. More research should focus on whether having an aesthetic sensitivity made someone more likely to develop BDD.

About The Author:

Nicole Sims is a successful author and regular contributor to http://www.1st-in-cosmetics.com.  Tips on skin care, hair care and beauty products to bring out natural beauty.