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Outcome of cosmetic surgery and ‘DIY’ surgery in patients with body dysmorphic disorder

Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, University College, c/o Grovelands Priory Hospital, The Bourne, Southgate, London N14 6RA

AIMS AND METHOD

Little is known about the outcome of cosmetic surgery in patients with body dysmorphic disorder (BDD). Self-reported outcome was collected on 25 patients with BDD who at the time of psychiatric assessment had reported that they had had cosmetic surgery in the past.

RESULTS

Twenty-five patients with BDD had a total of 46 procedures. The worst outcome was found in those who had had rhinoplasty and those with repeated operations. Mammoplasty and pinnaplasty was associated with higher degrees of satisfaction. Nine patients with BDD, either in desperation at being turned down for cosmetic surgery or because they could not afford it, had performed their own ‘DIY’ surgery in which they attempted by their own hand to alter their appearance dramatically.

CLINICAL IMPLICATIONS

Cosmetic surgery cannot at present be recommended for patients with BDD. However, patients turned down for surgery or who cannot afford it, may try to alter their appearance by themselves. The study contains a selection bias of patients in favour of treatment failures in cosmetic surgery and prospective studies are required on BDD patients who obtain cosmetic surgery or dermatological treatment.

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