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Related Experiment Video

Updated: Jun 13, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction

Published on: May 17, 2024

Body dysmorphia, self-mutilation and the reconstructive surgeon.

James Kwok-Kwan Chan¹, Sophie M Jones, Anthony J Heywood

¹Department of Plastic and Reconstructive Surgery, Stoke Mandeville Hospital, Aylesbury HP21 8AL, UK. jackichan17@hotmail.com

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS

|April 16, 2010

Summary

Body dysmorphic disorder (BDD) can lead patients to seek amputation of healthy limbs. This review addresses the diagnostic, ethical, and legal challenges BDD presents, especially in emergency surgical settings.

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Last Updated: Jun 13, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction

Published on: May 17, 2024

Area of Science:

Psychiatry
Plastic Surgery
Medical Ethics

Background:

Body dysmorphic disorder (BDD) involves preoccupation with perceived appearance flaws.
Rarely, BDD manifests as a desire for amputation of healthy limbs.
Patients may self-mutilate to achieve amputation, posing diagnostic and ethical dilemmas.

Observation:

BDD patients seeking amputation present unique challenges to plastic surgeons.
These patients often appear mentally sound but are uncooperative.
Self-amputation attempts create emergency surgical scenarios.

Findings:

No current guidance exists for managing BDD patients in emergency amputation settings.
Ethical and legal issues are complex, involving patient autonomy and surgeon responsibility.
Case illustration highlights the severity and risks associated with BDD-related amputation requests.

Implications:

Need for clear guidelines on managing BDD in emergency surgical contexts.
Importance of multidisciplinary assessment for BDD patients with amputation requests.
Surgeons must navigate complex ethical and legal frameworks when faced with BDD-related self-harm and amputation demands.