[The by law required assessment by a child psychiatrist before cosmetic interventions; retrospective file research]

Surgical and non-surgical cosmetic interventions are on the rise, also in minors. Therefore, the society, healthcare system and government are searching for an ethical-medical-legal framework. Numerous studies have shown the importance of patient selection. The absence of psychopathology correlates with a good outcome of cosmetic interventions. Since July 2013, the law in Belgium requires a consultation with a child psychiatrist or child psychologist before minors are allowed to undergo cosmetic intervention.
AIM: To evaluate the clinical impact and effectiveness of this Belgian law.
METHOD: Retrospective research of all patient evaluations by an independent child psychiatrist in the context of this law at the University Hospital, Free University Brussels from 12/07/2013-12/07/2017. Descriptive analysis of following variables as mentioned in the report of the child psychiatrist: type of cosmetic intervention, socio-demographic data, psychosocial problems, (symptoms of) child psychiatric diagnoses, recommendations.
RESULTS: Thirty-seven patients consulted a child psychiatrist before a planned cosmetic intervention, 36 of them had an otoplasty and 1 a rhinoplasty. Twelve patients had symptoms of at least 2 psychiatric disorders for whom further examination was required. However, these did not constitute a contraindication for the cosmetic intervention. None of the patients had (symptoms of) a body dysmorphic disorder.
CONCLUSION: Mainly patients who underwent otoplasty and with an obvious deviation from appearance that caused suffering were evaluated at the University Hospital, Free University Brussels four years after implementation of the law on cosmetic interventions. No child psychiatric contraindications for the cosmetic intervention were found in this population. It seems more useful to nuance this legislation and ask more specific for advice from a child psychiatrist in patients with risk factors. The identification of patients with a possible (child) psychiatric disorder remains of utmost importance.