Surgical Rhinoplasty in Mild Forms of Body Dysmorphic Disorder: Safety, Protocols, and Long-Term Outcomes

Area of Science:

• Plastic Surgery
• Psychiatry
• Psychology

Background:

• Body dysmorphic disorder (BDD) significantly impacts body image perception.
• Severe BDD contraindicates rhinoplasty due to poor patient satisfaction and symptom persistence.
• Mild to borderline BDD may benefit from rhinoplasty with appropriate protocols.

Purpose of the Study:

• To evaluate the outcomes of surgical rhinoplasty in patients with borderline to mild BDD.
• To assess the efficacy of a two-specialist protocol involving mandatory psychiatric evaluation (MPE).
• To analyze patient satisfaction using visual analog and Likert scales.

Main Methods:

• A two-specialist protocol with MPE was applied to identify suitable candidates.
• 1,602 patients seeking rhinoplasty were screened; 892 underwent MPE.
• 15 patients with mild BDD underwent rhinoplasty and were followed for 6-95 months.

Main Results:

• 2.5% (22/892) of patients were identified with mild BDD.
• All 15 surgically treated patients reported increased happiness post-rhinoplasty.
• Patient satisfaction scores ranged from 6/10 to 10/10 on the VAS.

Conclusions:

• Surgical rhinoplasty can yield safe and positive long-term outcomes for selected mild BDD patients.
• A structured protocol, including MPE, is crucial for patient selection.
• Patients with mild BDD may have a higher propensity for requesting revision surgery, necessitating pre-operative counseling.