Prevalence study of body dysmorphic disorder symptoms in plastic surgery

The objective of this work was to determine the prevalence of Body Dysmorphic Disorder (BDD) symptoms in plastic and aesthetic surgery consultations in a large cohort of patients presenting for initial consultations for various indications.

We conducted a prospective, single-center cohort study between January 2022 and November 2022. A total of 1169 questionnaires were collected, and 842 patients were included in the study. Among the entire population, 180 patients screened positive test and were thus considered at high risk for BDD. This represented 21.4% of our population. Regarding the impact on their sexual and/or romantic life, 40% of our patients indicated that their BDD symptoms affected their sexual life, which aligns with the findings of Brito, who found that patients with BDD+ had significantly higher sexual inhibition than those with BDD-, with sexual inhibition reported in 51% of patients with BDD+ compared with 28% of patients with BDD-.

The prevalence of BDD symptoms in our population (21.4%) is close to the average found in other prevalence studies on BDD in plastic surgery. Our cohort, which is the largest prospective cohort conducted on the subject to date, is very representative of the population presenting to plastic surgery for consultation. It also presents the most extensive range of surgical indications ever studied in the literature.

BDD most often affects patients under 50 years old who consult for rhinoplasty or otoplasty. Only severe presentations of BDD are risk factors for postoperative dissatisfaction. Therefore, it is essential to diagnose such cases and direct these patients toward psychiatric care rather than operating on them.