Borderline Personality Disorder Diagnoses in Facial Plastic Surgery: A Large Database Analysis

Area of Science:

• Plastic Surgery
• Psychiatry
• Health Services Research

Background:

• Facial plastic surgery is increasingly sought, necessitating understanding of patient demographics and psychological profiles.
• Borderline personality disorder (BPD) is a complex mental health condition that may influence surgical outcomes and patient behavior.
• Prevalence and characteristics of BPD in facial plastic surgery patients remain underexplored.

Purpose of the Study:

• To determine the prevalence of borderline personality disorder (BPD) among patients undergoing facial plastic surgery.
• To identify demographic and clinical characteristics associated with BPD in this patient population.
• To analyze postoperative outcomes for facial plastic surgery patients with and without BPD.

Main Methods:

• Retrospective cohort study utilizing data from over 80 US healthcare organizations via the TriNetX Research Network (2012-2023).
• Identified patients who underwent facial plastic surgery, comparing those with and without a BPD diagnosis.
• Analyzed demographics, clinical comorbidities (psychiatric, substance use), and postoperative outcomes (ED visits, hospitalizations).

Main Results:

• Of 60,792 patients, 309 (0.51%) had BPD. BPD patients were younger (mean age 45.0 vs 54.7) and more frequently female (77% vs 63.4%).
• BPD patients were more likely to undergo rhinoplasty but less likely to have blepharoplasty or facelift. They exhibited higher rates of psychiatric and substance use disorders.
• BPD patients had higher rates of postoperative emergency department visits (15.9% vs 4.8%) and hospitalizations (12.0% vs 6.6%) within 3 months, though not significantly increased from their own baseline rates.

Conclusions:

• Patients with borderline personality disorder undergoing facial plastic surgery tend to be younger, female, and have a higher burden of psychiatric comorbidities.
• While BPD is associated with increased postoperative healthcare utilization, the relative increase compared to baseline is not significant.
• Understanding these characteristics is crucial for tailored preoperative assessment and postoperative care in facial plastic surgery patients with BPD.