Recognizing and Managing Body Dysmorphic Disorder Among Patients Seeking Plastic Surgery: A Narrative Review.

Area of Science:

• Psychiatry
• Plastic Surgery
• Medical Ethics

Background:

• Body dysmorphic disorder (BDD) presents complex psychological, ethical, and surgical challenges, particularly in patients seeking plastic surgery.
• Patients often view surgery as a solution to underlying psychological distress associated with BDD.

Purpose of the Study:

• To explore the diagnostic and treatment intricacies of BDD in the context of plastic surgery.
• To review the ethical dilemmas and management strategies for BDD patients considering surgical interventions.

Main Methods:

• Systematic literature search of PubMed, Web of Science, and Google Scholar up to May 2025.
• Selection criteria prioritized articles on BDD prevalence, identification, management, and ethical considerations in plastic surgery.

Main Results:

• Insufficient BDD diagnosis leads to poor surgical outcomes and unmet patient expectations.
• Subjective evaluations hinder accurate screening; ethical concerns involve patient autonomy and potential harm.
• Social media and "snapchat dysmorphia" intensify body image issues and BDD symptoms.

Conclusions:

• Proactive BDD diagnosis using screening tools and multidisciplinary mental health referrals are essential.
• Plastic surgeons must manage patient expectations, sometimes necessitating compassionate surgical refusal.
• Further research is needed on screening recommendations and social media's impact on body perception and BDD.