Management of Body Dysmorphic Disorder in Plastic Surgery Patients

Body dysmorphic disorder (BDD) is frequently encountered among patients seeking cosmetic procedures. However, the impact of plastic surgery on BDD symptoms remains controversial. This study aimed to evaluate the impact of plastic surgery on patients with BDD, identify areas for improving their care, better define candidates for surgery or consultation, and contribute to the development of more effective treatment methods.

A total of 116 patients who applied to the plastic surgery department were prospectively evaluated. Participants completed a sociodemographic questionnaire, the Yale-Brown Obsessive-Compulsive Scale modified for BDD (YBOCS-BDD), the Global Aesthetic Improvement Scale (GAIS), and the Body Perception Scale. BDD diagnoses were established according to DSM-5 criteria following psychiatric evaluation. Patients were assessed preoperatively, one week postoperatively, and one year after surgery. Standardized pre- and postoperative photographs were independently evaluated by a blinded surgical team.

BDD was diagnosed in 35.3% of patients seeking plastic surgery. Symptomatic improvement was observed in 87.9% of patients with mild BDD and 81.1% of those with moderate BDD. The overall patient satisfaction rate was 68.9%, with the highest satisfaction observed in 78.4% of the moderate BDD group. Among the 46 patients diagnosed with BDD either preoperatively or postoperatively, complete clinical recovery was observed in 10.9% (n = 5) following surgery.

Patients with mild-to-moderate BDD symptoms may benefit from carefully selected plastic surgery procedures. Symptom severity and patient-physician interaction appear to play critical roles in postoperative satisfaction and clinical improvement.

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