If “feeling ugly” has reached the point of checking the mirror again and again and wanting to change it again and again, get a body-image assessment before talking about surgery

Cost

One registration at psychiatry or clinical psychology, a few dozen CNY. The hard part is making this trip before you book the surgery.

What you get

Following proper methods, 33 studies were gathered and pooled. Among patients at plastic surgery clinics, the prevalence of body dysmorphic disorder (blowing up a flaw that others can barely see until it affects life) was 15.04%, ranging across studies from 2.21% to 56.67%. In terms of people, about 15 of every 100 people going for plastic surgery qualify, while by individual study the figure runs from 2 to 57. The average age of this group was 34.54±12.41 years (the second number is the range of spread), and 74.38% were women. Among dermatology patients it was 12.65%, ranging across studies from 4.52% to 35.16%, with an average age of 27.79±9.03 years and 76.09% women. The authors recommend that plastic surgeons and dermatologists proactively assess patients, identify those at high risk, and arrange for several departments to manage them together. Another study asked 200 patients with body dysmorphic disorder: 71.0% had sought non-psychiatric treatment such as dermatology or plastic surgery, and 64.0% had received it. The authors concluded that such treatment “rarely improves” body dysmorphic disorder and appears to be ineffective for it.

Notes

The proportions measured in the studies range from 2.21% all the way to 56.67%, a huge spread. The reason is that the questionnaires and the populations surveyed were different. So all you can read from it is that “this proportion is not low and worth screening once”; 15.04% should not be treated as an exact number, which is also why it is rated B. By this proportion, most people who go to plastic surgery do not have body dysmorphic disorder. This item is aimed at the small group whose concern is “repeated, persistent, and already affecting work and social life,” and surgery or skin treatment rarely makes them better. The clues listed by the UK NHS include these: spending a lot of time comparing your looks with other people's, checking the mirror constantly or avoiding mirrors altogether, going to great lengths to cover up one body part, and picking at the skin to try to make it “smooth.” It affects work, social life and relationships.

Evidence grade

B : Supported by research but without a precise number, or based on small or single studies.

Sources

1. Ribeiro RVE (2017). Prevalence of Body Dysmorphic Disorder in Plastic Surgery and Dermatology Patients: A Systematic Review with Meta-Analysis. Aesthetic Plast Surg. https://doi.org/10.1007/s00266-017-0869-0
2. Crerand CE, Phillips KA, Menard W, Fay C (2005). Nonpsychiatric medical treatment of body dysmorphic disorder. Psychosomatics, 46(6), 549-555. https://doi.org/10.1176/appi.psy.46.6.549
3. NHS. Body dysmorphic disorder (BDD). https://www.nhs.uk/mental-health/conditions/body-dysmorphia/

Translated from the Chinese original. Original book, section 28, tip 8. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer