[Body dysmorphic disorder and cosmetic surgery: assessment of 24 subjects with a minimal defect in appearance 5 years after their request for cosmetic surgery].
La Presse Médicale. 2009-07-01; 38(7-8): 1062-1067
DOI: 10.1016/j.lpm.2008.07.025
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1. Presse Med. 2009 Jul-Aug;38(7-8):1062-7. doi: 10.1016/j.lpm.2008.07.025. Epub
2009 Apr 8.
[Body dysmorphic disorder and cosmetic surgery: assessment of 24 subjects with a
minimal defect in appearance 5 years after their request for cosmetic surgery].
[Article in French]
Biraben-Gotzamanis L(1), Aouizerate B, Martin-Guehl C, Grabot D, Tignol J.
Author information:
(1)Université Victor Segalen et CHU de Bordeaux, Hôpital Charles Perrens,
F-33076 Bordeaux Cedex, France.
OBJECTIVES: To evaluate the effect of cosmetic surgery in patients with a
minimal defect in appearance, with and without body dysmorphic disorder (BDD), 5
years after their request for plastic surgery.
METHODS: Thirty patients requesting cosmetic surgery with a minimal defect in
appearance, 12 diagnosed with BDD and 18 not, were contacted 5 years later for a
telephone interview about their cosmetic surgery, their satisfaction with it,
BDD diagnosis, handicap, and psychiatric comorbidity.
RESULTS: Of the 30 patients, we were able to re-evaluate 24 subjects (80%), 10
with BDD and 14 without. Seven BDD subjects had undergone cosmetic surgery
compared with 8 without BDD. Patient satisfaction with the intervention was high
in both groups. Nevertheless at follow-up, 6 of the 7 BDD patients who had
surgery still had a BDD diagnosis and showed higher levels of handicap and
psychiatric comorbidity than their non-BDD counterparts. Moreover, 3 non-BDD
patients had developed BDD at follow-up.
DISCUSSION: The high level of satisfaction with their surgery expressed by BDD
patients was surprising and in contrast to the literature. It may explain,
together with the patients’ strong insistence, why plastic surgeons do not fully
agree with psychiatrists on the contraindication of plastic surgery for BDD
patients. Nevertheless in our study, most of the BDD patients were still
diagnosed with BDD 5 years after surgery, with a significant handicap. The BDD
diagnosis at follow-up in patients initially without BDD might be related to the
presence of sub-threshold symptoms at the initial evaluation.
CONCLUSION: This prospective study confirms that cosmetic surgery is not
effective against BDD despite patients’ reported satisfaction. Cosmetic surgery
had no significant effects on BDD diagnosis, handicap or psychiatric comorbidity
in BDD patients 5 years after surgery. Furthermore, BDD appeared at follow-up in
some subjects not initially diagnosed. Patients’ reported satisfaction with
surgery may help explain why some plastic surgeons do not consider BDD a
complete contraindication to cosmetic surgery.
DOI: 10.1016/j.lpm.2008.07.025
PMID: 19359130 [Indexed for MEDLINE]