Awareness and identification of body dysmorphic disorder by aesthetic surgeons: results of a survey of american society for aesthetic plastic surgery members

Aesthet Surg J. 2002 Nov;22(6):531-5. doi: 10.1067/maj.2002.129451.


Background: A critical issue for aesthetic surgeons may be whether some patients have psychiatric conditions that contraindicate cosmetic procedures.

Objective: This study reports on the results of an e-mail survey of American Society for Aesthetic Plastic Surgery (ASAPS) members about their awareness of and experiences with body dysmorphic disorder (BDD).

Methods: In August 2001, all active ASAPS members with e-mail addresses listed in the ASAPS membership registry were e-mailed the "2001 Body Image Survey." Participants were given until August 31 to complete the 8-question survey. The responses were compiled by an independent research firm.

Results: Two hundred sixty-five ASAPS members responded to the survey. Respondents indicated that they believed 2% of patients seen for an initial cosmetic surgery consultation suffer from BDD. Eighty-four percent indicated that they have refused to operate on persons with BDD. Eighty-four percent indicated that they had operated on a patient whom they believed was appropriate for surgery, only to realize after operation that the patient had BDD. Eighty-two percent of these surgeons believed that these patients had a poor postoperative outcome. However, only 30% of respondents indicated that they believed BDD was always a contraindication to cosmetic surgery.

Conclusions: The estimated rate of BDD reported by participants in the survey is consistent with the rate of occurrence in the general population but lower than the rate reported for cosmetic surgery patients in other studies. This suggests that although most surgeons are aware that BDD exists among their patients, they may underestimate the rate at which it occurs. (Aesthetic Surg J 2002;22:531-535.).