Patients seeking plastic surgery may need mental health treatment instead

The American Society of Plastic Surgeons wants its members to be aware that some of their patients should seek mental health treatment instead of surgery.

A new study published in the August issue of Plastic and Reconstructive Surgery finds that 33 percent of people seeking rhinoplasty, a nose job, have a mental health condition called Body Dysmorphic Disorder. They hate the way they look and it interferes with their lives.

Philadelphia Children’s Hospital Psychologist Canice Crerand studies the connection between Body Dysmorphic Disorder, BDD, and plastic surgery. “They might spend hours a day consumed by thoughts about their appearance, they may spend time on the Internet, researching procedures,” said Crerand.

She says the nose is a common preoccupation for people with BDD, who are often not aware of their mental health issue. “Individuals with BDD tend to seek out cosmetic surgery as a means of addressing their appearance-related concerns, as opposed to the more appropriate psychiatric and psychological treatments,” she said.

Cherry Hill plastic surgeon Steven Davis says he carefully screens his patients to understand their motivations and expectations. These conversations have led him to ask patients not to have surgery. “I have dissuaded patients many times, and asked them to reevaluate their motivation for the surgery, or reevaluate what they are actually asking to be done,” said Davis.

Crerand says plastic surgeons should routinely screen all patients for body dysmorphic disorder. Several questionnaire type tests have been developed to detect BDD. Davis says his colleagues are generally becoming more aware of this issue.