Body dysmorphic disorder

Body dysmorphic disorder (BDD) "is defined in DSM-IV (1994) as “a preoccupation with an imagined defect in appearance; if a slight physical anomaly is present, the person's concern about this is markedly excessive.” The preoccupation must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. In addition, the preoccupation must not be better accounted for by another mental disorder (e.g., the dissatisfaction with body shape and size that occurs in anorexia nervosa)." (reference: Perugi, G., Akiskal, H. S., Gianotti, D., et al. Gender-related differences in body dysmorphic disorder (dysmorphophobia). J. Nerv. Ment. Dis. 185: 578, 1997).

Plastic and cosmetic surgery

An improvement in self-image is a real benefit to the patient having successful cosmetic surgery, however, a change in appearance alone is never enough to confer a good self-image to a person who lacks one. In general, cosmetic surgery is contraindicated in a person with a deep seated conviction that there is something terribly wrong with him or her because of the size, shape or appearance of a body part, especially when there is an expectation that changing that feature will transform her his entire life. No matter how the outcome of the surgery may be seen in another observer's eyes, patients who are deeply dissatisfied with themselves are likely to see the results as a failure, and remain dissatisfied with themselves. In such cases, the patient may embark on an endless series of additional operations to seek the elusive improvement, or strike out at the surgeon and health care team held responsible for the surgery.