RELATION BETWEEN RHINOPLASTY AND MENTAL ILLNESS

The desire for plastic surgery, and in particular nose jobs, may be a tell tale sign of a mental illness called dysmorphic disorder (BDD), which is basically is an unnatural preoccupation with slight or imagined defects in appearance. A person with BDD historically tends to have cosmetic surgery, and even if the surgeries are successful, does not think they are and is unhappy with the outcomes.

A new study released this week demonstrates a high rate of body dysmorphic disorder relation, up to one in three among nose job patients. Previous studies have shown that about 10% of patients seeking plastic surgery suffer from the condition and thus an increase is now present.

David B. Sarwer, associate professor of psychology at the Center for Human Appearance at the Perelman School of Medicine at the University of Pennsylvania explains:

"We know body image dissatisfaction falls on a continuum, and there has to be some degree of dissatisfaction that leads us to see a plastic surgeon in the first place. It's when it begins to interfere with daily functioning. Patients with more severe BDD struggle to maintain social relationships and have difficulty getting to work or staying employed. Almost all of us will get up in the morning and look in the mirror and see something in our appearance we may not like or wish looked different. But for patients with B.D.D., that thought never leaves their mind. They are chronically thinking about their nose, checking in the mirror or a reflective surface, or they avoid situations where people can see their profile. You can see that is a distraction and can make it hard to focus on jobs or studies or family."

The published report is based on a study of 266 patients evaluated by plastic surgeons in Belgium over a 16 month period. The patients made appointments to discuss a rhinoplasty procedure and were given a questionnaire to assess their symptoms of body dysmorphic disorder. Among those seeking the procedure for strict medical reasons only 2% of patients exhibited symptoms of the disorder.

However on the flip side, among patients seeking to change their noses for cosmetic reasons only, 43% showed signs of the disorder, expressing an unreasonable preoccupation and distress about their bodies despite having noses that were relatively normal.

It is important to note that researchers found no relationship between the level of body dysmorphic disorder and the level of abnormality in the nose, meaning that the perception of a faulty nose shape or size matches a clinical poor self esteem issue.

Dr. Phillip Haeck, a Seattle plastic surgeon and president of the American Society of Plastic Surgeons speaks from his personal professional experience in the field:

"The biggest mistake is to offer to operate on them, because the chances that they will be satisfied afterward, no matter how good the shape of the nose may be, are very low. Often patients who have this can't stop looking at themselves. When I've encountered cases like this, I've found it difficult to make eye contact. They tend to stand in the mirror in the examination room and look at themselves throughout the exam."