body dismorphia disorder

What is Body Dysmorphia and How to Handle Such Patients

They say that beauty is in the eye of the beholder — but when it comes to seeing it in ourselves, it’s not always recognizable. Since we’re usually our toughest critics, it’s easy to see why someone would want to improve their appearance with plastic surgery.

And why not? Today, there are so many minimally invasive procedures that can nip, tuck, firm and lift our faces and body with little to no downtime. However, when it comes to maintaining or recapturing a more youthful appearance, traditional facelifts are still the golden standard.

Learn more about body dysmorphia and how to handle patients who suffer from it:

body dismorphia disorder

Quest for Perfection

Unfortunately, somewhere in between body dysmorphia and some plastic surgeons who genuinely don’t really care, a lot of patients can go overboard with cosmetic procedures. They go from wanting a slight lift to wanting a revision because it just isn’t lifted enough. That, in turn, can become a vicious cycle of going from one plastic surgeon to another, hoping that this one will help them perfect their look.

In many cases, patients who end up going overboard start off only with reasonable requests. Maybe they’re developing premature jowls and want a slight lift that accentuates their jawline. Once completed, they might then notice the difference between their newly lifted jawline and the rest of their face.

This leads to another procedure to lift the midface and create symmetry. While some patients are happy with only these procedures, many are not. The cycle then begins where no matter how work is done, they’re never truly happy with the final result.

Reputable plastic surgeons will know when to say enough is enough, which often leads to patients suffering from dysmorphia to another surgeon in their question for perfection.

What is Body Dysmorphia?

Body Dysmorphia, or BDD, occurs when patients’ perception of what they look like is distorted. They may think their nose is too big or their lips are too thin. This leads them to find ways to correct their “imperfections.” And while they may be temporarily happy with initial cosmetic procedures they have done, eventually they start to see their “imperfection’ as not being corrected. Unfortunately, they will then have multiple procedures performed on the same area to correct what they see as a flaw.

When it comes to the face, it’s not uncommon for patients suffering from BDD to want their faces, lifted, pulled and altered to the point that they’re unrecognizable. They don’t see what even the most skilled and experienced plastic surgeon sees.

Multiple Procedures at One Time

In addition to patients who bounce from one plastic surgeon to another, there are other types of patients who request multiple procedures to be performed at one time. While it’s perfectly normal to combine several procedures together, such as a neck lift with a lower facelift, some patients will request multiple procedures be performed at one sitting.

Performing certain procedures together can complement the final result, however, there’s a fine line of enhancement and performing too many procedures on a patient. In addition to the ethical factor, Dr. Anurag Agarwal, a facelift expert from Naples, stresses that some patients aren’t suitable candidates for plastic surgery. Whether they suffer from an underlying medical condition that prevents them from going under anesthesia or suffer from a bleeding disorder, there are contraindications to having specific procedures done.

Less is More

Help patients define their goals and understand that not every procedure is suited for them. Facelifts, int particular, are still considered invasive, so it’s important to educate patients about the procedure, recovery period and all of the potential complications of having too much done. Combining less invasive procedures that create a subtle, yet noticeable change is the best place to start. For example, upper and lower blepharoplasties can do wonders for patients who suffer from hooding and sagging of the upper and lower eyelids.


Dermal fillers are also an excellent alternative to facelifts and when combined with Botox, it’s possible to mimic the effects of a facelift, although the results will not be as dramatic. Thread lifts are also a viable option for patients who may have already had a facelift but still think they need further surgical intervention.

Finally, if patients are deemed suitable candidates for a facelift, they need to have realistic expectations. While having a facelift can dramatically improve one’s appearance and make them look considerably younger, it won’t stop the aging process. Facelifts are also not a quick fix to any psychological issues that may be present, prompting the need to be perfect.

Final Thoughts

Not every patient will need the cosmetic procedures they’re requesting. While minimally invasive techniques can be done to help them reach their aesthetic goals, plastic surgeons need to recognize patients who may be suffering from BDD, even when it comes to their faces.

Salman Zafar

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