Doctors May Ignore Body Dysmorphia in Cosmetic Surgery Seekers

Patient consulting with doctorAccording to findings from a study published in the journal Plastic and Reconstructive Surgery, providers of cosmetic procedures may not detect body dysmorphia in their patients. The study’s authors also suggest many providers do not adequately address body image issues in people seeking cosmetic procedures. Medical and mental health providers recommend against cosmetic surgery for people with body dysmorphia because they may seek more surgery than is healthy or safe.

About 5-15% of cosmetic procedure seekers have body dysmorphia, compared to 2% in the general population. The condition distorts body image, causing people to perceive flaws that are not present or obsess over an unrealistic standard of beauty.

Body Image Issues in People Seeking Cosmetic Procedures

For the study, 173 Dutch providers of cosmetic procedures answered online survey questions about patient screening. Providers included plastic surgeons, dermatologists, cosmetic doctors who offer cosmetic procedures but who have not formally trained in plastic surgery, and other providers of cosmetic surgery, such as maxillofacial surgeons. The group represented 17.2% of Dutch membership in various cosmetic medicine and dermatology associations.

The majority of respondents said they were aware of body dysmorphia, with most saying they had encountered one to five patients with the diagnosis during the previous year. A third (36.4%) estimated its prevalence in cosmetic practice at 5%, 28.9% putting the prevalence at 10%, and 19.1% estimating a prevalence of 15%. The remaining 15.6% said they had no idea how common the diagnosis is.

Just 6.9% said they always addressed body image issues during the initial intake interview. An additional 17.3% reported never addressing these issues, with the remainder addressing them only sometimes. Even when treating people with body dysmorphia, 4.6% of providers said they never addressed body image issues. Only 27.2% always addressed body image issues with this group.

Approximately 70% said they would refuse to perform a procedure on someone with body dysmorphia. However, less than half said they consulted with mental health providers about these patients. Plastic surgeons were more likely than other providers to refuse treatment and refer patients to mental health providers. Dermatologists were less likely than other doctors to address body image issues.

The study points to a potential gap in the knowledge of professionals who routinely deal with people who have body image issues. Its authors recommend better training and education on body dysmorphia for people who treat cosmetic issues.


Bouman, T. K., PhD, Mulkens, S., PhD, & Van der Lei, B., MD, PhD. (2017). Cosmetic professionals’ awareness of body dysmorphic disorder. Plastic and Reconstructive Surgery, 139(2), 336-342. doi:10.1097/PRS.0000000000002962

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  • Harriett


    February 22nd, 2017 at 11:40 AM

    So the cosmetic surgeons have to be mind readers now too??
    Wow we are taking this a little too far.
    If you are looking to make a living and this is how you do it and the patient has the money and is physically and mentally capable of having the surgery do I now need someone to step in and tell me that this is being done for the wrong reasons?
    I am an adult, I should be able to make those kinds of decisions for myself

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