What is Body Dysmorphia?

Body Dysmorphia, also known as Body Dysmorphic Disorder (BDD) or, in some cases, Dysmophophobia, is a psychological condition characterised by an individual spending extensive time worrying or obsessing about their appearance and what they see as flaws or concerns. These concerns may appear much more severe or dramatic to them, while to others, they are unnoticeable or much less severe.

People of any age or gender can be affected by Body Dysmorphia; however, it is most common in teenagers and young adults.

Examples of Body Dysmorphia may include:

• Perceiving minor flaws in the skin as more severe, which may lead to picking to make the skin smooth or spending significant time applying makeup
• Seeing your body fat distribution as higher than it is. This can lead to a disordered relationship with food, or behaviour such as over-exercising
• Muscle Dysmorphia is worrying that your body is too skinny or not muscular enough, although you are of an average or larger than average build. This is more common amongst men, and can lead to over-exercising or abusing substances such as steroids

Although the outward signs of Body Dysmorphia may seem vain or self-obsessed, for the affected individual, it can be very distressing and have a significant impact on their quality of life.

For individuals with Body Dysmorphia, it is common to feel highly self-conscious and have low confidence. This may impact the clothing they feel comfortable wearing or the activities they participate in, such as exercise, swimming or social events.

In severe cases, Body Dysmorphia may affect a person’s social and professional lives, limiting their ability to live a normal life.

Does Plastic Surgery Help Body Dysmorphia?

Body Dysmorphic Disorder is a complex condition that affects each patient differently. It is essential that it is handled sensitively with an entirely bespoke approach. Therefore, it can be difficult to give an exact answer to whether Plastic Surgery can help Body Dysmorphia.

During your consultation, your surgeon will discuss your concerns and reasons for considering surgery. If they feel you are showing any signs of Body Dysmorphia, they will ask you about this and also discuss various points to assess your suitability and decide on the next steps of your treatment plan.

• Your expectations: People with Body Dysmorphia often have much higher or unrealistic expectations of what surgery can achieve. It is vital to have a realistic understanding of what surgical outcomes are possible.
• Your mental health: Your surgeon may discuss your current mental health, but also any historical concerns you have had, to decide what the best path forward is for you.
• Psychological assessment: In some cases, if your surgeon is concerned about how your mental health may affect your surgery, they will refer you to a psychological Body Dysmorphia specialist to further assess whether you are suitable for surgery.
• Delay your surgery: If your surgeon feels that having surgery may not relieve your Body Dysmorphia, or may even exacerbate it, they may ask you to seek further advice or treatment before considering a procedure again in the future.

Although Plastic Surgery isn’t considered suitable for individuals experiencing severe Body Dysmorphia, studies have shown that mild cases of BDD can be addressed with surgical procedures when carried out with the right level of care and pre-assessment.

What Causes Body Dysmorphia?

It is not fully understood what causes Body Dysmorphia, and what may prompt it in one person may not have the same effect on another.

There are several Body Dysmorphia causes which have been identified. In most cases, there may be a combination of factors:

If your surgeon is concerned about Body Dysmorphia influencing the effects and influence of your surgery, they will discuss the potential cause of your BDD, and may ask you to discuss it further with a psychological specialist.

How to Treat Body Dysmorphia?

Body Dysmorphia requires sensitive and personal treatment to ensure that it is effective, doesn’t exacerbate the condition and that the treatment and management is sustainable over many years.

Determining the right Body Dysmorphia treatment is based on the cause, severity and impact of an individual’s BDD. Body Dysmorphic Disorder treatment is managed by a Psychologist who specialises in the field and who has expert knowledge of the various factors which influence the condition.

Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy is a goal-oriented type of talking therapy. It is based on the principle that thoughts, feelings and behaviours are interconnected.

The main aim of CBT is to make practical changes to solve your problems.  You will talk about situations you find challenging and discuss how they make you think, feel and behave. You will then work with your therapist to develop strategies for approaching these situations more healthily and constructively. This may include:

• Questioning negative thoughts and beliefs, and considering alternative perspectives
• Understanding your feelings and emotions without reacting to them
• Changing your behaviour, this may include doing activities you’ve been avoiding

You must implement these changes between sessions, and you may be asked to keep a diary. This will then help you and your therapist to understand which strategies are working and which areas require more attention.

Medication

In cases where an individual requires further support either alongside or after therapy, medication may be offered as a Body Dysmorphia treatment.

The medications which are typically used in Body Dysmorphic Disorder treatment are Fluoxetine and Clomipramine, which are both a type of antidepressant known as SSRIs (Selective Serotonin Reuptake Inhibitors).

SSRIs work by redirecting the passage of the hormone serotonin to make it more available between brain cells. As serotonin is responsible for regulating mood, this results in feeling calmer and happier. This allows patients to manage their concerns and maintain a healthy and typical life. Some patients may need SSRI treatment temporarily, while others may require longer-term medication.

Surgery

In cases of mild to moderate Body Dysmorphia, surgical procedures may be an appropriate treatment. It is essential that this is assessed and managed appropriately by specialist medical professionals to ensure that it does not worsen the effects of BDD.

Surgery is only suitable for patients whose Body Dysmorphia affects localised and specific areas of the body, for example, the breasts or the abdomen, rather than more generally. Performing surgery inappropriately on an individual with severe Body Dysmorphic Disorder may result in them seeking further or more drastic procedures unnecessarily.

Cadogan Clinic’s team of leading Consultant Plastic Surgeons is committed to providing the highest standards of patient care. This includes understanding the importance of considering patient mental health when assessing their suitability for any surgical procedure and basing any treatment plan on these requirements.

Cadogan Clinic’s Approach to Body Dysmorphia

At Cadogan Clinic, we take our duty of care extremely seriously and are committed to the highest ethical standards in patient selection. We recognise that some individuals seeking cosmetic procedures may be affected by Body Dysmorphic Disorder (BDD). In cases where our surgeons believe surgery would not be in a patient’s best interests, we may decline to proceed altogether. In milder cases, our multidisciplinary team (MDT) carefully assess suitability, which may include input from a consultant psychologist, to ensure any treatment pathway is safe, appropriate, and truly beneficial for the individual.

Words From Our Founder