Plastic surgeons unemployment crisis

Nose Job Patients May Have Mental Illness

This is staggering. Why, if this is true, is plastic surgery not being closed down as a profession? One third? One third?

Why is this acceptable that people with a serious and debilitating - but treatable - mental illness are being "treated" by plastic surgeons instead of getting proper care?

"The findings are 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 medical reasons — to correct a breathing problem, for example — only 2 percent of patients exhibited symptoms of the disorder. But among patients seeking to change their noses for cosmetic reasons, 43 percent showed signs of the disorder, expressing an unreasonable preoccupation and distress about their bodies despite having noses that were relatively normal. Over all, 33 percent of patients in the study showed symptoms of the disorder."


  1. I remember this study from several months ago. First question is, why are we surprised by this finding? Who seeks out a procedure, undergoing a blow to the face, changing the structure of their face under general anesthesia if they are not suffering from grave discomfort, physical (ie deviated septum with breathing difficulty) or psychological?

    The question I have is if it fixes the "dysmorphoria"? If it's really dysmorphia, then they'd continue to be dissatisfied, the presumption of the MD who discourages these surgeries, fearing disgruntled customers. But if it fixes the problem and they stop obsessing? Interesting to consider.

  2. It's not that surprising when you think about it! It's just that most of us, well, we don't think about people who are having plastic surgery!

    I don't know the epilogue but do those people just move on to another surgery or do they feel better after just one operation?? Does the surgery help??? Is therapy necessarily better??

  3. From what I know of Body Dysmorphic Disorder, patients often repeatedly seek surgery or other "treatments" for their perceived flaws and deformities but find only temporary relief - often having the focus of the obsession moves from one body part to another.

    Which, of course, is often happening with EDs, where the patient perceives the body size or shape as intolerable and seeks remedy through dieting or changing dietary composition or exercising or using constricting or loose or layered clothing. With EDs, however, there is no relief and the medical impacts of these efforts cause their own damage - and perpetuate the thoughts and feelings.

    Learning about BDD was one of the pivotal moments of understanding EDs as an OCD parallel.

    BDD is a horrible condition but made worse when the world around you joins your delusion and enables your "solution."

    Plastic surgeons should have to assess for BDD and should be sanctioned for performing surgery in these cases. In my opinion.

  4. Interesting article - to me, personally. I hate the shape of my nose. Truly, I hate it. I despise my side view profile - because it accentuates my humongous nose. If I had enough money and the recovery period from rhinoplasty wasn't so long, I would seriously consider getting my nose re-shaped.

    That may surprise people who know me and know that I had non-fat-phobic anorexia nervosa. I am 100% certain that I didn't restrict food or over-exercise because of BDD or body dissatisfaction, and I haven't been aversed to weight gain during recovery, or thought I look too fat. But I would very much like to change the shape of my nose...

    Whether this is a symptom of BDD, I really don't know, but when I look in the mirror, the image I see is of a huge, mis-shapen nose that eclipses my face.

  5. Cathy, have you ever had a chance to read The Broken Mirror, by Phillips? Very interesting and authoritative. She does discuss the plastic surgery connection there. You'll appreciate the lack of psychobabble.

    It helped me a lot to understand that our perceptions of our appearance have so little to do with reality - all of us - and that there is no good outcome to trying to reason or talk someone out of a perceived appearance as I would otherwise be tempted to do with you here (I've met you and your nose).

    The pathway out of this hate for your nose - if it is distressing enough to lower your pleasure in life - may be similar to the pathway for those suffering from body size dysmorphia - through treatment rather than changing the body part.

  6. Thanks Laura.. No, I haven't read 'The Broken Mirror', but I am aware that BDD is often neurophysiological - and may be linked to both OCD and weak central coherence (or an over-focus on detail) - both of which I have. I have undertaken a battery of neuropsychological tests as a research participant - which clearly showed my high attention to detail. I have always had OCD - in a number of forms, and one such presentation is a distress at a lack of symmetry (pictures on the wall that are not straight totally freak me out..), or specks of dust on the floor (which cause me to clean compulsively).

    Therefore, I have concluded that either:

    1. My dislike of my nose is associated with neurophysiological, perceptual processing and OCD; or -

    2. My nose really IS huge and gross.

    My mother insists that my nose is fine and 'just right' for my face - but I do wonder whether she is just being her usual nice and protective self! My nose doesn't cause me so much grief that I cannot leave the house, but I am very conscious of its size and I hate having my photo taken.

  7. My temptation is to say "listen to your mother Cathy, she's totally right you know" but in doing so I know that I am just compounding problems - I will seek out the book Laura


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