Body Dysmorphic Disorder in Patients Seeking Abdominoplasty, Rhinoplasty, and Rhytidectomy

de Brito MJA, Nahas FX, Cordás TA, Tavares H, Ferreira LM.

What this paper says

Among 300 patients seeking three cosmetic operations, symptoms of body dysmorphic disorder were present in 52 percent of the 151 rhinoplasty candidates, the lowest severity of the three groups.

Overview

Body dysmorphic disorder distorts how a person sees their own appearance and can drive them to seek cosmetic surgery. The authors measured body dissatisfaction and the prevalence of disorder symptoms in candidates for three procedures, using a structured assessment administered before surgery.

Sections of note

300 patients of both sexes in three groups: abdominoplasty 90, rhinoplasty 151, facelift 59.
Classified as having or not having symptoms using the Body Dysmorphic Disorder Examination, administered before surgery. Rhinoplasty group: 79 with symptoms, 72 without.
Prevalence of symptoms was 57 percent for abdominoplasty, 52 percent for rhinoplasty and 42 percent for facelift.
Groups differed significantly in age (p less than 0.001), body mass index (p = 0.001) and age at which symptoms began (p less than 0.001).
Severity varied significantly within each group: abdominoplasty and rhinoplasty p less than 0.001, facelift p = 0.005.
Severity was significantly associated with degree of body dissatisfaction, avoidance behaviours, sexual abuse (p = 0.026), suicidal ideation and suicide attempt (p = 0.012). Facelift candidates had the highest proportion of severe cases and rhinoplasty candidates the lowest.

What it means for a patient

Symptoms of the disorder were common across all three groups, present in roughly half of the people assessed.
Screening before cosmetic surgery is the practical implication, since surgery does not treat the underlying condition.
The association with suicidal thoughts and past abuse indicates why the assessment is treated as a safety matter rather than a formality.
Symptoms measured on a questionnaire are not the same as a formal diagnosis, and this study reports only what patients presented with, not how they fared after surgery.

Why this paper matters

Rhinoplasty consistently ranks among the procedures most sought by people with this condition, and operating on them is understood to make matters worse rather than better. Measuring prevalence across three procedures at one point of assessment gives comparative figures. Whether these patients were operated on, and what happened afterwards, is not reported.

Terms

Body dysmorphic disorder: a psychiatric condition involving preoccupation with a perceived flaw in appearance.
Prevalence: the proportion of a group affected at a given time.
Abdominoplasty: surgery to remove excess skin and fat from the abdomen.
Rhytidectomy: a facelift.
Avoidance behaviour: avoiding situations because of distress about appearance.
Suicidal ideation: thoughts of ending one's own life.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Body dysmorphic disorder may negatively affect self-perception of body shape and lead patients to seek cosmetic surgery. This study estimates the level of body dissatisfaction and prevalence of body dysmorphic disorder symptoms in candidates for three plastic surgical procedures. Methods: Three hundred patients of…”

Excerpt; the full abstract is on PubMed.