Body Dysmorphic and Narcissistic Personality Disorder in Cosmetic Rhinoplasty Candidates

Sahraian A, Janipour M, Tarjan A, Zareizadeh Z, Habibi P, Babaei A.

PubMed 34820690 Publisher (DOI)Free full text (PMC)

What this paper says

Screening 380 rhinoplasty candidates, 25 percent had severe body dysmorphic symptoms and 29.5 percent showed narcissistic traits, with no link to age, gender, income or previous surgery.

Overview

Body dysmorphic disorder and other psychological problems are more common among people seeking cosmetic surgery. This descriptive cross sectional study measured how often symptoms of body dysmorphic disorder and narcissistic personality disorder appeared in rhinoplasty applicants. All participants completed a body dysmorphic questionnaire and the 16 item narcissistic personality inventory.

Sections of note

Descriptive cross sectional study of 380 rhinoplasty applicants; the journal assigns level of evidence IV.
Mild body dysmorphic symptoms were present in 31.6 percent of patients.
Moderate symptoms were present in 43.4 percent and severe symptoms in 25 percent.
Mean body dysmorphic scores did not differ significantly by gender, age, marital status, previous cosmetic surgery, education, place of residence or income.
Narcissistic symptoms were present in 29.5 percent of subjects.
Narcissism showed no significant relationship with gender, age, marital status, previous cosmetic surgery, residence or income.
Higher education was associated with higher rates of narcissistic personality disorder, P equals 0.021.

What it means for a patient

Every applicant in this sample registered at least mild body dysmorphic symptoms, since the three categories account for 100 percent.
That total prevalence is far higher than most published estimates, which raises questions about where the screening threshold was set.
No demographic feature identified who screened positive, so screening cannot be targeted by patient profile.
These are questionnaire screens, not psychiatric diagnoses, and no surgical outcomes were followed.

Why this paper matters

Psychological screening before cosmetic rhinoplasty is widely recommended and inconsistently done. This study reports very high symptom rates in a large sample and finds no demographic shortcut for identifying at risk patients. Whether these scores predict dissatisfaction after surgery was not examined.

Terms

Body dysmorphic disorder: a condition in which a perceived flaw in appearance causes disproportionate distress.
Narcissistic personality disorder: a personality pattern marked by grandiosity and need for admiration.
NPI-16: a 16 item questionnaire screening for narcissistic traits.
Cross sectional study: a snapshot of a group measured at one point in time.
Prevalence: the proportion of a group showing a condition at a given time.

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

Abstract

Background: Body dysmorphic disorder (BDD) and other psychological problems are more common in cosmetic surgery applicants.

Objective: The aim of this study was to investigate the frequency of the symptoms of BDD and narcissistic personality disorder in rhinoplasty candidates.

Materials And Methods: This descriptive cross-sectional study was performed on rhinoplasty applicants. All subjects were evaluated by BDD and narcissistic personality questionnaires (NPI-16).

Results: A total of 380 patients were studied. Our findings showed that the prevalence of mild, moderate, and severe BDD symptoms was 31.6%, 43.4% and 25%, respectively. The mean BDD scores were not significantly different in variables such as gender, age, marital status, history of cosmetic surgery, education, place of residence, and income. 29.5% of the subjects had symptoms of narcissism. There was no significant relationship between the symptoms of narcissism and variables such as gender, age, marital status, history of cosmetic surgery, place of residence, and income. Higher education was associated with higher rates of narcissistic personality disorder (p-value = 0.021).

Conclusions: According to the results of the study, there was no statistically significant relationship between BDD score and demographic parameters. Also, association between narcissistic personality disorder and demographic characteristics was not significant except for education.

Level Of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Abstract as indexed by PubMed; the article is open access (PubMed Central).