Body Dysmorphic Disorder and Plastic Surgery Addiction
Many patients ask or assume that I frequently see so called ‘plastic surgery addicts’ as they phrase it. Their perception of the plastic surgery addict is the patient who just can’t stop having plastic surgery and comes back over and over. In reality, there is some truth to their assumption but also a lot of misconceptions.
The misconception part is that the vast majority of plastic surgery patients are normal, have one or two procedures, are immensely happy, and are cetainly not addicts by any stretch of the imagination. Probably most plastic surgery practices have about 1/3 of their patients who come back at some point after one surgery to have another. I call this ‘accomplishment feedback’. They have had a very positive experience from their initial plastic surgery procedure and, as a result, are motivated to seek out other procedures in the future. This type of patient is hardly an addict. It is this happiness that accounts for much of the increase in people having plastic surgery procedures over the past five years. (TV shows, the internet, and widely available financing programs make significant contributions as well)
The true plastic surgery addict really falls under the psychiatric diagnosis of Body Dysmorphic Disorder. (BDD) They obsess over perceived problems or have greatly exaggerated concerns over small imperfections. They frequently have seen numerous plastic surgeons, have had multiple operations, and will travel great distances to be seen. Often they do have some real physical problems and they can be quite charming and convincing. Often they are not easy to spot and the heroic and egotistical mentality that goes with being a surgeon can make one easily overlook such a patient. They often do not appear crazy……until after surgery.
I have had personal experience with five true BDD patients and have mistakenly operated on several of them earlier in my practice. The pain that I have endured in taking care of them have taught me several valuable lessons that influence how I practice today. As an unaltered rule, I will not even consider performing surgery on someone that comes in with complaints or concerns about a prior plastic surgery procedure by another surgeon…..until I have spoken to that surgeon and received copies of their medical records. This simple step is the surest method to diagnose a BDD patient, the most dangerous form of a plastic surgery addict.
Dr Barry Eppley
Indianapolis, Indiana