Plastic surgery: a cure for body and mind? New study says no.
Friday, August 20, 2010
A new study, published recently in Annals of Plastic Surgery, finds that while many people who suffer from body dysmorphic disorder (BDD) seek cosmetic procedures, only 2 percent of procedures actually reduced the severity of BDD. However, although this long-term outcome seems poor, physicians continue to suggest cosmetic surgeries to people suffering from BDD.
"BDD is a psychiatric disorder characterized by preoccupation with an imagined or slight defect in appearance which causes clinically significant distress or functional impairment," says Katharine A. Phillips, MD, the director of the body image program at Rhode Island Hospital and a co-author of the paper. "A majority of these individuals believe they have an actual deformity that can be corrected by cosmetic treatments to fix these perceived defects rather than seeking psychiatric intervention."
In previous studies, Phillips and her co-author, Canice Crerand, PhD (of The Children's Hospital of Philadelphia), reported that BDD appears relatively common among individuals who receive cosmetic surgery, with reported rates of 7 to 8 percent in cosmetic surgery patients in the United States.
In this new study, researchers reported that in a small retrospective study of 200 individuals with BDD, 31 percent sought and 21 percent received surgical or minimally invasive treatment for BDD symptoms. The most common of these surgical procedures sought were rhinoplasty and breast augmentation, and the most common minimally invasive treatments were collagen injections and microdermabrasion. Three quarters of all the requested procedures involved facial features. The findings also indicate that more than a third of patients received multiple procedures.
Post-surgery, nearly all of these individuals continued to have symptoms. Some actually developed new appearance preoccupations. They also noted that in a survey of 265 cosmetic surgeons, 65 percent reported treating patients with BDD, yet only one percent of the cases resulted in BDD symptom improvement.
As for long-term outcomes from the procedures, only 25 percent of the patients showed an improvement in their view of the treated body part and a longer-term decreased preoccupation. However, co-author Crerand noted, "Only two percent of surgical or minimally invasive procedures led to longer-term improvement in overall BDD symptoms."
Additionally, the researchers also found that when treatment was requested, 20 percent of the procedures were not received. Cost was the most common reason for not receiving the requested procedure (30 percent), followed by physician refusal to perform the procedure (26 percent). Findings also indicate that physicians were significantly less likely to refuse a surgical or minimally invasive treatment than other procedures (dermatological, dental and others). "This suggests that many surgeons were not aware of the patient's BDD or do not consider BDD a contraindication to treatment," said Phillips.
The researchers concluded that the study findings ultimately indicate that there is a clear need to investigate this topic further - and that in the meantime, physicians need to be aware that psychiatric (and not surgical) treatments for BDD appear to be much more effective.
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