The Mind Body Connection Part I

Cosmetic surgeons often talk about patients having realistic expectations. Aspects of realistic expectations include not only what can physically be achieved, but also how the results of cosmetic surgery will affect your life. By now many of you are familiar with the concept of Body Dysmorphic Disorder (BDD). This is a psychological disorder that impairs an individual’s self image. Much like other mental health disorders that primarily influence the mind/body connection (anorexia nervosa would be another I could mention), BDD distorts a person’s perception of the reality of his or her body. People who have mental health issues that distort their body image are generally not candidates for cosmetic surgery because these people continue to see their bodies unrealistically, or they may expect dramatic life changes that cannot be produced by a surgical procedure. Here is what psychologist Vivian Diller has to say about realistic expectations and how she assesses her patients who want cosmetic surgery.

BDD is defined by a persistent preoccupation with imagined defects in appearance. A slight flaw is blown up out of proportion. The concern over the perceived flaw impedes the individuals social functioning, occupational functioning, and cause marked distress.

Patients with BDD are prone to voicing dissatisfaction with cosmetic procedures that are quite acceptable. Sometimes they shift their focus to another perceived flaw on another body part. These are the patients that can often become cosmetic surgery addicts. This is partially because people with BDD tend to be compulsive in their behavior. These people also suffer from depression and anxiety and are sometimes prone to suicide. An article in the American Journal of Clinical Dermatology suggests cosmetic surgeons look for these signs of BDD:

• Excessive concern with, or distress over, minor or nonexistent appearance flaws

• Difficulty functioning –  problems at work or social avoidance

• Skin picking & Camouflaging –  wearing heavy makeup or a hat

• Other BDD-related behaviors, such as reassurance seeking or excessive grooming

• Referential thinking –  thinking that others are taking special notice of them because of how they look

• Dissatisfaction with previous dermatologic or surgical treatment

• Unusual or excessive requests for cosmetic procedures

• Belief that the procedure will transform the individual’s life or fix all of their problems

Because cosmetic surgery is elective, essentially unnecessary medically by definition, patient satisfaction is the criteria for success. Although most of the research that has been done about the psychological issues of patient satisfaction have been with breast augmentation, people with BDD tend to focus on facial flaws. Appearance is closely related to a sense of identity, and it has been found that rhinoplasty in particular can be linked to identity. It is important for a cosmetic surgeon to be aware of the patient’s internal perceptions of a defect versus an actual objectively measurable defect and also what that “defect” means to the patient. What has been found over and over again is that unrealistic expectations and lack of patient education about risk are the factors that predict poor patient satisfaction rates. At Little Rock Cosmetic Surgery Center we want you to be satisfied, simple as that!

Dr. Branman

Please call Melinda to set up your consultation 501 227-0707