[Surgical approach and indications in aesthetic treatment of body dysmorphic disorder]

INTRODUCTION: patients with body dysmorphic disorder often go to the plastic surgeon to correct what they consider a physical deformity or defect, although their appearance falls within normal aesthetic standards. The aim of our study was to evaluate the real need for aesthetic treatments in such patients. PATIENTS AND METHODS: we included patients who practised an intense sport activity and believed they had body deformities ascribable to their sport activity. We evaluated whether the deformities described by the patients were real or exaggerated. The patients who did have a deformity underwent surgery to correct it; their level of satisfaction was evaluated at a 6-month follow-up examination. The patients with subjective deformities underwent a psychiatric examination. RESULTS: we enrolled 51 patients who practised an intense sport activity and reported body deformities. Forty-one of these patients were found to have a body deformity upon examination and underwent surgery. Surgery was considered to be unnecessary in the remaining 10 patients. Thirty-two of the 41 patients who did undergo were highly satisfied with the outcome. DISCUSSION: the plastic surgeon often sees patients with minor body deformities that do not require treatment but are a major cause of psychological disorders. A thorough psychiatric examination is necessary in such patients to rule out psychiatric diseases. The plastic surgeon should make every effort to identify patients with subjective body dysmorphic disorder to avoid the negative consequences due to the patient's insatisfaction for the outcome of surgery.