"It is routine practice for surgeons to assess the mental health and motivations of people seeking surgery for cosmetic reasons. Surgeons also speak of the need for reasonable expectations, rather than searching for perfection in the results of cosmetic surgery."

Is there a Link Between Cosmetic Surgery and Mental Illness?

These headlines make rhinoplasty sound rather scary, especially if you have been considering having this procedure. You may feel even more concerned knowing that one in five Australians experience mental illness at some stage in their lives.

Posted: 10 September 11

Take a look at headlines that appeared in the media recently:

  1. Relation Found Between Rhinoplasty And Mental Illness
    [Medical News Today]
  2. Mental illness higher in nose job seekers
    [Press TV]
  3. Mental Disorder Behind Many Nose Job Patients [livescience.com]
  4. 1 in 3 Nose Job Patients Has a Mental Illness: Study
    [medicinenet.com]
  5. Some Nose-Job Patients May Have Mental Illness
    [Well Blog, New York Times]
  6. Rhinoplasty Seekers Should Be Screened for Mental Disorder
    [Internal Medicine News]

To find out what prompted these headlines, we went to the source of the news. They were the result of a study published in the August issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons.

Media outlets, in their drive to sell more products, can literally make mountains out of molehills, creating sensational headlines that twist the facts. By contrast, the headline of the press release from the American Society of Plastic Surgeons, Plastic Surgeons Should Be Aware of Patients with ‘Excessive Concern’ about Appearance better reflects the study’s findings.

So what did the study really find? As it turns out, there is no need for alarm. Wanting to have your nose fixed does not put you at risk of losing your mind. The study was based on 266 patients in Belgium who were evaluated by plastic surgeons over a period of 16 months. The group included those seeking rhinoplasty for medical reasons alone, as well as those who wanted it for aesthetic reasons. All patients were asked to fill in a questionnaire to assess their risk of body dysmorphic disorder (BDD).

BDD is concern over appearance to such a degree that it interferes with daily life. The study found moderate to severe symptoms of the disorder in 33 percent of patients seeking nose-reshaping surgery. There was a wide variance between the group seeking nose reshaping for medical reasons and those interested in cosmetic enhancement. In the former group, just 2 percent of the patients showed moderate to severe symptoms, but in the latter group around 43 percent had moderate to severe symptoms of BDD. The members of this second group displayed a high level of preoccupation and distress about their faces even though they mostly had relatively normal looking noses. Researchers say there was no noticeable relationship between the disorder and the level of abnormality in the nose.

These results highlight the fact that patients undergoing revision rhinoplasty, that is, having a previous nose surgery redone (about 20%), and those who with a history of psychiatric problems (4 %) were more at risk of BDD symptoms than were other members of the group.

It is routine practice for surgeons to assess the mental health and motivations of people seeking surgery for cosmetic reasons. Surgeons also speak of the need for reasonable expectations, rather than searching for perfection in the results of cosmetic surgeryMedical News Today quotes Dr. Phillip Haeck, a plastic surgeon and president of the American Society of Plastic Surgeons as saying “The biggest mistake is to offer to operate on them [people looking for perfection] because the chances that they will be satisfied afterward, no matter how good the shape of the nose may be, are very low. Often patients who have this [disorder] can’t stop looking at themselves. When I’ve encountered cases like this, I’ve found it difficult to make eye contact. They tend to stand in the mirror in the examination room and look at themselves throughout the consulation.”

People who have rhinoplasty obviously have some level of dissatisfaction with their noses. Otherwise why bother having the surgery? But thinking about one’s nose and its imperfections to the point of distraction, letting it affect work and personal life, is the sign of an underlying problem that has nothing to do with one’s appearance. People who fit this description, not the usual run of people looking to improve their looks, probably need to be evaluated for BDD.

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