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Extreme Plastic Surgery: How Much Is Too Much?

Body Dysmorphia

For about 2% of the population, being extremely critical about their own body is a mental health condition known as body dysmorphic disorder (BDD).

People with BDD obsess on a flaw that is minor or imagined. Katharine Phillips, MD, director of the Body Dysmorphic Disorder Program at Rhode Island Hospital, says that people with the disorder look normal, and are often considered beautiful. But they don’t see themselves that way. Instead, they obsess about their perceived flaw. "It is very distressing and can sometimes make them housebound," she says.

People who have BDD sometimes have the same body part operated on multiple times. Phillips says that surgery is rarely effective since mental health is the root of the problem.

Phillips and her colleagues studied 200 people with BDD who had cosmetic surgery or minimally invasive cosmetic procedures. Only 2% of them had even slight improvement in their BDD symptoms after their procedures. Even when their obsession eases, Phillips says they often switch their focus to another body part.

Her study also found that, of the 200 patients in the survey, only one-quarter were refused cosmetic treatment at some point by physicians. Surgeons were less likely to turn down surgical treatments than minimally invasive procedures.

The ASPS trains its members to recognize people who may have body dysmorphic disorder, who often have multiple surgeries on the same body part. They will sometimes try to hide the other surgeries, or they will claim previous procedures have been botched and "heap a lot of praise," Haeck says, on the new surgeon, saying he or she will be the one to get it right.

"Any surgeon who has been through this once regrets operating on someone with body dysmorphic disorder," Haeck says. If you're obsessed with any part of your body, consider delaying your cosmetic surgery plans until you've talked to a counselor. Getting clear about those issues may help you appreciate any procedure you eventually decide to get.

Before you get a cosmetic procedure done, you'll consult with your surgeon. At the consultation, you should talk to them about your goals and your motivation for getting the procedure. You should make sure your expectations are in line with the likely results, and that you understand the risks.  

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