The Cosmetic Surgery Junkie

Up to 6-15% of patients presenting to the plastic surgeon for cosmetic surgery may suffer from BDD [13]. Patients previously operated upon, especially if multiple times and the patients are still dissatisfied, could likely be afflicted by BDD.

The cosmetic surgery junkie is a red flag candidate. In rhinoplastic surgery, it is estimated that men are three times more likely to be dissatisfied with their surgery than women [7]. The outcome of cosmetic surgery for each patient must be judged in psychological terms as well as in objective changes and for the patient the expectations are mostly psychological or psychosocial [11]. We need to appreciate the expectations of external factors improving (enhancement of social networks, relationships and employment) is paramount for the patient (Fig. 18.2); hence, a dissatisfied patient may have failed with the external factors and attributes failure to the perceived unsuccessful cosmetic surgery operation.

Fig. 18.2. The expectations for a patient are mainly psychological or psychosocial

The solution becomes more surgery, which compounds a pre-existing unresolved, psychosocial problem. If patients regard cosmetic surgery as a life panacea or epic-changing event, they are likely to be disappointed when the physical changes do not lead to the anticipated social outcome. After surgery, pain, numbness, minor healing problems or complications will accentuate anxieties in all patients and especially in the BDD patient, resulting in the exacerbation of symptoms or a BDD attack with feelings of anger, hopelessness and despair.

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