ASAPS Survey: Plastic Surgeons Reject Patients with Symptoms of Body Dysmorphic Disorder (BDD)

New York, NY (October 23, 2001) — An exclusive survey conducted by the American Society for Aesthetic Plastic Surgery (ASAPS) reveals that plastic surgeons overwhelmingly reject surgery for people they suspect may suffer from Body Dysmorphic Disorder (BDD). The 265 ASAPS-member respondents estimate that approximately 2% of individuals who consult them for surgery exhibit symptoms of BDD - a number consistent with the estimated percentage of BDD sufferers in the general population, but not as high as found in some studies investigating the prevalence of BDD among persons who seek cosmetic surgery. Ninety-three percent (93%) of responding ASAPS members said that, among some patients they have evaluated for surgery, they have observed at least one of the common behaviors that can be associated with BDD. 

The ASAPS survey was developed by David Sarwer, PhD, Assistant Professor of Psychology in Psychiatry and Surgery at the University of Pennsylvania Medical Center, and a leading expert in body image psychology. "The primary objective of the survey was to get a sense of ASAPS members' experience with BDD and find out how they handle people with BDD," says Dr. Sarwer.

BDD is a psychiatric disorder characterized by an uncontrollable preoccupation with an imagined or slight defect in appearance. Research suggests, and the experience of the ASAPS survey respondents seems to confirm, that BDD sufferers are unlikely to be satisfied with the outcome of cosmetic surgery no matter how successful it might be. "It is ASAPS' position that patients diagnosed as suffering from BDD generally are inappropriate candidates for plastic surgery. ASAPS is committed to educating all of its members about this important issue especially in light of some patients' ability to disguise their symptoms," said ASAPS President Malcolm Paul, MD.

According to Laurie Casas, MD, Vice-Chair of ASAPS' Communications Commission, "Plastic surgeons are not trained as mental health professionals. There is no foolproof method for us to differentiate sufferers from BDD from many others seeking elective cosmetic surgery; but it helps to ask prospective patients about their expectations and lifestyles. Appropriate cosmetic surgery candidates have realistic expectations and a healthy mental and physical outlook."

Dr. Sarwer recommends that plastic surgeons try to evaluate whether a prospective patient demonstrates an inappropriate degree of distress or preoccupation with appearance, and if this produces a degree of disruption or impairment in daily functioning. Signs such as these often point to the possibility of BDD.

Adds Sarwer, "What I found impressive was that fully 84% of ASAPS members refuse to perform surgery on people who display symptoms suggestive of BDD, and 50% of those responding have referred such patients for psychiatric consultation."

Dr. Paul says that ASAPS is committed to an ongoing effort to educate its members about BDD. At the same time, Dr. Paul, Dr. Casas, and Dr. Sarwer agree that it is important to make a clear distinction between the very small minority of people who suffer from BDD and the millions of normal men and women who elect plastic surgery as a means to enhance their overall sense of well being.

*Malcolm Paul, MD, Laurie Casas, MD, and David Sarwer, PhD are available for interviews. Contact the Communications Office.

Other information related to this topic: Excessive Cosmetic Plastic Surgery: How Much is Too Much? -- ASAPS Position


The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world's leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body. ASAPS is comprised of over 2,600 Plastic Surgeons; Active Members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and nonsurgical aesthetic procedures. International Active Members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.


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