Abstract
Body dysmorphic disorder (BDD) is a serious and debilitating psychiatric condition
that disproportionately presents in dermatologic and cosmetic surgery patients. BDD
is currently underrecognized in cosmetic medical settings and is thought to be underdiagnosed
by behavioral health professionals. The significant comorbidities associated with
this disorder, as well as potential harm done to both patient and physician, raise
ethical and medicolegal concerns regarding its treatment. Although cosmetic interventions
have historically been discouraged in BDD, recent studies have provided controversial
evidence of benefit in certain cohorts. The rise of “snapchat dysmorphia” and the
proposed explanatory phenomenon of perception drift have generated further debate
around the de novo development or unmasking of BDD. We critically review and summarize existing debates
around the treatment of BDD in cosmetic medicine. We provide guidance for screening,
clinical interviewing, and the provision of psychoeducation in cases of suspected
BDD.
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Published online: August 07, 2021
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