Recent headlines have raised the issue of addiction to plastic surgery. The true story has very little to do with actual plastic surgery addiction and more to do with sensationalizing what a celebrity might do to keep themselves in the spotlight. I have no intention of discussing whether this celebrity is in fact addicted to anything, but to determine if plastic surgery addiction exists, and if it does, what is it?
Over the course of my 25+ year plastic surgery career I’m pleased to say that many of my patients have returned to me repeatedly and elected to have several different procedures done over the course of 5, 10, 20 years or more. These patients aren’t addicted to plastic surgery, but are instead responding to physiological changes that happen over time due to genetics, gravity, sun damage, etc. When creams, lotions, injectables, and other non-invasive treatments are no longer effective enough, patients have the option to consider a surgical solution. Our practice works closely with the aestheticians at EpiCentre ParkLane in developing a long term treatment plan for patients that envelops skin care, diet, injectables, laser treatments and surgery when appropriate. We work in partnership with patients to help them achieve whatever their goals are…within reason.
I’d venture to say that every plastic surgeon doing cosmetic cases routinely sees patients suffering Body Dysmorphic Disorder (BDD). BDD is a mental illness in which the patient is preoccupied with an imagined or minor defect that most other people can’t even see. An estimated 1% of the total population suffer from BDD, and as many as 10% of those seeking cosmetic treatments may have Body Dysmorphic Disorder. These patients think they are ugly and will repeatedly turn to plastic surgery to improve their appearance. As a physician, sometimes you will notice an immediate red flag on these patients.
They have seen numerous other surgeons and have had many different procedures
They overstate the size or scope of the problem, if the problem exists at all
They want their consultation earlier because they can’t be seen “like this”
Unfortunately, not every BDD patient is so obvious and it’s not until after you’ve done surgery on the patient that you discover that there’s a problem. Often when we approach these patients to encourage them to see a psychiatrist or psychologist, they seldom do, and instead just choose another plastic surgeon who won’t be as aware of their background who will do the procedure they’re currently requesting.
These are the patients that may be seen as plastic surgery “addicts”. Unfortunately though, taking plastic surgery away from them won’t make them any less addicted, and when they’ve exhausted the pool of surgeons in their area, they’ll then turn to excessively high numbers of other types of cosmetic treatments. It’s a very difficult disease to uncover as these patients look good, and when they’re not focused on their perceived physical flaw, they can be intelligent, charming and generous people.
BDD is somewhat similar to eating disorders in that both involve a concern with body image. They are very different though. Eating disorders target primarily young women, while BDD is an equal opportunity foe, attacking young men and women equally. A person with an eating disorder is supremely concerned with a number on the scale and their complete body image. BDD patients tend to worry about a very specific body part. In their minds if that one flaw could be fixed, everything would be fine. Of course, that one flaw may not even exist, and it will never be fixed enough for them, but it is what fuels the mindset of the Body Dysmorphic patient.
Unfortunately the “Addicted to Plastic Surgery” headline will generate few conversations about a very real, and very deadly disorder. BDD patients are quite likely to develop major depression and the stress of the disorder puts them at very high risk for suicide.
Patients should feel free to pursue whatever treatments they deem necessary to achieve their goals without worrying that they’ll be labeled a plastic surgery addict. Too many patients are already worried about their friends or families finding out that they’re having cosmetic surgery done because they don’t want to deal with the ridicule and/or teasing. That sad fact alone keeps our entire staff extremely protective of our patients’ privacy even beyond the government mandated privacy laws. It’s important that options and access remain open to all while still remaining vigilant for those few who make up the minority of patients who are seeking treatment driven by a mental illness.