اختلال بدریخت انگاری و درمان های پزشکی بهبود ظاهر

This article reviews the literature on body dysmorphic disorder (BDD) in persons who seek appearance enhancing medical treatments such as cosmetic surgery and dermatological treatment. We begin with a discussion of the growing popularity of cosmetic surgical and minimally invasive treatments. The literature investigating the psychological characteristics is briefly highlighted. Studies investigating the rate of BDD among persons who seek appearance enhancing treatments are detailed and, collectively, suggest that approximately 5–15% of individuals who seek these treatments suffer from BDD. Retrospective reports suggest that persons with BDD rarely experience improvement in their symptoms following these treatments, leading some to suggest that BDD is a contraindication to cosmetic surgery and other treatments. The clinical management of patients with BDD who present for these treatments is briefly described and directions for future research are provided.

According the American Society of Plastic Surgeons, 10.9 million cosmetic surgical and minimally invasive treatments were performed in 2006 (ASPS, 2007). Just under 2 million of these treatments were traditional cosmetic surgical procedures such as liposuction, breast augmentation, and rhinoplasty. The vast majority, over 9.1 million, were minimally invasive procedures such as Botox® injections and chemical peels. The number of all of these procedures has increased by 48% since 2000 and over 800% since 1992, the first year that the ASPS started reporting procedural statistics. While these numbers are staggering, they likely are an underestimate of the number of procedures performed annually, as they do not account for the growing number of non-plastic surgeons who now offer these and other appearance enhancing treatments. A discussion of the popularity of cosmetic surgery must consider a number of contemporary theoretical explanations (Sarwer, Crerand, & Gibbons, 2007; Sarwer & Magee, 2006). These include the large body of social psychological research on the role of physical appearance in daily life as well as the growing literature on body image and, specifically, its contribution to the pursuit of appearance modifying behaviors. The role of the mass media and entertainment industries, from the relentless bombardment of images of physical perfection to the popularity of “reality-based” cosmetic surgery television programs, undoubtedly contribute to the popularity. The technological advances in cosmetic medicine, which have made both surgical and non-surgical procedures safer than ever before, have likely fueled the growth. Finally, evolutionary theories of physical attractiveness also can be used to explain the popularity (Sarwer & Magee, 2006), as many procedures are designed to enhance facial symmetry and youthfulness, or alter the waist-to-hip ratio.