The Impact of Body Dysmorphic Disorder in the Cosmetic Industry
In this blogpost we will be exploring Body Dysmorphic Disorder or BDD, in the world of Medical Aesthetics
What is Body Dysmorphic Disorder?
BDD is a psychiatric diagnosis characterized by:
An exaggerated preoccupation with perceived flaws that are not easily observable to other people
A large amount of time spent obsessively comparing personal appearance to others
Excessive efforts are taken to conceal these perceived flaws by using makeup, clothing, or repeated and unnecessary cosmetic treatments
Repetitive behaviours such as skin picking or mirror checking, or conversely, avoiding mirrors altogether.
In severe cases, this preoccupation can interfere with a person's ability to interact normally in society or perform simple tasks such as going to work.
Body Dysmorphic Disorder and Aesthetics
Although the prevalence of BDD in the general population is around 2%, a 2017 systematic review and meta-analysis concluded that an average of 15% of plastic surgery patients exhibited body dysmorphia disorder symptoms. This number exceeded 50% in some studies.
Among dermatology patients, the prevalence was around 12%, exceeding 35% in some studies. Thus, both population groups showed a significantly above-average rate of BDD.
A recent BBC article discussed a that there is potentially a higher prevalence of body dysmorphia disorder among aesthetic practitioners. This was based on a 2017 survey conducted by Dr. Harris and Dr. Johnson. Interestingly, BDD was most common among aesthetic nurses at 50%, followed by aesthetic doctors at 16%. The lowest prevalence was seen amongst aesthetic dentists.
Are Aesthetic patients at risk?
So what does that mean for potential aesthetic patients?
Firstly, let’s address the debate of whether aesthetic practitioners pose a risk to their patients if they themselves are exhibiting traits of BDD.
Good, ethical and sensible practitioners will always have their patient’s best interests in mind and therefore it follows on that they should respect the anatomy and aesthetic goals of their patients and avoid imposing unnatural results. It's crucial to choose a clinic and practitioner carefully, look at their results, patient testimonials, qualifications, experience and determine whether their techniques and ethos are aligned with your personal aesthetic preferences.
As the saying goes “your vibe attracts your tribe” and so to some extent patients will gravitate towards a practitioner whose personal look or signature results reflect what it is that they want. A patient who loves a very undetectable look is unlikely to book into a clinic who is known for a super exaggerated look and vice versa.
So, I genuinely don’t believe that a practitioner with BDD or BDD traits is a risk to their patients, but it is certainly food for thought, especially when we start to explore a very interesting subcategory of BDD which is BDD by proxy. BDD by proxy is a BDD variant whereby the sufferer becomes preoccupied with perceived imperfections of another person’s appearance. In this context we may be seeing a situation where an individual practitioner’s perception may start to affect a patient.
The fact that BDD is significantly higher in patients seeking out aesthetic procedures means that as practitioners we must be vigilant as to the fact that our patients may have greater vulnerabilities linked to self-image. Therefore we have a duty of care to assess our patients for any red flag symptoms during their consultation, advise against treatments that aren’t appropriate and support them through seeking appropriate counselling and treatment (such as Cognitive Behavioral Therapy) to get to the root cause of the problem.
Notoriously in patients with BDD, it has been shown that even when a particular feature is “corrected” the feeling of self-loathing and distorted self-image will still be there. And this is because we are dealing with a problem that is deep-rooted and hardly ever just “skin deep”.
Navigating Body Dysmorphia in the Cosmetic Industry
Without a doubt, a more important discussion to be having overall is the fact that generally as a society our perception of beauty and normal has gradually become distorted and alienised, and this is more obvious in the social media, beauty and aesthetic industries.
Although we can’t avoid what information and images are being blasted at us all day, all we can do is try to curate the information we consume, avoid feeds that propagate unnatural beauty standards, diversify beauty, take everything we see with a MASSIVE pinch of salt and take the time daily to remind ourselves and those around us that we are all beautiful in our own unique way.
And if you do seek out treatments or aesthetic enhancements, do so from a place of love for yourself not a place of hate or loathing and visit professionals who can help support you through such treatments and importantly, who know when to say no.
P.S…
If you’re struggling with any of the issues discussed in this blog, there is help and support out there, so please reach out to a trusted friend, relative, teacher or healthcare professional.
The NHS link below in references includes some useful resources and organisations you can speak to if you are struggling.
References
Ribeiro, Rafael Vilela Eiras. “Prevalence of Body Dysmorphic Disorder in Plastic Surgery and Dermatology Patients: A Systematic Review with Meta-Analysis.” Aesthetic plastic surgery vol. 41,4 (2017): 964-970. doi:10.1007/s00266-017-0869-0
https://www.bbc.co.uk/news/uk-england-london-66177418
https://cdn.shopify.com/s/files/1/2379/8747/files/074-078_AM_OCT17_BBD-3.pdf?2069276598739791117. Authors: Dr Steven Harris Published in Aesthetic Medicine Journal October 2017
https://www.nhs.uk/mental-health/conditions/body-dysmorphia/