Body Dysmorphia,the Plastic Surgeon,and the Counselor

Abstract

Trauma repair, deformity, and unsightly blemishes may cause social embarrassment and take thousands of individuals to plastic surgeons. A few persons have endless preoccupation with a slight, real, or perceived appearance defect. Some of either gender, age 10 to 80, seek cosmetic surgeons for aesthetic correction. However, a minority continues to have intense obsessive preoccupation with an imagined body defect. Their concern is excessive and causes significant distress in social, work, or study functions not due to another clinical condition such as anorexia nervosa, in which subjects reject their body as obese. Misperceived ugliness is called body dysmorphia or dysmorphophobia, often only diagnosed after several discontented return visits to the surgeon who refers the patient for counseling—rarely welcome referrals by the patient when they are convinced the problem is physical and not psychological. Careful listening and patient acceptance are essentials in management.