More often than not, we find ourselves flooded with all forms of media where material wealth and superficial beauty take centre stage. The amount of social media personalities and influencers dominating our screens has led to an increase in the desire to attain a certain look or image, resulting in the rise of Body Dysmorphic Disorder (BDD).

Furthermore, marketing through these platforms has enabled make-up artists, cosmetic practitioners and plastic surgeons to capitalize on these urges. As a result, we have seen a huge rise in aesthetic procedures, both surgical and non-surgical. These said procedures, are now readily available more than ever before, considering you can have access to them in your local mall or somewhere down the high street. And with the ever-rising competition in the industry, prices have become quite discounted and attainable to most.

I’m not saying that wanting to have a little nip and tuck here or there is a bad thing, I mean, there are many patients who benefit from these procedures but there can also be negative consequences. The psychological effect it can have on many patients is barely discussed. This can easily lead to discontentment in one’s body image, loss of self-confidence and some instances mental health issues such as Body Dysmorphic Disorder.

Enter the Expert

To try and demystify the psychological effects that come with cosmetic surgery as well as Body Dysmorphic Disorder, I caught up with Dr Peter Loizou, Consultant ENT/Head and Neck Surgeon, and Facial Plastic Surgeon in Dubai.

According to Dr Peter, aesthetic procedures have been on the rise globally. “This is not only happening in the western world, but also in the Far East and the Middle East. Here in Dubai, we have seen a drastic increase in non-surgical and surgical aesthetic procedures, which has led to the mushrooming of aesthetic clinics and cosmetic surgery day-case units throughout the region.

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Most Common Procedures

Dr Peter notes that the most common procedures which are increasingly being requested are those of botulinum toxin treatments, commonly known as “Botox”, and soft dermal fillers. “These treatments are increasing by about 10% each year, and we’ve also seen an increase in our male clientele requesting for non-surgical procedures.”

Then there Are the Unrealistic Cosmetic Requests

That said, there are times that the doctor may receive an unrealistic request such as ‘doctor are you able to shrink my ears?’ or ‘doctor are you able to make my nose look like this person’s’.

“Obviously, there are certain limitations with what we can provide depending on whether the person wishes to proceed with a surgical or non-surgical procedure. So, the most important thing any plastic surgeon must do is to have a detailed dialogue with the patient to pinpoint their main concerns and discuss possible treatment strategies. What can be achieved with cosmetic surgery versus non-surgical procedures, or by using a mixture of both to optimise an outcome”

Again, he states, we need to understand what the expectations are of the patient and if they are realistic as to whether we can address them and achieve the desired outcome, mitigating the downtime and reducing the chance of any complications. To do this we must recognize our limitations which may not only be dependent on the patient’s anatomy, age and previous medical history, but also on the patient’s mental well-being.

Mental Health Matters when it Comes to Cosmetic Procedures

When it comes to patients looking to have any aesthetic procedure, says Dr Peter, it’s always important to assess the patient holistically. “What I mean by this is not only from a physical point of view but also to understand the motives behind the surgery or the treatment, and also to ascertain their mental health and emotional maturity before they go ahead with such a procedure.”

Obviously, he adds, since the non-surgical procedures are temporary, and some procedures can be reversed, patients tend to take these procedures rather lightly. “After all, according to them, it’s just a short visit to the office during a lunch break”. Sometimes a patient may ask ‘so, doctor what can you do for me?’ without any specific request but just a generalization on what can be improved. However, with any procedure, whether it is non-surgical, reversible or temporary, there are still risks involved.

By assessing the patient holistically, we will be better informed on making the decision to treat or not to treat. What I mean by this is whether they truly need a cosmetic procedure vs treating an underlying psychological condition aka Body Dysmorphic Disorder.

Body Dysmorphic Disorder

Body Dysmorphic Disorder, which is an example of OCD (obsessive-compulsive disorder) is present in about 1 in 50 of the population. “However, in aesthetic practices, we may see this being the case in up to 10% of our clientele,” states Dr Peter.

He adds that it is important to see how life-changing the patient feels about the area of focus and if they highlight it as a ‘deformity’ or a ‘flaw’. In some instances, they may wish to hide this from others or even themselves by avoiding mirrors and cameras. Others may magnify the focus on this body part or facial characteristic by constantly looking at it in the mirror. “This can lead to anxiety and sometimes even depression around this focused area, which more often than not is usually on the face.

“In this COVID-19 era we are currently living in, we are seeing some of these patients coming to the clinic very comfortable wearing a mask, but then they become rather anxious when asked to remove it. This would raise caution and be consistent with someone who may be suffering from Body Dysmorphic Disorder.”

According to the doctor, if this patient’s focus is on something that looks within the normal range of what is expected for anatomical size and proportion, and the focus is exceedingly exaggerated and considered a deformity or flaw, then this is typical of Body Dysmorphic Disorder. “So, what we do in this sort of case is to recognise early on in the consultation by carrying out a detailed assessment and then provide them with the appropriate support.

Treatment for Body Dysmorphic Disorder

There are specially trained doctors, who understand aesthetics, and have experience with mental health management. Some of these patients who suffer from Body Dysmorphic Disorder may require medical therapy with a course of antidepressants, while some may benefit from cognitive behavioural therapy.

That said, what are your thoughts on Body Dysmorphic Disorder, and cosmetic surgery in general? And do you think the rise of social media and so-called filters are to blame for this? Share your thoughts in the comments section below.