Prevalence of Body Dysmorphic Disorder Among Rhinoplasty Candidates: A Systematic Review

Abstract

Objective Body dysmorphic disorder (BDD) represents a bridge between the fields of psychiatry and cosmetic surgery. It is a psychiatric disorder involving altered body image and has been associated with cosmetic surgery. Many studies have investigated BDD following rhinoplasty. However, their findings were inconsistent, which prompted us to conduct this systematic review to obtain strong evidence about the prevalence of BDD among rhinoplasty candidates. Methods We searched the literature using electronic databases such as PubMed, Scopus, Web of Science, and others using keywords relevant to the study outcomes. We also manually examined the references of the included studies and relevant reviews to look for articles that might have been missed during the electronic search. Results Nine articles met the inclusion criteria. We identified 7 other relevant articles; since they had been included in a review conducted in 2016, they were not included in the final list of articles. However, they were included in the discussion, and their findings have been compared with ours. The included articles resulted in a total sample of 712 rhinoplasty candidates. The estimated prevalence rates of BDD in these articles ranged from 22% to 52%, which was considered high by all the authors of the included studies. Conclusion The prevalence of BDD among rhinoplasty candidates is high, and adequate management and interventions are needed to reduce it.

Evidence-Based Medicine: Rhinoplasty Surgical Outcomes

“…66,67 Finally, the importance of evaluating the psychology of patients is beginning to come into the forefront of surgery, in particular with cosmetic rhinoplasty with a significant amount in the literature examining body dysmorphic disorder. 68,69 The development of new screening tools such as the Body Dysmorphic Disorder Questionnaire-Aesthetic Surgery (BDDQ-AS) have sought to identify these patients preoperatively for effective counseling on surgical expectations. 70 With the prevalence of underlying psychiatric disorder within the general population on the rise, these are certainly considerations that will require more attention moving forward.…”

Quality of Life and Screening on Body Dysmorphic Disorder, Depression, Anxiety in Septorhinoplasty

“…For preoperative evaluation of rhinoplasty patients, the BDD concern questionnaire‐aesthetic version (BDDQ‐AS) has been developed, culturally adapted, and validated in this patient population and different languages 8–10 . Despite the high prevalence of BDD and its association with higher levels of depression and anxiety, the prevalence of these psychiatric conditions in rhinoplasty patients is understudied 11,12 and their effect on rhinoplasty outcomes and QoL remains unclear 6,13–17 …”

The Body Dysmorphic Disorder Questionnaire—Aesthetic Surgery: Are We Screening the Troublesome Patients?

“…6 However, the prevalence is known to be higher in a clinical setting and especially in rhinoplasty candidates. 4,[7][8][9][10][11][12][13][14] According to a meta-analysis from Nabavizadeh et al, the pooled prevalence for BDD was 32.7% in rhinoplasty candidates. 6 AlAwadh et al found a preoperative prevalence of BDD ranging from 22 to 52% in publications between 2016 and 2021.…”

“…6 AlAwadh et al found a preoperative prevalence of BDD ranging from 22 to 52% in publications between 2016 and 2021. 10 The wide range in prevalence rate in various studies is most likely due to differences in population but also in the interpretation and application of the diagnostic criteria for BDD. 15 The gender ratio is reported as equal, although some studies have found a slight preponderance in women.…”