Prevalence of body dysmorphic disorder in rhinoplasty candidates: A systematic review and meta‐analysis

Abstract

BackgroundBody dysmorphic disorder (BDD) is a prevalent mental disorder, particularly in those seeking plastic surgery, leading to unnecessary surgeries and postsurgical dissatisfaction. Among the plastic surgeries, rhinoplasty is the most commonly sought, yet the data on prevalence of BDD among the candidates of rhinoplasty is limited. Therefore, this systematic review and meta‐analysis aimed to estimate the prevalence of BDD in rhinoplasty candidates.MethodsThe online libraries of Web of Science, PubMed, Cochrane Library, ProQuest, Research Square, Scopus, and Google Scholar were searched up to August 2022. Statistical analyses were performed using STATA software (v. 16). The heterogeneity was determined using the I2 statistic, and an overall estimated analysis was conducted. Subgroup analyses were performed on study year, age, gender, World Health Organization regional classification, sociodemographic index, country, sample size, and employed diagnostic tool. A meta‐regression analysis was performed to identify potential sources of heterogeneity.ResultsOut of 12,999 studies assessed, 18, with a combined sample size of 2132 individuals, met our criteria and were included in the study. The pooled prevalence of BDD was 32.7% (95% CI: 23.6−41.7; I2 = 96.45%). Subgroup analyses revealed the studies that were conducted in the European region (42.8%), with a sample size of ≥100 (40.2%), utilized the BDD modification of the Y‐BOCS (BDD‐YBOCS) diagnostic method (47.3%), and with a quality score of ≥6 (34.2%) demonstrated higher prevalence of BDD. The meta‐regression analysis identified a higher prevalence in the BDD‐YBOCS diagnostic method than in the BDD questionnaire (β: 0.23; 95% CI: 0.04−0.43; p = 0.022).ConclusionsThe prevalence of BDD is high in those seeking rhinoplasty. Clinicians should be aware of BDD symptoms to prevent unnecessary surgery and dissatisfaction. Public awareness through the media and access to affordable medical services should also be provided.

Persistent cosmetic dissatisfaction in rhinoplasty & management of the difficult patient

“…Patients with psychopathology ranging from personality disorders, including narcissistic personality disorder (NPD), to posttraumatic stress conditions, to obsessive-compulsive type disorders, such as body dysmorphic disorder (BDD), have been shown to potentially have a lower rate of satisfaction after surgery [11,27,28] . According to a study by Constantian and Lin, a history of psychological trauma including abuse or neglect was the most significant factor influencing patient satisfaction and a number of operations, and the most prominent factor driving surgery in patients with milder deformities [29] . In fact, some authors have suggested that potentially causative links exist between trauma (abuse/neglect), body image disorders, and obsessive plastic surgery [29] .…”

“…According to a study by Constantian and Lin, a history of psychological trauma including abuse or neglect was the most significant factor influencing patient satisfaction and a number of operations, and the most prominent factor driving surgery in patients with milder deformities [29] . In fact, some authors have suggested that potentially causative links exist between trauma (abuse/neglect), body image disorders, and obsessive plastic surgery [29] . Body dysmorphic disorder may be a model of the disordered adaptation to abuse or neglect, a variant of posttraumatic stress disorder.…”

The relationship between cleft palate repair technique and audiological outcomes: A retrospective cohort study

“…One of the frequent complications, otitis media with effusion (OME), stands as the leading cause of conductive hearing loss in children with clefts. It tends to be both more prevalent and persistent compared with the general population 4–7 …”

“…It tends to be both more prevalent and persistent compared with the general population. [4][5][6][7] OME originates from the dysfunction of the eustachian tube, involving changes in para-tubal muscle architecture, tubal cartilage density, tubal curvature, and luminal diameter. These alterations facilitate inadequate ventilation and negative pressure within the middle ear cavity, culminating in OME and subsequent hearing loss.…”