Aesthetic Plastic Surgery

, Volume 43, Issue 4, pp 1115–1116 | Cite as

Invited Response on: Body Dysmorphic Disorder: There is an "Ideal" Strategy?

  • Maria José Azevedo De BritoEmail author
  • Fabio Xerfan Nahas
  • Miguel Sabino Neto
Response to Letter to the Editor


Body dysmorphic disorder (BDD) has been considered the most relevant neuropsychiatric condition to cosmetic treatments. Patients’ ideal expectations often exceed what is expected to be achieved in reality by plastic surgery, signaling the presence of BDD. It is fundamental to detect BDD symptoms during screening for cosmetic surgery. A secondary concern with physical appearance may be one of the most important parameters to be detected during patient assessment, as it may interfere with overall patient satisfaction following treatment. A good doctor–patient relationship is essential for detecting this psychopathology. Mild-to-moderate BDD is not an exclusion criterion for cosmetic surgery, but specific treatment planning and a multidisciplinary approach are required. Recent studies have presented preliminary evidence for the effectiveness of cosmetic procedures in reducing BDD symptoms and providing patient satisfaction with treatment results. The use of validated instruments at pre- and postoperative assessments to systematically evaluate the patient’s level of distress with the physical appearance and patient satisfaction with treatment results will provide important information for the development of more sensitive validated tools for detection of severe levels of BDD symptoms to help plastic surgeons in the selection of patients in a more effective and practical manner.

Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Body dysmorphic disorders Body image Patient satisfaction Patient selection Plastic surgery Doctor–patient relations 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest to disclose.

Statement of Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

For this type of study, informed consent is not required.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Authors and Affiliations

  • Maria José Azevedo De Brito
    • 1
    • 2
    Email author
  • Fabio Xerfan Nahas
    • 1
  • Miguel Sabino Neto
    • 1
  1. 1.Division of Plastic Surgery, Department of SurgeryUNIFESPSão PauloBrazil
  2. 2.College of Health ScienceUniversity of Vale do Sapucaí (UNIVÁS)Pouso AlegreBrazil

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