Goh Chin Guan Jeremy, Lo Stephen
Importance: To improve understanding of body dysmorphic disorder in Asian rhinoplasty patients
Objective: To determine the prevalence of body dysmorphic disorder (BDD) in Asian patients who received cosmetic rhinoplasty and determine its impact on subjective outcomes after surgery.
Design: A survey study of patients who received cosmetic rhinoplasty between January 2009 and December 2012 was undertaken. Telephone interview using validated instruments (Body Dysmorphic Disorder Questionnaire and Rhinoplasty Outcome Evaluation) were performed to determine the prevalence of BDD and the subjects? pre-/ post-operative subjective scoring of their noses.
Setting: Tertiary care hospital
Participants: All adult patients who received rhinoplasty for mainly cosmetic indications were included into our study population.
Main Outcome Measures: Those who screened positive on the Body Dysmorphic Disorder Questionnaire were considered to have BDD. The Rhinoplasty Outcome Evaluation quantified the individual?s perception of his/her nose before and after the operation.
Results: Fifty-two patients who received cosmetic rhinoplasty were approached and forty-seven (90%) agreed to and completed the interview. The mean age of participants was 31.1 years. Twenty-seven (57%) of the participants were male and 20 were female. Of the 47 patients who participated in the study, seven (15%) were identified to have possible BDD. Six out of 7 of them were male. The BDD-group (mean age=26.0) was significantly younger (p=0.003) than the non-BDD group (mean age=32.0). Although the revision rate was clinically higher for the BDD group (29%) than the non-BDD group (12.5%), this was not statistically significant (p=0.276). Both groups reported overall improvement in ROE scores but patients with BDD had significantly lower pre- and post-operative ROE scores compared to non-BDD patients (p<0.05).
Conclusion and Relevance: Our results show that BDD is quite prevalent amongst patients who have received cosmetic rhinoplasty. BDD patients are likely to have poorer subjective outcomes after surgery although they may experience some improvement in satisfaction when compared to before surgery.
Level of Evidence: 3