Dr. Buonassisi Explains Body Dysmorphic Disorder and Rhinoplasty

<p>In this insightful video, Dr. Thomas Buonassisi, MD, FRCSC — Specialist in Otolaryngology – Head and Neck Surgery, with a practice limited to facial plastic surgeries, discusses the critical considerations for rhinoplasty candidacy, particularly focusing on body dysmorphic disorder (BDD). With over 20 years of experience and having performed over 2,500 rhinoplasties, Dr. Buonassisi shares his expertise on why understanding a patient's perception of their own appearance is crucial before proceeding with surgery.</p> <p>Dr. Buonassisi explains that while many patients seek rhinoplasty to change a feature they are unhappy with, it is essential to evaluate whether their perception of their nose and facial features is realistic. He notes that some individuals may view their noses as significantly larger than they are, despite comparisons with others who have similar nasal structures. This misperception can be indicative of body dysmorphic disorder, a condition where individuals obsess over perceived flaws in their appearance.</p> <p>Body dysmorphic disorder is relatively common among those seeking rhinoplasty, and Dr. Buonassisi stresses that performing surgery on patients with BDD can be detrimental. Even with an almost perfect surgical outcome, these patients may not perceive the results accurately, leading to dissatisfaction. He advises that the underlying issues, such as self-esteem problems or BDD, should be addressed through psychiatric treatment before considering cosmetic surgery.</p> <p>Dr. Buonassisi outlines some signs of BDD, including obsessions about appearance that can last for hours and interfere with daily life, as well as compulsive behaviors like frequently checking one's appearance in the mirror. He emphasizes that cosmetic surgery is not a solution for those with BDD, as they are unlikely to be satisfied with the results, regardless of the surgical outcome.</p> <p>What is body dysmorphic disorder (BDD)? BDD is a mental health condition where individuals obsess over perceived flaws in their appearance, which are often minor or not visible to others.</p> <p>How does BDD affect rhinoplasty candidacy? Patients with BDD may not perceive surgical results accurately, leading to dissatisfaction. Therefore, addressing BDD through psychiatric treatment is crucial before considering rhinoplasty.</p> <p>What are some signs of BDD? Signs include prolonged obsessions with appearance, low self-esteem, and compulsive behaviors like excessive mirror checking.</p> <p>Why is realistic self-perception important for rhinoplasty? A realistic perception ensures that patients have achievable expectations and are more likely to be satisfied with the surgical outcome.</p> <p>Can online tools diagnose BDD? Online tools cannot diagnose BDD but can provide initial assessments to help individuals understand their condition better.</p> <p>What should patients with BDD do before considering surgery? They should seek psychiatric treatment to address the underlying issues affecting their self-perception.</p> <p>How does Dr. Buonassisi approach rhinoplasty consultations? He evaluates both the physical aspects and the patient's psychological readiness to ensure they are suitable candidates for surgery.</p> <p>Why is it important to treat BDD before surgery? Treating BDD first ensures that patients have a healthier self-image and are more likely to appreciate the results of cosmetic surgery.</p>

My name is Doctor. Bonesisi and I'm a board certified facial plastic surgeon with a practice in Vancouver, Canada. I've been specializing in cosmetic rhinoplasty for almost twenty years and I'm here to answer your questions about this very interesting procedure. Happy patients are educated patients, and that's why every question is a good one. So as a surgeon, I'm trying to evaluate whether you're a good candidate for rhinoplasty or not. And it's not just whether or not you have a feature that I can change that I can change for the better, it's also whether or not you're really looking at your nose and your other facial features in a way that is realistic and accurate. I've had patients in the past feel that their nose is incredibly big, and I'll look at them and I'll show them other patients who have noses that are very similar to theirs. It's interesting how they sometimes find the other patients look good, but they still don't like their nose. I think there are situations where even if we get an almost perfect result, some patients just do not see themselves in a way that is really accurate and one of the terms used for that is body dysmorphic disorder. It's actually fairly common amongst patients who are seeking rhinoplasty and I think that it does them a disservice to do this type of surgery when we feel that they're unlikely to perceive their nose realistically even with surgery. And I think that the underlying issue, whether it's a self esteem issue or just in general a type of body dysmorphic disorder, I think that really needs to be treated first. Here are some of the signs and symptoms. You suffer from obsessions about your appearance that lasts for hours or maybe even an entire day. Sometimes these obsessions make it hard to focus on anything other than your imperfection. This can lead to low self esteem or problems at work or school. You also may have repetitive compulsive behaviors, like looking at your flaw many, many times in a mirror every day. So somebody with body dys dysmorphic disorder should not have cosmetic surgery. They need to be treated psychiatrically because you're just not going to be happy with your cosmetic result no matter how perfect it is. Online tools cannot properly diagnose BDD, but if you visit bddfoundation dot org, you'll find some online assessments that will help you get started in evaluating yourself. You'll also find some tools for reaching out if you need help. Thanks for listening, and check back regularly for new questions and my honest answers about rhinoplasty.

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