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Mandavia R, D'Souza H, Rupasinghe T, Cariati M, Mandavia T. An Evidence-based Pathway for Body Dysmorphic Disorder in Facial Aesthetics. Facial Plast Surg 2024. [PMID: 38216141 DOI: 10.1055/a-2244-1066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024] Open
Abstract
Aesthetic procedures should be avoided in patients with body dysmorphic disorder (BDD) since they can negatively impact mental health and lead to further aesthetic dissatisfaction. There are no evidence-based patient pathways for BDD in facial aesthetics which can result in the failure to identify patients with BDD, leading to unsuitable treatments and suboptimal patient care. We aim to construct the first evidence-based patient pathway for BDD in surgical and nonsurgical facial aesthetics. A systematic review was performed and articles that discussed screening or patient pathways for BDD in field of facial aesthetics were included. We extracted relevant information from each article on screening tools and pathways for BDD. Data were synthesized by summarizing the data under column headings into a structured narrative and into new tables. Based on this synthesis, a practical pathway for BDD was constructed. Forty articles fulfilled the criteria for inclusion. Twenty-eight BDD screening tools were discussed in the included articles, and we provide an overview of these tools. Thirty-one articles discussed patient pathways for BDD, and we synthesized this information into a structured narrative. Combining these findings, we present an evidence-based patient pathway for BDD for patients presenting for facial aesthetic treatments. This systematic review has resulted in the first, evidence-based, patient pathway for BDD in surgical and nonsurgical facial aesthetics. This practical pathway can be used by aesthetic clinicians to identify patients with potential BDD and provide clear guidance for managing cases where BDD is suspected. It will help reduce the number of facial aesthetic procedures performed on patients with BDD, safeguard patient mental well-being, and prevent further aesthetic dissatisfaction.
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Affiliation(s)
- Rishi Mandavia
- Drs Tatiana+Rishi Advanced Aesthetics, Non-Surgical Aesthetics, London, United Kingdom
| | - Hanna D'Souza
- King's College London, School of Medicine, London, United Kingdom
| | - Thiara Rupasinghe
- University College London, School of Medicine, London, United Kingdom
| | - Massimiliano Cariati
- Drs Tatiana+Rishi Advanced Aesthetics, Non-Surgical Aesthetics, London, United Kingdom
| | - Tatiana Mandavia
- Drs Tatiana+Rishi Advanced Aesthetics, Non-Surgical Aesthetics, London, United Kingdom
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Fernandes HM, Soler P, Monteiro D, Cid L, Novaes J. Psychometric Properties of Different Versions of the Body Shape Questionnaire in Female Aesthetic Patients. Healthcare (Basel) 2023; 11:2590. [PMID: 37761787 PMCID: PMC10531348 DOI: 10.3390/healthcare11182590] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/09/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
The purpose of this study was to examine and compare the psychometric properties (internal consistency and factorial validity) of different versions of the Body Shape Questionnaire (BSQ) in a sample of female aesthetic patients. The sample included 296 women attending aesthetic clinics, with ages ranging between 18 and 70 years (M = 32.23, SD = 11.35) and body mass index between 17.10 and 45.00 kg/m2 (M = 24.70, SD = 4.07). Nine different length versions of the BSQ (BSQ-34, BSQ-32, BSQ-16A, BSQ-16B, BSQ-14, BSQ-8A, BSQ-8B, BSQ-8C and BSQ-8D) were subjected to confirmatory factor analyses, using a robust maximum likelihood estimator. Robust fit indices indicated that the BSQ-8D version was the better-fitting and more parsimonious model (S-Bχ2/df = 1.81, CFI = 0.963, RMSEA = 0.052, SRMR = 0.043). This short version also showed appropriate reliability (McDonald's omega and composite reliability = 0.87) and a very high correlation with the original BSQ-34 version (r = 0.95). In sum, these findings suggest that the BSQ-8D is the most valid, reliable and suitable BSQ version for measuring body shape concerns in female aesthetic patients.
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Affiliation(s)
- Helder Miguel Fernandes
- Polytechnic Institute of Guarda (IPG), 6300-559 Guarda, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal; (D.M.); (L.C.)
| | - Patrícia Soler
- Department of Aesthetics and Cosmetology, Unigran Capital University, Campo Grande 79010-010, Brazil;
| | - Diogo Monteiro
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal; (D.M.); (L.C.)
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
| | - Luís Cid
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal; (D.M.); (L.C.)
- Research Center in Quality of Life (CIEQV), 2001-904 Santarém, Portugal
- Sport Science School of Rio Maior (ESDRM), Polytechnic of Santarém, 2040-413 Rio Maior, Portugal
| | - Jefferson Novaes
- Physical Education and Sports Department, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-901, Brazil;
- Faculty of Physical Education and Sports, Federal University of Juiz de Fora, São Pedro 36036-900, Brazil
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Lăzărescu GM, Vintilă M. The relationship between personality traits and willingness to undergo cosmetic surgery in the non-clinical population - a systematic review and meta-analysis. Front Psychol 2023; 14:1241952. [PMID: 37744591 PMCID: PMC10514507 DOI: 10.3389/fpsyg.2023.1241952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
Objective Conducting a systematic review and meta-analysis to synthesize previously obtained results regarding the relationship between interest in cosmetic surgery and personality traits. Methodology A series of criteria were applied (at the level of design, independent variables, dependent variable, participants) in order to decide which existing studies could be considered eligible for inclusion in the meta-analytic procedure. The identification of research that met the eligibility criteria was carried out with the help of the electronic search function in the following databases: ScienceDirect, PsycInfo, Web of Science, Scopus, Springer, and PubMed. Following this approach left 13 studies that were then subjected to the final analysis and included in the meta-analysis. Results The researchers' expectations were partially supported by the results of the analyses, thus demonstrating the existence of a significant relationship between perfectionism (socially prescribed perfectionism; perfectionistic self-promotion), appearance-based rejection sensitivity, and interest in pursuing esthetic surgery. Discussions Identifying these relationships will allow cosmetic surgeons to understand both the mechanisms underlying this decision and the need for psychological assessment/counseling before patients undergo such procedures. It will also allow psychologists to develop best practice guidelines for how they relate to the patient before they perform cosmetic surgery. At the same time, psychotherapists will be able to devise targeted and personalized interventions for each personality profile, so that the decision to undergo an esthetic operation is not made based on a dispositional trait (fear of rejection, stress caused by body dissatisfaction).
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Affiliation(s)
| | - Mona Vintilă
- Faculty of Sociology and Psychology, West University of Timisoara, Timisoara, Romania
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Rehman U, Perwaiz I, Sohaib Sarwar M, Brennan PA. Mental health screening in facial cosmetic surgery: a narrative review of the literature. Br J Oral Maxillofac Surg 2023; 61:455-463. [PMID: 37442708 DOI: 10.1016/j.bjoms.2023.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/24/2023] [Accepted: 05/07/2023] [Indexed: 07/15/2023]
Abstract
The popularity of cosmetic surgery is on the increase with the face being one of the most common anatomical areas operated on. Pre-existing mental health conditions can be associated with adverse patient outcomes after cosmetic surgery and can result in deterioration of postoperative mental health and lack of patient satisfaction. Therefore, identifying the presence of psychiatric disorders through preoperative screening should be considered during consultation for facial cosmetic surgery. In this study, we reviewed the types of preoperative mental health screening tools used in cosmetic facial surgery and the prevalence of mental health conditions among patients undergoing cosmetic facial surgery. A literature search was conducted on Pubmed, Prospero, Dynamed, DARE, EMBASE, and COCHRANE databases. A total of 12 articles fulfilled the inclusion criteria. A total of 2194 participants were included in this review. Rhinoplasty (n=1154), blepharoplasty (n=138) and rhytidectomy (n=83) were the most performed facial cosmetic procedures, respectively. A total of 758 (34.1%) had a diagnosis of a potential mental health problem following the preoperative screening. With body dysmorphic disorder (BDD) being the most common (20.0%). The BDD questionnaire was the most used screening tool (n=4). Mental health diagnoses were more common in patients in low-income countries (48.4%) compared to patients from non-low-income countries (25.7%). Given our findings, we propose the routine use of mental health screening tools in all patients undergoing facial cosmetic surgery. This will improve satisfaction rates post-facial cosmetic surgery and may reduce the number of unnecessary procedures.
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Affiliation(s)
- Umar Rehman
- Core Surgical Trainee, Department of Plastic Surgery, Chelsea and Westminster Hospital, London, United Kingdom.
| | - Ibrar Perwaiz
- Foundation Year One Doctor, Department of General Surgery, Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom.
| | - Mohammad Sohaib Sarwar
- Locum Clinical Fellow, Department of Oral and Maxillofacial Surgery, The Queen Victoria Hospital, East Grinstead, United Kingdom.
| | - Peter A Brennan
- Honorary Professor of Surgery, Consultant Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, United Kingdom.
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Pereira IN, Chattopadhyay R, Fitzpatrick S, Nguyen S, Hassan H. Evidence-based review: Screening body dysmorphic disorder in aesthetic clinical settings. J Cosmet Dermatol 2023. [PMID: 36847707 DOI: 10.1111/jocd.15685] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/26/2022] [Accepted: 02/02/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Body dysmorphic disorder (BDD) is a psychiatric disturbance with high incidence in aesthetic clinical settings. Early recognition may avoid unnecessary elective procedures with ethical and medicolegal consequences. AIMS To identify validated BDD screening tools and critically appraise current literature regarding its implementation and efficacy in aesthetic medicine and surgery scenarios, with the purpose of transposing the findings to the broad clinical settings in the field. METHODS Data was collected using advanced search from PubMed (MEDLINE). Having satisfied the search parameters, 12 studies referring BDD definition according to Diagnostic and Statistical Manual of Mental Disorder (DSM-5) criteria and including a BDD screening tool in clinical aesthetic settings were selected. RESULTS While BDD screening enables the recognition of at-risk individuals, further work is required to uncover the best screening tool for general aesthetic clinical practice. Level III evidence favored BDD Questionnaire (BDDQ)/BDDQ-Dermatology Version (DV), and The Dysmorphic Concern Questionnaire (DCQ) among the limited available validated screening instruments to be used outside the psychiatric environment. Based on level II self-classification, one study selected BDDQ-Aesthetic Surgery (AS) version for rhinoplasty patients. The validation process of both BDDQ-AS and Cosmetic Procedure Screening Questionnaire (COPS) had limitations. For BDD screening potential in avoiding postoperative complications, the limited studies found evaluating the outcomes following aesthetic treatments using validated BDD screening measures showed a trend toward less satisfaction with aesthetic treatment outcome among positive screening population against non-BDD counterparts. CONCLUSION Further research is necessary to establish more effective methods to identify BDD and evaluate the impact of positive findings on aesthetic intervention outcomes. Future studies may elucidate which BDD characteristics best predict a favorable outcome and provide high-quality evidence for standardized protocols in research and clinical practice.
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Affiliation(s)
| | - Rashmi Chattopadhyay
- Barts & The London School of Medicine & Dentistry, Centre for Cutaneous Research, Blizard Institute of Cell and Molecular Science, Queen Mary University, London, UK
| | - Sean Fitzpatrick
- Barts & The London School of Medicine & Dentistry, Centre for Cutaneous Research, Blizard Institute of Cell and Molecular Science, Queen Mary University, London, UK
| | - Sheila Nguyen
- Barts & The London School of Medicine & Dentistry, Centre for Cutaneous Research, Blizard Institute of Cell and Molecular Science, Queen Mary University, London, UK
| | - Haidar Hassan
- Barts & The London School of Medicine & Dentistry, Centre for Cutaneous Research, Blizard Institute of Cell and Molecular Science, Queen Mary University, London, UK
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Wijaya WA, Liu Y, Zhou M, Qing Y, Li Z. Translation, cross-cultural adaptation and validation of the Mandarin version of the BDDQ-AS for rhinoplasty patients. J Otolaryngol Head Neck Surg 2022; 51:6. [PMID: 35123589 PMCID: PMC8818153 DOI: 10.1186/s40463-022-00557-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 01/02/2022] [Indexed: 02/08/2023] Open
Abstract
Background The BDDQ-AS (Body Dysmorphic Disorder Questionnaire—Aesthetic Surgery) is a simple and reliable patient-reported outcome measure. It can be used as a screening tool for body dysmorphic disorder (BDD) in patients undergoing aesthetic rhinoplasty. The aim of this study was to translate and culturally adapt the Mandarin version of the BDDQ-AS (M-BDDQ-AS) and evaluate its selected psychometric validation in patients after rhinoplasty. Method According to international guidelines, the BDDQ-AS questionnaire was translated from English to Mandarin. Twenty Mandarin-speaking rhinoplasty patients were interviewed in order to evaluate the understandability and acceptability of the translation and produce a final version. It was then administered to 137 patients with a mean age of 38.75 ± 6.24 years. Psychometric validation were evaluated using reliability (internal consistency, test–retest reliability) and item-reponse theory (IRT) test. Result High internal consistency of 0.823 was found using Cronbach’s α coefficient. Reliability of the M-BDDQ-AS resulted in Intraclass Correlation Coefficient (ICC) = 0.863. Besides, based on IRT analysis, the discrimination abilities of all the items were good (over 2.0), and their difficulty estimates were reasonable. Conclusion The M-BDDQ-AS is a reliable and valid self-reported questionnaire that can be used in rhinoplasty patients. The very good psychometric validation of the M-BDDQ-AS indicates that it can be used in clinical practice and scientific research. Graphical Abstract ![]()
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Affiliation(s)
- Wilson A Wijaya
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, No.37 Guoxue Alley, Wuhou District, Chengdu City, Sichuan Province, 61000, People's Republic of China
| | - Yu Liu
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, No.37 Guoxue Alley, Wuhou District, Chengdu City, Sichuan Province, 61000, People's Republic of China
| | - Min Zhou
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, No.37 Guoxue Alley, Wuhou District, Chengdu City, Sichuan Province, 61000, People's Republic of China
| | - Yong Qing
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, No.37 Guoxue Alley, Wuhou District, Chengdu City, Sichuan Province, 61000, People's Republic of China.
| | - Zhengyong Li
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, No.37 Guoxue Alley, Wuhou District, Chengdu City, Sichuan Province, 61000, People's Republic of China
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