Published in BioEdge Feb 14th 2021

Australia’s spending on cosmetic procedures topped A$1 billion in 2020 for the first time, according to the Cosmetic Physicians College of Australasia.

And a clinical psychologist has warned of the dangers of normalising cosmetic procedures. Dr Ben Buchanan, a specialist in body dysmorphia, told that people are getting procedures which they might not need.

Cosmetic surgery is becoming as commonplace as getting braces, said Dr Buchanan, who runs a body image clinic in Melbourne.

He says that many people benefit from cosmetic procedures; they become happier and have more self-esteem. However, people with body dysmorphia disorder (BDD) are often very dissatisfied and step onto a treadmill of having procedure after procedure. In fact, 84% of cosmetic surgery patients who have BDD will be disappointed with the results.

“Cosmetic procedures can be a reasonable thing for most people to do, unfortunately it’s very risky for someone with body dysmorphia disorder, to the extent where they think their surgery made them look worse or even that their surgeon did a botched job.”

Dr Buchanan said people with BDD have an “exceptionally detailed visual perception compared to most people” and are far more likely to see so-called flaws that others don’t see.

“People with BDD often think if only they looked better they’d be in a better job, they’d have a better relationship, they’d be richer, that everything would fall into line. There’s this false idea that looking good leads to a good life.”

People with BDD can be thinking about their appearance “every moment of the day”. Their illness has high comorbidity with depression and obsessive-compulsive disorder.

There are risks, too, for the surgeons. A 2002 study indicated that a third of cosmetic surgeons had been threatened with legal action. About 10% said that patients with BDD had threatened them both legally and physically.

Risks for both surgeons and patients notwithstanding, only 30% of the surgeons believed that BDD was a contraindication for their handiwork. It must be a lucrative business!

Michael Cook is editor of BioEdge