The Research On The Indication And Contraindication Of The Plastic And Aesthetic Surgery For The Patients With Body Dysmorphic Disorder

First Part of clinical study The preliminary research on the influence of plastic and aesthetic surgery on the body image1.Objective:The purpose of the research was to find out the prevalence of the body dysmorphic disorder in the patients seeking plastic and aesthetic surgery,to observe the characteristic of the body image of the plastic and aesthetic populations and that of the body dysmorphic disorder patients seeking plastic and aesthetic surgery,to identify the influence of plastic and aesthetic surgery on the body image, and to discuss the feasibility and treatment of plastic and aesthetic surgery for body dysmorphic disorder.2.Methods:324 patients were tested with the self- rating scale of body image before and after the plastic and aesthetic surgeries.3.Results:In this research the number of the plastic and aesthetic population was 324,and the prevalence of body dysmorphic disorder in plastic and aesthetic population was 10.2%.Before plastic and aesthetic surgeries,the common population paid much more attention to the sense of the body defect and the others' appreciation. At the same time,the body dysmorphic disorder patients paid much more attention to all aspects,especially to the appearance attention,the body defect and the impaired emotion.In plastic and aesthetic population,the score of the scales was 19.503±11.097 preoperatively,and reduced to16.015±10.250(P＜0.01) postoperatively.The descending scores of the items were concentrated on the aspects of the body defect,the impaired emotion and the social intercourse.In the body dysmorphic disorder patients,the score of the scales was 41.636±5.656 preoperatively, and reduced to 18.758±11.568(P＜0.01) postoperatively.The descending scores of the items were almost in every aspect.4.Conclusions:Body dysmorphic disorder is the frequent psychological complication in the plastic and aesthetic population.The plastic and aesthetic population have the strong self- defective consciousness,and pay much attention to others' appreciation of their body image;body dysmorphic disorder patients pay much attention to their body image.Plastic and aesthetic surgery can improve their body image.Body dysmorphic disorder is not the contraindication of the plastic and aesthetic surgery,and the indication should be studied further combined with the patients' personalities. Second Part of clinical study The preliminary research on the plastic and aesthetic surgical satisfaction of the patients combined with body dysmorphic disorder and personality disorder1.Objective:The purpose of the research was to find out the prevalence of personality disorder in the plastic and aesthetic population,especially in the patients combined with body dysmorphic disorder seeking plastic and aesthetic surgery,to analyze the relationship between the plastic and aesthetic population with personality disorder and body dysmorphic disorder and the plastic and aesthetic surgical satisfaction,and to research the indication and contraindication of plastic and aesthetic surgery for the patients with body dysmorphic disorder.2.Methods:95 patients were tested with the self- rating scale of body image and the personality diagnostic questionnaire- 4 preoperatively,and their plastic and aesthetic surgical satisfaction was evaluated postoperatively.3.Results:In this research the number of the plastic and aesthetic population was 95, body dysmorphic disorder patients were 13,and personality disorder patients were 52. In plastic and aesthetic population,the score of the PDQ-4 scales was 18.03±11.08, that in body dysmorphic disorder patients was ascended to 24.69±12.37(P＜0.05).In plastic and aesthetic population,52 patients were combined with one or more types of personality disorders;and those in body dysmorphic disorder patients were 10 patients.In plastic and aesthetic population,the surgical satisfactory scores of schizotypal,compulsive and histrionic personality disorder patients were highest,and those of the dependent,borderline and antisocial personality disorder patients were lowest.In body dysmorphic disorder patients combined with personality disorder,the surgical satisfactory scores of the avoidant personality disorder patients were highest, and those of the narcissistic and compulsive personality disorder patients were lowest. In body dysmorphic disorder patients,the number of the patients combined with personality disorders who were satisfied the operations was less than that of the patients who were not combined with personality disorder(P＜0.05).In the patients who were not combined with body dysmorphic disorder,the number of the patients combined with personality disorder who were satisfied with the operations was less than that of the patients who were not combined with personality disorder(P＜0.05), and the number of the patients combined with schizoid,avoidant,narcissistic, paranoid,compulsive or borderline personality disorder who were satisfied with operations was less than that of the patients who were not combined with such a personality disorder(P＜0.05).In the patients combined with personality disorder, there was no significant statistic defference between the number of the patients combined with body dysmorphic disorder who were satisfied with the operations and that of the patients who were not combined with body dysmorphic disorder(P＞0.05).4.Conclusions:Personality disorder is the frequent psychological complication in the plastic and aesthetic population,especially those combined with body dysmorphic disorder.The extent of the body dysmorphic disorder and personality disorder in the patients combined with body dysmorphic disorder and personality disorder is more severe,and personality disorder is the primary factor which induces to the lowing surgical satisfaction of the body dysmorphic disorder patients seeking plastic and aesthetic surgeries.Plastic and aesthetic surgeons should be cautious to choice the paitents combined with body dysmorphic disorder and personality disorder to have plastic and aesthetic surgeries...