Asian Cosmetic Surgery and BDD

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Asian Cosmetic Surgery and Body Dysmorphic Disorder

A recent report by a group of rhinoplasty surgeons and psychiatrists appearing in Plastic and Reconstructive Surgery, the official journal of the American Society of Plastic Surgeons, suggests that one-third of patients seeking purely cosmetic nose surgery (that is, not for functional or reconstructive purposes but solely to change the appearance) suffer from moderate to severe body dysmorphic disorder, or BDD. Conducted in Belgium and Greece, the assessment was academically rigorous and as objective as possible.

"According to its current definition," write the authors, "body dysmorphic disorder is defined as an excessive concern with an imagined or slight defect in physical appearance, leading to significant distress and/or impairment in one or more important areas of functioning." Body dysmorphic disorder symptoms significantly reduce the quality of life and cause appearance-related disruption of everyday living.

The study also references an earlier paper noting a high rate of other psychiatric disease in patients with body dysmorphic disorder, the most common of which includes "major depression, social phobia, substance abuse, obsessive-compulsive disorder, and personality disorders." Depression was said to have the highest rate of co-occurrence, with a lifetime incidence of 80 percent, and suicide rates are elevated.

While the 40 minute "Western Eyes" documentary by Ann Shin that follows was first released in 2001, there's nothing about its content that makes it seem any less current today. It follows the lives of two Asian-American women seeking facial cosmetic surgery - one for double eyelid surgery, the other for rhinoplasty - each for the stated purpose of Westernizing their natural and entirely normal Asian features. Both women seem bothered by appearance to the point of significant interference with happiness, self-confidence, and ability to interact and function.

APSG Comment: After watching this movie, it's impossible to believe that the two Asian-American women featured here are not burdened by an unhealthy fixation on their perfectly normal and attractive Asian facial traits. Both seem to meet the criteria above for suffering from substantial, if not severe, body image problems characteristic of body dysmorphic disorder, a psychiatric disorder.

One has to wonder: Is the psychological pain and conflict shown by these two women typical of that felt by most others intent on altering normal ethnic traits?

After all, to view the websites and glitzy ads produced by cosmetic surgeons in both East and West (but especially in the East) makes the whole process seem like great fun.

Surprisingly, such concerns are seldom discussed as such, possibly because the high rate of Asian cosmetic surgery in at least seemingly well-adjusted young adults makes it easier to accept the idea that such psychological distress focused around surgical modification of attractive anatomy may be more or less "normal" under certain circumstances and in certain settings.

Because, really, who wants to contend with the notion of mass psychiatric illness?

It's a very touchy question, for sure. Perhaps you have an opinion.

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Body dysmorphic disorder and Asian cosmetic surgery