Level of satisfaction of patients with Body Dysmorphic Disorder after rhinoplasty

Abstract

The esthetic standards of beauty shape thoughts that lead to an increasing demand for plastic surgery and, secondly, the discrepancy between what is seen as ideal and personal reality. However, this demand can be enhanced by a psychiatric condition - the Body Dysmorphic Disorder (BDD), to the extent that individuals often look for procedures in plastic surgery to correct the defect and improve the perceived extreme dissatisfaction with their physical appearance. The BDD can be described as a worry with one or more defects or failures found in physical appearance that may not be observable to others. The condition is also characterized by compulsive behavior or repetitive, resulting in clinically significant distress. One of the most common psychiatric conditions found in patients seeking plastic surgery procedures. Thus, as a result of the increase of patients seeking plastic surgery, in most cases BDD will be treated by plastic surgeons and not by psychiatrists. Rhinoplasty is one of the most requested cosmetic procedures for patients with BDD as well as one of the greatest instances of disputes between cosmetic surgery. Dissatisfaction with the nose can be exacerbated by social and cultural issues related to ethnicity, because the esthetic standard culturally dominant values the nasal morphology Caucasian over other morphologies associated with various ethnicities. Thus, it would be important to identify the patients whose assessment of the surgery could be compromised by the presence of variations in the demographic and clinical profile and the occurrence of BDD, thereby allowing advance which patients have a higher risk to express dissatisfaction of short and long term. The risk of request for new interventions and dispute between surgeon and patient could be prevented. It is a primary study, observational, longitudinal, prospective, analytical held in one center. There will be included consecutively 100 patients of both genders who wish to go under rhinoplasty, from the Rhinoplasty Clinic - House of Plastic Surgery - Hospital Sao Paulo (UNIFESP). All patients will participate of the study after understand and sign the Informed Consent Term. All questionnaires will be applied pre- and postoperatively after 1 year of rhinoplasty. Patients will respond to a protocol for collecting demographic and clinical data, recording specific information. Moreover it will be applied the "Visual Analogue Scale (VAS)", which will assess the degree of dissatisfaction with the nose, and the "Rhinoplasty Outcomes Evaluation (ROE)", designed to help the surgeon determine the best outcomes of the patients after rhinoplasty. After comparing the two groups identified with or without symptoms of TDC, will be used: t-Student parametric test and the nonparametric Mann-Whitney, Chi-square and Fisher exact. To compare several independent unpaired groups, shall be using the nonparametric Kruskal-Wallis. In all tests will be used 5% significance level for the decision making. That way, you can assess the level of satisfaction in patients with Body Dysmorphic Disorder after rhinoplasty. (AU)