Skip to main content
Top
Published in: Aesthetic Plastic Surgery 4/2016

01-08-2016 | Original Article

Eumorphic Plastic Surgery: Expectation Versus Satisfaction in Body Dysmorphic Disorder

Authors: Paolo Giovanni Morselli, Alessandro Micai, Filippo Boriani

Published in: Aesthetic Plastic Surgery | Issue 4/2016

Login to get access

Abstract

Background

Eumorphic Plastic Surgery aims at improving the severe psychosocial pain caused by a deformity. Dysmorphopathology is an increasingly relevant problem facing the plastic surgeon.

Objective

The aim of this study is to describe the perioperative questionnaires created by the senior author and to present a cohort of plastic surgery patients suffering from dysmorphopathies. These patients were prospectively followed and evaluated with the proposed questionnaires through their surgical pathway to explore the degree of satisfaction or disappointment compared to expectations.

Methods

All candidates for plastic surgery procedures between April 2011 and June 2013 were included in the study. Preoperatively, all patients completed the Patient Expectation Questionnaire (E-pgm). Twelve months postoperatively, they completed the Patient Satisfaction Questionnaire (S-pgm). The E-pgm and S-pgm were compared to evaluate the consistency between the patient’s preoperative expectations and postoperative evaluations.

Results

A total of 158 patients were included in the study. Out of them, 79 % experienced an improvement or no variation between preoperative expectations and postoperative satisfaction. With regard to the motivation for undergoing surgery, 91 % showed that the surgical procedure met the motivation. An overall positive perioperative change in life was experienced by 93 % of patients.

Conclusions

The E-pgm questionnaire proved to be a valid and reliable tool for the selection of suitable candidates for surgery and for identification of dysmorphophobic patients. Enhancing the doctor–patient relationship and communication can reduce ambiguity and avoid troublesome misunderstandings, litigation and other legal implications.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literature
1.
go back to reference Morselli PG, Boriani F (2012) Should plastic surgeons operate on patients diagnosed with body dysmorphic disorders? Plast Reconstr Surg 130(4):620e–622eCrossRefPubMed Morselli PG, Boriani F (2012) Should plastic surgeons operate on patients diagnosed with body dysmorphic disorders? Plast Reconstr Surg 130(4):620e–622eCrossRefPubMed
2.
go back to reference De Brito MJ, Nahas FX, Ferreira LM (2012) Should plastic surgeons operate on patients diagnosed with body dysmorphic disorders? Plast Reconstr Surg 129(2):406e–407eCrossRefPubMed De Brito MJ, Nahas FX, Ferreira LM (2012) Should plastic surgeons operate on patients diagnosed with body dysmorphic disorders? Plast Reconstr Surg 129(2):406e–407eCrossRefPubMed
3.
go back to reference Picavet V, Gabriëls L, Jorissen M, Hellings PW (2011) Screening tools for body dysmorphic disorder in a cosmetic surgery setting. Laryngoscope 121(12):2535–2541CrossRefPubMed Picavet V, Gabriëls L, Jorissen M, Hellings PW (2011) Screening tools for body dysmorphic disorder in a cosmetic surgery setting. Laryngoscope 121(12):2535–2541CrossRefPubMed
4.
go back to reference Diagnostic and statistical manual of mental disorders (DSM-V) (2013), 5th edn. American Psychiatric Association, Washington D.C Diagnostic and statistical manual of mental disorders (DSM-V) (2013), 5th edn. American Psychiatric Association, Washington D.C
5.
go back to reference Sterodimas A, Radwanski HN, Pitanguy I (2011) Ethical issues in plastic and reconstructive surgery. Aesthet Plast Surg 35(2):262–267CrossRef Sterodimas A, Radwanski HN, Pitanguy I (2011) Ethical issues in plastic and reconstructive surgery. Aesthet Plast Surg 35(2):262–267CrossRef
6.
go back to reference Chung KC, Pushman AG, Bellfi LT (2009) A systematic review of ethical principles in the plastic surgery literature. Plast Reconstr Surg 124(5):1711–1718CrossRefPubMedPubMedCentral Chung KC, Pushman AG, Bellfi LT (2009) A systematic review of ethical principles in the plastic surgery literature. Plast Reconstr Surg 124(5):1711–1718CrossRefPubMedPubMedCentral
7.
go back to reference Crerand CE, Franklin ME, Sarwer DB (2006) Body dysmorphic disorder and cosmetic surgery. Plast Reconstr Surg 118(7):167e–180eCrossRefPubMed Crerand CE, Franklin ME, Sarwer DB (2006) Body dysmorphic disorder and cosmetic surgery. Plast Reconstr Surg 118(7):167e–180eCrossRefPubMed
8.
go back to reference Morselli PG (2008) Maxwell Maltz, psychocybernetic plastic surgeon, and personal reflections on dysmorphopathology. Aesthet Plast Surg 32(3):485–495CrossRef Morselli PG (2008) Maxwell Maltz, psychocybernetic plastic surgeon, and personal reflections on dysmorphopathology. Aesthet Plast Surg 32(3):485–495CrossRef
9.
go back to reference Maltz M (1960) Psycho-cybernetics a way to get more living out life. Prentice-Hall Inc., Englewood Cliffs Maltz M (1960) Psycho-cybernetics a way to get more living out life. Prentice-Hall Inc., Englewood Cliffs
10.
go back to reference Morselli E (1891) Sulla dismorfofobia e sulla tafofobia, due forme non ancora descritte di Pazzia con idee fisse. Bollettino della Regia Accademia delle Scienze Mediche di Genova, VI Morselli E (1891) Sulla dismorfofobia e sulla tafofobia, due forme non ancora descritte di Pazzia con idee fisse. Bollettino della Regia Accademia delle Scienze Mediche di Genova, VI
11.
go back to reference Berrios GE, Kan CS (1996) A conceptual and quantitative analysis of 178 historical cases of dysmorphophobia. Acta Psychiatr Scand 94(1):1–7CrossRefPubMed Berrios GE, Kan CS (1996) A conceptual and quantitative analysis of 178 historical cases of dysmorphophobia. Acta Psychiatr Scand 94(1):1–7CrossRefPubMed
12.
go back to reference Sarwer DB, Crerand CE, Didie ER (2003) Body dysmorphic disorder in cosmetic surgery patients. Facial Plast Surg 19(1):7–18CrossRefPubMed Sarwer DB, Crerand CE, Didie ER (2003) Body dysmorphic disorder in cosmetic surgery patients. Facial Plast Surg 19(1):7–18CrossRefPubMed
13.
14.
go back to reference Sarwer DB (2002) Awareness and identification of body dysmorphic disorder by aesthetic surgeons: results of a survey of American Society for Aesthetic Plastic Surgery members. Aesthet Surg J 22(6):531–535CrossRefPubMed Sarwer DB (2002) Awareness and identification of body dysmorphic disorder by aesthetic surgeons: results of a survey of American Society for Aesthetic Plastic Surgery members. Aesthet Surg J 22(6):531–535CrossRefPubMed
15.
go back to reference Honigman RJ, Phillips KA, Castle DJ (2004) A review of psychosocial outcomes for patients seeking cosmetic surgery. Plast Reconstr Surg 113(4):1229–1237CrossRefPubMedPubMedCentral Honigman RJ, Phillips KA, Castle DJ (2004) A review of psychosocial outcomes for patients seeking cosmetic surgery. Plast Reconstr Surg 113(4):1229–1237CrossRefPubMedPubMedCentral
17.
go back to reference Edgerton MT, Langman MW, Pruzinsky T (1991) Plastic surgery and psychotherapy in the treatment of 100 psychologically disturbed patients. Plast Reconstr Surg 88(4):594–608CrossRefPubMed Edgerton MT, Langman MW, Pruzinsky T (1991) Plastic surgery and psychotherapy in the treatment of 100 psychologically disturbed patients. Plast Reconstr Surg 88(4):594–608CrossRefPubMed
18.
go back to reference Hanes KR (1996) Body dysmorphic disorder and the plastic surgeon. Plast Reconstr Surg 97(5):1082CrossRefPubMed Hanes KR (1996) Body dysmorphic disorder and the plastic surgeon. Plast Reconstr Surg 97(5):1082CrossRefPubMed
19.
go back to reference Morselli PG (2003) Plastic surgery and psychomorphology: a new tool for improving communication between physician and dysmorphopathic patient and for perfecting appropriate patient selection. Aesthet Plast Surg 27(6):485–492CrossRef Morselli PG (2003) Plastic surgery and psychomorphology: a new tool for improving communication between physician and dysmorphopathic patient and for perfecting appropriate patient selection. Aesthet Plast Surg 27(6):485–492CrossRef
20.
go back to reference Morselli PG, Avalon O (2010) Metamorfosi in chirurgia plastica aspetti psicomorfologici. Tecniche Nuove, Milano Morselli PG, Avalon O (2010) Metamorfosi in chirurgia plastica aspetti psicomorfologici. Tecniche Nuove, Milano
21.
go back to reference Morselli PG (1993) The minotaur syndrome: plastic surgery of the facial skeleton. Aesthet Plast Surg 17(2):99–102CrossRef Morselli PG (1993) The minotaur syndrome: plastic surgery of the facial skeleton. Aesthet Plast Surg 17(2):99–102CrossRef
22.
go back to reference Pruzinsky T (1993) Psychological factors in cosmetic plastic surgery: recent developments in patient care. Plast Surg Nurs 13(2):64–69CrossRefPubMed Pruzinsky T (1993) Psychological factors in cosmetic plastic surgery: recent developments in patient care. Plast Surg Nurs 13(2):64–69CrossRefPubMed
23.
go back to reference Mancuso SG, Knoesen NP, Castle DJ (2010) The dysmorphic concern questionnaire: a screening measure for body dysmorphic disorder. Aust N Z J Psychiatry 44(6):535–542PubMed Mancuso SG, Knoesen NP, Castle DJ (2010) The dysmorphic concern questionnaire: a screening measure for body dysmorphic disorder. Aust N Z J Psychiatry 44(6):535–542PubMed
24.
go back to reference Metcalfe DB, Duggal CS, Gabriel A, Nahabedian MY, Carlson GW, Losken A (2014) Prevalence of body dysmorphic disorder among patients seeking breast reconstruction. Aesthet Surg J 34(5):733–737CrossRefPubMed Metcalfe DB, Duggal CS, Gabriel A, Nahabedian MY, Carlson GW, Losken A (2014) Prevalence of body dysmorphic disorder among patients seeking breast reconstruction. Aesthet Surg J 34(5):733–737CrossRefPubMed
25.
go back to reference Felix GA, de Brito MJ, Nahas FX, Tavares H, Cordás TA, Dini GM, Ferreira LM (2014) Patients with mild to moderate body dysmorphic disorder may benefit from rhinoplasty. J Plast Reconstr Aesthet Surg 67(5):646–654CrossRefPubMed Felix GA, de Brito MJ, Nahas FX, Tavares H, Cordás TA, Dini GM, Ferreira LM (2014) Patients with mild to moderate body dysmorphic disorder may benefit from rhinoplasty. J Plast Reconstr Aesthet Surg 67(5):646–654CrossRefPubMed
26.
go back to reference Picavet VA, Gabriëls L, Grietens J, Jorissen M, Prokopakis EP, Hellings PW (2013) Preoperative symptoms of body dysmorphic disorder determine postoperative satisfaction and quality of life in aesthetic rhinoplasty. Plast Reconstr Surg 131(4):861–868CrossRefPubMed Picavet VA, Gabriëls L, Grietens J, Jorissen M, Prokopakis EP, Hellings PW (2013) Preoperative symptoms of body dysmorphic disorder determine postoperative satisfaction and quality of life in aesthetic rhinoplasty. Plast Reconstr Surg 131(4):861–868CrossRefPubMed
27.
go back to reference Moss TP, Harris DL (2009) Psychological change after aesthetic plastic surgery: a prospective controlled outcome study. Psychol Health Med 14(5):567–572CrossRefPubMed Moss TP, Harris DL (2009) Psychological change after aesthetic plastic surgery: a prospective controlled outcome study. Psychol Health Med 14(5):567–572CrossRefPubMed
Metadata
Title
Eumorphic Plastic Surgery: Expectation Versus Satisfaction in Body Dysmorphic Disorder
Authors
Paolo Giovanni Morselli
Alessandro Micai
Filippo Boriani
Publication date
01-08-2016
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 4/2016
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-016-0655-4

Other articles of this Issue 4/2016

Aesthetic Plastic Surgery 4/2016 Go to the issue