If the feeling of “being unattractive” has reached the point where you constantly check your reflection and obsess over changes, get a body image assessment before considering surgery.

When we combine data from 33 studies, we find that 15.04% of people seeking cosmetic surgery meet the criteria for body dysmorphic disorder — a condition where a flaw barely noticeable to others becomes a major source of distress. Among dermatology patients seeking cosmetic treatments, the rate is 12.65%. In both groups, over 70% are women. Surgery can alter facial features, but it cannot break the cycle of constant self‑scrutiny and dissatisfaction; this often leads to repeated operations. Spending a modest amount on an initial evaluation can help determine whether you fall into this category, guiding your decision about surgery.

A single visit to a psychiatrist or clinical psychologist costs only a few dozen yuan. The real challenge is making that appointment before scheduling any surgery.

A comprehensive review of those 33 studies shows that the prevalence of body dysmorphic disorder among cosmetic surgery patients is 15.04%, with individual study estimates ranging from 2.21% to 56.67%. Roughly 15 out of every 100 patients fit this description, though some studies report as few as 2 or as many as 57. The average age of these patients is 34.54 ± 12.41 years, and 74.38% are female. Among dermatology patients, the rate is 12.65%, with study figures ranging from 4.52% to 35.16%; their average age is 27.79 ± 9.03 years, and 76.09% are female. Researchers recommend that plastic surgeons and dermatologists proactively screen for this disorder and coordinate care across specialties.

The reported prevalence varies widely — from 2.21% up to 56.67% — because different studies use distinct questionnaires and populations. Thus we can only conclude that this condition is fairly common and warrants screening; the 15.04% figure should not be taken as an exact statistic. This is why it is graded B. Importantly, most people seeking cosmetic treatments do not have psychological issues; only a small subset — those whose preoccupation is persistent, interferes with work or social life, and leads to repeated surgical attempts — are at risk. Warning signs include spending excessive time each day inspecting or concealing a body part, avoiding social interactions or photos, and constantly fixating on new areas after previous corrections. 〔13〕

Ribeiro RVE (2017). Prevalence of Body Dysmorphic Disorder in Plastic Surgery and Dermatology Patients: A Systematic Review with Meta-Analysis. Aesthetic Plast Surg. https://doi.org/10.1007/s00266-017-0869-0；Crerand CE, Phillips KA, Menard W, Fay C (2005). Nonpsychiatric medical treatment of body dysmorphic disorder. Psychosomatics, 46(6), 549-555. https://doi.org/10.1176/appi.psy.46.6.549；NHS. Body dysmorphic disorder (BDD). https://www.nhs.uk/mental-health/conditions/body-dysmorphia/