I am passionate about mentoring young women and men who are interested in careers in plastic surgery, and the below article comes from a bright, intelligent high schooler who is working toward what will certainly be a promising career in medicine. -Lara Devgan, MD, MPH
What Reid Ewing Can Teach Us About Body Dysmorphia
By Noelle Garbaccio
Television actor Reid Ewing, who plays Dylan on the hit show Modern Family, has recently made headlines for his struggles with his self-image.
Just last month, Ewing penned an editorial in the Huffington Post entitled “I Underwent Cosmetic Surgery for My Body Dysmorphia…And I Wish I Hadn’t.” Published on November 19, the intimate narrative discloses Dylan’s struggle with body dysmorphia.
According to the Anxiety and Depression Association of America, body dysmorphic disorder (BDD) is a “body image disorder characterized by persistent and intrusive preoccupations with an imagined or slight defect in one’s appearance.” Faults are most frequently identified in the hair, skin, nose, chest, and stomach. Individuals with BDD can spend an entire day trying to mask or improve perceived perfections, and many resort to cosmetic surgery in an attempt to correct them.
The International OCD Foundation article, “Cosmetic Treatments and Body Dysmorphic Disorder,” reports that 26-50% of individuals with BDD pursue plastic surgery, but the operations rarely appease patients’ concerns. Body dysmorphic disorder is consequently considered a contraindication to plastic surgery: because surgery cannot alleviate the symptoms of BDD, people with BDD should not undergo surgery.
Reid Ewing’s experience emphasizes why cosmetic surgery should not be considered for patients with body dysmorphia. When he moved to Los Angeles at 19, Ewing would “sit alone in [his] apartment and take pictures of [himself] from every angle, analyzing every future,” a practice that would occupy the majority of his time. Ewing wrote, “After a few years of doing this, one day I had to get cosmetic surgery. ‘No one is allowed to be this ugly,’ I thought. ‘It’s unacceptable.’”
Because body dysmorphia is a psychological condition, people like Ewing who find themselves preoccupied with their physical appearance or perseverating on a perceived flaw are unlikely to find satisfaction in plastic surgery. Rather, psychologic or psychiatric treatment is considered the gold standard in helping people with BDD get back to feeling self-assured.
Ewing is not alone. A 1998 study by the American Society of Plastic Surgeons found that 7% of cosmetic surgery patients meet BDD criteria. (Plast. Reconstr. Surg. 101: 1644, 1998) Rhinoplasties are among the most common procedures for individuals with body dysmorphia, with 21% of rhinoplasty patients meeting BDD criteria.
Although cosmetic surgery is a great option for some patients, it is not the appropriate choice for everyone.
It is certainly not unusual for a plastic surgery patient to dislike certain aspects of his or her physical appearance. However, if your physical imperfections are preoccupying you, causing you anguish, or altering your life, you may have BDD.
Patients with body dysmorphic disorder should address their BDD before seeking surgical solutions. If you think that you may have body dysmorphia, take a self-test here.
"Body Dysmorphic Disorder (BDD) | Anxiety and Depression Association of America." Anxiety and Depression Association of America, ADAA. N.p., n.d. Web. 25 Nov. 2015. <http://www.adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd>.
Ewing, Reid. "I Underwent Cosmetic Surgery for My Body Dysmorphia... And I Wish I Hadn't."The Huffington Post. N.p., 19 Nov. 2015. Web. 22 Nov. 2015. <http://www.huffingtonpost.com/reid-ewing/reid-ewing-body-dysmorphia_b_8593076.html>.
Kelly, Megan M., PhD, Elizabeth R. Didie, PhD, and Ashley S. Hart, PhD. "Cosmetic Treatments and Body Dysmorphic Disorder." International OC Foundation. N.p., n.d. Web. 23 Nov. 2015. <https%3A%2F%2Fbdd.iocdf.org%2Fexpert-opinions%2Fcosmetic-treatments-and-bdd%2F>.