Body Dysmorphia And The Dark Side of Cosmetic Surgery

November 15, 2018

Can you trust what you see in the mirror?

We all experience moments when something on our faces or bodies doesn’t look right.

Maybe your thighs feel like tree trunks, your nose seems too wide (or too thin). Or perhaps you’re bothered by acne scars or birthmarks.

For many of us, these feelings are normal and fleeting. But, according to the American Society of Plastic Surgeons, unhappiness with one’s weight, complexion or body parts is agonizing and self-destructive for two percent of Americans – and as many as 15 per cent of cosmetic surgery patients.

Millions of us are ashamed to admit we hate our reflections. In our eyes, small flaws are monstrous. Mirrors are instruments of torture. And these obsessive worries can snowball into depression, self-harm and even suicide.

More than meets the eye

“I thought I was truly hideous,” recalls Charlotte MacNeil of her 19 year-old self.

“It was an obsession that absorbed most of my waking minutes. I found it hard to leave the house. I stayed in, staring at my face, self-harming with razor blades.

“I just thought I was ugly. I didn’t think I had a psychological problem.”

For years, Charlotte suffered from body dysmorphic disorder (BDD), a legitimate psychological syndrome that’s more than just perfectionism or wanting to “look pretty”.

This insatiable preoccupation can drive otherwise smart and capable people to seek out plastic surgeons in hopes of re-sculpting their faces or bodies into imaginary and unattainable ideals.

Famous sufferers are ridiculed in the media, such as New York multi-millionaire Jocelyne Wildenstein, whose misguided surgical attempts to stretch her eyes and face into the shape of a lynx’s have earned her nicknames like “Catwoman” and the “Bride of Wildenstein.”

Jocelyne Wildenstein has become, to many, the poster child of BDD.

More recently, Ukrainian model Valeria Lukyanova, dubbed the “Human Barbie,” has captivated digital tabloid headlines. Compared to photos from years ago, her current appearance suggests Valeria has had various surgeries to obtain her tiny, aquiline nose, round, doll-like face and top-heavy hourglass figure.

But she recently denied those claims in a 2016 interview with website, toofab.com.

“We all have changed since childhood,” she insisted.

“From the age of 14 years, I have not particularly changed, except for body and hair color.”

Cosmetic surgeries promise quick fixes, but they’re really invasive procedures with serious medical risks. Reactions to general anesthesia, accidental organ perforation or post-operative infections are all possible complications.

But besides risking those and other permanent damage, such as collapsed muscles or excess scar tissue, women with BDD also face a difficult emotional road riddled with disappointment.

The bitter irony is that even when someone with BDD achieves their longed-for procedure, they’re almost inevitably unhappy with the results. A startling 81 percent of patients reported dismay with previous cosmetic enhancements, according to a 50-person study in the British Journal of Psychiatry. 

That’s because, like the old adage says, beauty really is in the eye of the beholder. BDD is a trickster, a mental distortion of how you really look.

It typically strikes at age 12 or 13, and is rooted in the seeds of anxiety and obsessive compulsive disorder, psychiatrists say, rendering its victims unable to see their often reflections accurately.

“It’s not your fault. You’re dealing with a brain glitch that’s causing you a lot of pain and suffering,” explains BDD specialist and clinical psychologist, Dr Paul Gilbert.

“If you just hate yourself, you’re creating an internal environment where it’s very difficult to feel anything but anxious and depressed.”

A gentle approach

Gilbert founded ‘compassion focused’ therapy, which uses techniques from cognitive behavioral therapy to help people with extreme shame and self-criticism learn to be kinder and more accepting of themselves. He educates mental health professionals on how to treat people with dysmorphia issues.

In the general practice and cosmetic surgery field, doctors are getting better at recognizing BDD with the help of compassionate, standardized questions.

A doctor might ask, “How much time would you estimate that you spend each day thinking about your appearance, if you were to add up all the time you spend?” foremost BDD expert and author of The Broken Mirror, Dr Katharine A. Phillips suggests.

Sufferers of BDD can’t see what we see when they look in the mirror.

“Thinking about perceived flaws for at least one hour a day” is a sign of BDD, she says, although many patients report worrying about upsetting features as much as three to 8 hours every day.

Some sufferers also commonly seek reassurance that they “look okay,” according to the non-profit organization, Mental Health America.

Other telltale symptoms you might notice are anxious, repetitive behaviors such as hair pulling, skin picking or scratching, excessive grooming, mirror checking and nail or cheek biting, MHA says.

Charlotte confesses that she indulged in several of these habits throughout her teens and 20s as she struggled for help and understanding.

“It was such a relief to get that diagnosis. I remember crying, just thinking, ‘Finally, this feels right. This is what I need help with’. I had several sessions of therapy which really moved me along, mainly helping me take a step back from my thoughts about my face and realizing what they really were; symptoms of an anxiety disorder, and not actually a problem with my face.”

With the help of anti-depressants (serotonin reuptake inhibitors are preferred for people with BDD, Dr Phillips says), group support and cognitive behavioral therapy, Charlotte says she was finally able to find relief from her inner demons.

“I’m now 41, and haven’t had any serious dysmorphic thoughts for years. I even have times where I look in the mirror and feel quite pleased with what I see, which I think is amazing, considering where I was.”

Images via shutterstock.com.

Comment: Have you ever felt obsessed about something to do with your appearance?

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