Prevalence of Body Dysmorphic Disorder Among Patients Seeking Breast Reconstruction.
BACKGROUND
Body dysmorphic disorder (BDD) is characterized by a preoccupation with a slight or imagined defect in physical appearance. It has significant implications for patients who desire breast reconstruction, because patient satisfaction with the aesthetic outcome is a substantial contributor to the success of the procedure.


OBJECTIVES
The authors estimated the prevalence of BDD among women seeking breast reconstruction by surveying patients with the previously validated Dysmorphic Concerns Questionnaire (DCQ).


METHODS
One hundred eighty-eight women who presented for immediate or delayed breast reconstruction completed the DCQ anonymously, during initial consultation with a plastic surgeon. Two groups of respondents were identified: those who desired immediate reconstruction and those who planned to undergo delayed reconstruction. The prevalence of BDD among breast reconstruction patients was compared between the 2 groups, and the overall prevalence was compared with published rates for the general public.


RESULTS
Body dysmorphic disorder was significantly more prevalent in breast reconstruction patients than in the general population (17% vs 2%; P < .001). It also was much more common among patients who planned to undergo delayed (vs immediate) reconstruction (34% vs 13%; P = .004).


CONCLUSIONS
Relative to the general public, significantly more women who sought breast reconstruction were diagnosed as having BDD. Awareness of the potential for BDD will enable clinicians to better understand their patients' perspectives and discuss realistic expectations at the initial consultation. Future studies are warranted to examine the implications of BDD on patient satisfaction with reconstructive surgery.


LEVEL OF EVIDENCE
3.
['Metcalfe|Drew B|DB|', 'Duggal|Claire S|CS|', 'Gabriel|Allen|A|', 'Nahabedian|Maurice Y|MY|', 'Carlson|Grant W|GW|', 'Losken|Albert|A|']
D000328:Adult D000368:Aged D057215:Body Dysmorphic Disorders D019928:Breast Implantation D002170:Canada D004954:Esthetics D005260:Female D006801:Humans D008875:Middle Aged D010342:Patient Acceptance of Health Care D017060:Patient Satisfaction D015995:Prevalence D011795:Surveys and Questionnaires D013997:Time Factors D016896:Treatment Outcome D014481:United States
breast reconstruction body dysmorphic disorder (BDD) Dysmorphic Concerns Questionnaire (DCQ) mastectomy tissue expander transverse rectus abdominis myocutaneous (TRAM) flap