Healing from a rhinoplasty with body dysmorphic disorder. What should I expect?

Rhinoplasty is a very psychological surgery. If there is any concern of body dysmorphic disorder then you must consult with the therapist and or a psychiatrist to ensure healthy recovery physically and mentally.

Also it is very important to not rely on computer imaging as it will give you a perfect nose and you will not see it after surgery.

Regards

Dr. J

Believe it or not, you're not alone. 13% of people who request rhinoplasty have Body Dysmorphic Disorder (BDD), and surgery on those with BDD should be avoided. Why? Rhinoplasty is not a "cure" for BDD, and may lead to exacerbation of BDD. Some feel that a personal history of BDD is a "contraindication" for offering rhinoplasty since it tends to make the disorder worse, not better.

That said, you have a challenging finesse rhinoplasty since you appear to have very thin nasal skin which is unforgiving insofar as being prone to showing stigmata of previous surgery...

The best person to get initial clearance from, before asking the opinions of facial plastic surgeons, is the psychiatrist who is managing your BDD. I hope this is helpful, and thank you for this excellent question. Sincerely, Dr Joseph

If you had bdd related to your nose then there would be benefit from rhinoplasty. I think you are an excellent candidate for rhinoplasty and it does not indicate to me a bdd issue

First of all, most patients with BDD are not aware of the fact that they have it. With psychotherapy, patients can gain insight into why they are overly concerned about the slightest imperfections in their physical appearanc. Secondly, surgery is NOT a treatment for BDD and in fact should only be considered carefully after many months of therapy to address the underlying psychological issues. Many of the psychological triggers for BDD stem from adverse childhood experiences and these absolutely need to be worked out before considering elective surgery. If you have worked extensively with a psychotherapist, and you both agree that surgery is reasonable at this point, I would urge you to consider a non-operative rhinoplasty first. Using filler, the slight imperfections in your nose can be addressed and while these changes are long -lasting; they are reversible. By adding filler, the reversible non-operative changes can help you and your surgeon with further discussions about your desires and expectations for the shape of your nose. It will also help your surgeon understand that your goals and desires can be satisfied as most patients with true BDD are never satisfied even with the most exceptional result. Good luck to you and your surgeon.

Good Morning! Great question. BDD as you know can be very challenging. A finesse rhinoplasty will likely accomplish your goals that you're showing. But, sometimes we can't get exactly the outcome we hope for. Having flexibility regarding your outcome and healing will help keep your expectations realistic. Healing can vary in rhinoplasty. Thin skinned tips tend to improve faster than thicker skinned ones. But, everyone varies and I tell patients it takes well through 6 months to heal with a finesse rhinoplasty. Patience is the largest part and flexibility regarding the final result. If one of my patients has someone who advises them regarding their BDD (i.e. psychologist), I make sure a plan is in place so we achieve the best possible outcome. Hope this helps!