| EDITORIAl
changing perceptions with regard to appearance. however, while many cases of female genital surgery over the past 3 years were to correct
R Affiliated partners:
a medical problem (such as discomfort), it is estimated that the majority of women are actually worried about the appearance of their vagina, with referrals even being made for girls of school age (including one as young as 11 years of age, according to the British Journal of Obstetrics and Gynaecology). while appearance and aesthetics are a very important part of our business, these findings
can inevitably be linked to another report from belgium, which details that 43% of patients undergoing rhinoplasty exhibit signs of body dysmorphic disorder (bdd). working in an industry in which appearance is everything, it is perhaps a duty that we owe to patients to consider aspects of bdd and other mental health conditions before undertaking any treatment — invasive or non-invasive. bdd is an anxiety disorder in which sufferers are constantly
Those with BDD are
preoccupied with what they consider to be a defect in their appearance
that may be non‑existent.
dissatisfied with their appearance. while the majority of us have ‘hang-ups’ concerning our appearance, those with bdd are preoccupied with what they consider to be a defect in their appearance that is either non-existent, or something others would not notice or consider important. this distorted view of themselves leads to the development of time-consuming rituals in order to hide the perceived defect(s) (e.g. excessive checking of appearance in mirrors, excessive grooming, camouflaging with clothes and/or make-up). however, research has shown that surgical procedures do not help to allay the fears and obsessions of the sufferer. indeed, dr phillip haeck, american society of plastic surgeons, advises:
‘the biggest mistake is to offer to operate, because the chances that they will be satisfied
afterward ... are very low. ‘often patients who have [bdd] can’t stop looking at themselves. when i’ve encountered cases
like this, i’ve found it difficult to make eye contact. they tend to stand at the mirror in the examination room and look at themselves throughout the exam.’ in the study published in the British Journal of Obstetrics and Gynaecology1
, of the 33 women
who asked for surgery, only three were offered surgery. of those refused, 12 were still keen to pursue surgery by another route, 11 accepted a referral to psychological services, and one participant was referred to mental health services.
Rosalind Hill managing editor, PRIME
rosalind.hill@informa.com;
twitter.com/primeJournal
1. Crouch NS, Deans R, Michala L, Liao L-M, Creighton SM. Clinical characteristics of well women seeking labial reduction surgery: a prospective study. BJOG 2011 [Epub ahead of print]
epoRts have suRfaced in the uK of moRe and moRe women being referred, by their general practitioner (gp), for female genital cosmetic surgery on the nhs (national health service). the so-called ‘designer vagina’ has certainly increased in popularity over the
past decade, with many believing future demand for this type of surgery is potentially endless owing to a generally growing desire for cosmetic surgery and
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prime-journal.com | September 2011 ❚ 3
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