28-008 · EVIDENCE B · SOURCE-SENSITIVE
If the feeling of “being unattractive” has reached the point where you constantly check your reflection and obsess over changes, get a body image assessment before considering surgery.
如果「觉得自己丑」已经到反复照镜子、反复想改的程度，先做一次体像评估再谈手术
A single visit to a psychiatrist or clinical psychologist costs only a few dozen yuan. The real challenge is making that appointment before scheduling any surgery.
When we combine data from 33 studies, we find that 15.04% of people seeking cosmetic surgery meet the criteria for body dysmorphic disorder — a condition where a flaw barely noticeable to others becomes a major source of distress. Among dermatology patients seeking cosmetic treatments, the rate is 12.65%. In both groups, over 70% are women. Surgery can alter facial features, but it cannot break the cycle of constant self‑scrutiny and dissatisfaction; this often leads to repeated operations. Spending a modest amount on an initial evaluation can help determine whether you fall into this category, guiding your decision about surgery.
B
Move “If the feeling of “being unattractive” has reached the point where you constantly check your reflection and obsess over changes, get a body image assessment before considering surgery.” to Future Me's calendar
The excuse
There is no immediate alarm, so the sensible choice can wait for a less busy week.
What feels good now
Today I keep a little money, a few minutes, a bit of persistence and avoid interrupting my default routine.
What the source says
The source summarizes the return this way: “When we combine data from 33 studies, we find that 15.04% of people seeking cosmetic surgery meet the criteria for body dysmorphic disorder — a condition where a flaw barely noticeable to others becomes a major source of distress. Among dermatology patients seeking cosmetic treatments, the rate is 12.65%. In both groups, over 70% are women. Surgery can alter facial features, but it cannot break the cycle of constant self‑scrutiny and dissatisfaction; this often leads to repeated operations. Spending a modest amount on an initial evaluation can help determine whether you fall into this category, guiding your decision about surgery.” Evidence grade B. The original states the population, caveats, and sources; this is not a personal forecast.
Use the original facts and limits. For an urgent medical, safety, financial, or legal issue, contact a qualified local professional or service.
THE ENGLISH EDITION
Original recommendation and evidence
8. If the feeling of “being unattractive” has reached the point where you constantly check your reflection and obsess over changes, get a body image assessment before considering surgery.
Cost: A single visit to a psychiatrist or clinical psychologist costs only a few dozen yuan. The real challenge is making that appointment before scheduling any surgery.
In plain terms: When we combine data from 33 studies, we find that 15.04% of people seeking cosmetic surgery meet the criteria for body dysmorphic disorder — a condition where a flaw barely noticeable to others becomes a major source of distress. Among dermatology patients seeking cosmetic treatments, the rate is 12.65%. In both groups, over 70% are women. Surgery can alter facial features, but it cannot break the cycle of constant self‑scrutiny and dissatisfaction; this often leads to repeated operations. Spending a modest amount on an initial evaluation can help determine whether you fall into this category, guiding your decision about surgery.
Benefit: A comprehensive review of those 33 studies shows that the prevalence of body dysmorphic disorder among cosmetic surgery patients is 15.04%, with individual study estimates ranging from 2.21% to 56.67%. Roughly 15 out of every 100 patients fit this description, though some studies report as few as 2 or as many as 57. The average age of these patients is 34.54 ± 12.41 years, and 74.38% are female. Among dermatology patients, the rate is 12.65%, with study figures ranging from 4.52% to 35.16%; their average age is 27.79 ± 9.03 years, and 76.09% are female. Researchers recommend that plastic surgeons and dermatologists proactively screen for this disorder and coordinate care across specialties.
Evidence grade: B
Sources: Ribeiro RVE (2017). Prevalence of Body Dysmorphic Disorder in Plastic Surgery and Dermatology Patients: A Systematic Review with Meta-Analysis. Aesthetic Plast Surg. <https://doi.org/10.1007/s00266-017-0869-0>
Notes: The reported prevalence varies widely — from 2.21% up to 56.67% — because different studies use distinct questionnaires and populations. Thus we can only conclude that this condition is fairly common and warrants screening; the 15.04% figure should not be taken as an exact statistic. This is why it is graded B. Importantly, most people seeking cosmetic treatments do not have psychological issues; only a small subset — those whose preoccupation is persistent, interferes with work or social life, and leads to repeated surgical attempts — are at risk. Warning signs include spending excessive time each day inspecting or concealing a body part, avoiding social interactions or photos, and constantly fixating on new areas after previous corrections. 〔13〕
Read the complete Chinese source and notes
8. 如果「觉得自己丑」已经到反复照镜子、反复想改的程度，先做一次体像评估再谈手术
成本: 去精神科或者临床心理科挂一次号，几十元。难的是在约手术之前先去这一趟。
说人话: 去做整形手术的人里约 15% 有躯体变形障碍，就是把别人基本看不出的缺陷放大到影响生活。去皮肤科求美的人里约 13%，两边都是七成多为女性。这种人做完一处又会盯上下一处，手术解决不了。先挂一次号看看自己是不是这种情况，再决定动不动手术。
收益: 按规矩把 33 项研究找齐再合起来算。整形外科就诊者中，躯体变形障碍（把别人基本看不出的缺陷放大到影响生活）患病率 15.04%，各项研究在 2.21%–56.67% 之间。换成人数，每 100 个去做整形的人里约 15 个符合，单看各项研究则从 2 个到 57 个不等。这批人平均年龄 34.54±12.41 岁，后一个数是上下浮动的幅度，74.38% 为女性。皮肤科就诊者是 12.65%，各项研究在 4.52%–35.16% 之间，平均年龄 27.79±9.03 岁，76.09% 为女性。作者建议整形外科医师与皮肤科医师主动评估、把高风险的人认出来，并安排几个科室一起管
证据等级: B
来源: Ribeiro RVE (2017). Prevalence of Body Dysmorphic Disorder in Plastic Surgery and Dermatology Patients: A Systematic Review with Meta-Analysis. Aesthetic Plast Surg. <https://doi.org/10.1007/s00266-017-0869-0>
备注: 各项研究测出来的比例从 2.21% 一直到 56.67%，差得极大。原因是用的问卷和调查的人群都不一样。所以只能读出「这个比例不低、值得先筛一次」，不能把 15.04% 当准确数字，记 B 级也是因为这个。想做医美的人绝大多数没有心理问题。本条针对的是「反复、持续、已经影响到工作和社交」这一小部分人，手术解决不了他们的问题。判断线索有这几条：一天里花很长时间检查或者遮挡某个部位，因此回避社交或者拍照，做完一处又盯上下一处。
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