High Prevalence of Body Dysmorphic Disorder Among Rhinoplasty Candidates: Insights From a Cross-Sectional Study in Saudi Arabia.

Background Body dysmorphic disorder (BDD) is a psychiatric disorder characterized by excessive preoccupation with a perceived defect in one's appearance. Patients with BDD often seek cosmetic surgery to correct their perceived defect. Rhinoplasty is one of the most requested cosmetic surgeries. Our study aims to determine the prevalence of BDD among patients desiring rhinoplasty. Methods In a cross-sectional study using the Body Dysmorphic Disorder Questionnaire-Aesthetic Surgery (BDDQ-AS), we evaluated BDD prevalence in 340 participants who expressed a desire for rhinoplasty.  Results We found that among 340 participants, 143 (43.3%) expressed a desire for rhinoplasty, with the majority being females (83.8%), and a prevalence of BDD among participants was 37.6%. It was also observed that the willingness to have rhinoplasty was significantly associated with BDD (p < 0.001), with 53.1% of participants expressing a wish for rhinoplasty screening positive for BDD.  Our findings underscore the need for BDD screening in rhinoplasty candidates to prevent dissatisfaction and improve postoperative outcomes. Logistic regression analysis identified significant predictors of BDD, with female gender demonstrating a substantial impact (OR = 4.26, 95% CI: 1.99-10.3, p < 0.001). This means that females are over four times more likely to experience BDD compared to males, highlighting a critical gender disparity. Similarly, the desire for rhinoplasty was strongly associated with BDD prevalence (OR = 3.45, 95% CI: 2.15-5.59, p < 0.001), indicating that individuals seeking rhinoplasty are more than three times as likely to have BDD compared to those without this desire. These findings underscore the importance of gender-specific screening and psychological evaluation, particularly for patients considering rhinoplasty, to identify and address potential body image concerns effectively. Conclusion Our study highlights the critical need for integrating mental health assessments into the preoperative process and standard practice for all rhinoplasty candidates to identify potential psychological concerns early. However, follow-up mental health support should be reserved for those who exhibit significant dissatisfaction with the results or show persistent BDD symptoms. It shows that BDD prevalence among individuals desiring rhinoplasty was high at 53.1%, and individuals who have a desire for rhinoplasty were 3.45 times more likely to screen positive for BDD than those with no desire.