If “feeling ugly” has reached the point of checking the mirror again and again and wanting to change it again and again, get a body-image assessment before talking about surgery

Moderate value
Evidence B
Buys life
Costs a little
Takes some hours
Some willpower

In plain words

About 15% of people who go for plastic surgery have body dysmorphic disorder (躯体变形障碍), which means blowing up a flaw that others can barely see until it affects your life. Among people who go to a dermatologist for cosmetic treatment it is about 13%, and in both groups more than 70% are women. Such a person finishes one area and then fixes on the next, and surgery can't solve it. First register for one visit to see whether this is your situation, and then decide whether to have surgery.

Cost: One registration at psychiatry or clinical psychology, a few dozen CNY. The hard part is making this trip before you book the surgery.
What you get: Following proper methods, 33 studies were gathered and pooled. Among patients at plastic surgery clinics, the prevalence of body dysmorphic disorder (blowing up a flaw that others can barely see until it affects life) was 15.04%, ranging across studies from 2.21% to 56.67%. In terms of people, about 15 of every 100 people going for plastic surgery qualify, while by individual study the figure runs from 2 to 57. The average age of this group was 34.54±12.41 years (the second number is the range of spread), and 74.38% were women. Among dermatology patients it was 12.65%, ranging across studies from 4.52% to 35.16%, with an average age of 27.79±9.03 years and 76.09% women. The authors recommend that plastic surgeons and dermatologists proactively assess patients, identify those at high risk, and arrange for several departments to manage them together.
Notes: The proportions measured in the studies range from 2.21% all the way to 56.67%, a huge spread. The reason is that the questionnaires and the populations surveyed were different. So all you can read from it is that “this proportion is not low and worth screening once”; 15.04% should not be treated as an exact number, which is also why it is rated B. The great majority of people who want medical cosmetology have no psychological problem. This item is aimed at the small group whose concern is “repeated, persistent, and already affecting work and social life,” and surgery will not solve their problem. Clues include these: spending a long time each day checking or covering up one body part, avoiding social situations or photos because of it, and fixing on the next area after finishing one.
Evidence grade: B : Supported by research but without a precise number, or based on small or single studies.
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

Translated from the Chinese original. Original book, section 28, tip 8. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer