Rhinoplasty or nose job surgery is not only one of the most difficult facial plastic surgeries to perform, but the results can also change a person’s appearance the most drastically. Of course, many who seek this plastic surgery procedure desire exactly that–but a new study reveals that 33% of patients considering cosmetic nose job surgery show symptoms of a chronic condition called body dysmorphic disorder (BDD).

BDD is a type of mental illness in which negative thoughts of body image overwhelm someone to the point that it negatively affects his or her life, getting in the way of healthy relationships, careers, and socializing. The disorder can lead to suicidal thoughts, eating disorders, depression, anxiety and — as seen in this study — unnecessary cosmetic surgery.

Because the rate of BDD is so high in rhinoplasty patients (and even higher in those patients who have already had a nose job previously),  it is especially important for the doctor to take a detailed psychological evaluation during the consultation to make sure that the patient is mentally healthy before authorizing this plastic surgery procedure. Rhinoplasty is a team approach: you, the patient, have to come in with realistic expectations and sound motivation, and I, the facial plastic surgeon, will provide noticeable and natural results.