How common is plastic surgery addiction?

The media often portrays examples of people who suffer from body dysmorphia and who become "addicted" to plastic surgery procedures - so much so that it gives the impression that it's actually quite a common thing.

Some of these people obviously have gender issues (ex: the guy who wants to look like Kim Kardashian http://www.mirror.co.uk/tv/tv-news/see-male-kim-kardashian-wannabes-8591385), while others are obsessed with physical defects that they may or may not have.

How common are such cases? Have you seen many throughout your career? What do you say to people who come in to your practice with expectations and behaviours that suggest underlying personality issues?

9HopeHarp

F, 54, New York

Body Dysmorphic Disorder, fortunately, is not as common as it is portrayed in the media. Most plastic surgery patients are well grounded individuals who have realistic expectations about what surgery can and cannot do for them. I have seen a number of patients in my career whom I thought had unrealistic expectations ("I want celebrity X's nose") or who thought one of their features was horribly awful when in reality it was barely perceptible. When it comes to these folks, I believe honesty is the best policy. As a surgeon, it is ok to say "I don't think you need ANY surgery". They may not like that answer and find someone else who will. I feel its best to be honest and ethical and sometimes that means not operating on someone who may have other more pressing issues.