Outcomes of Aesthetic Treatment in Individuals with Body Dysmorphic Disorder in Hospital and Outpatient Settings: A Scoping Review

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Abstract
Background/Objectives: Body dysmorphic disorder (BDD) is characterized by a persistent and intrusive preoccupation with a perceived defect in physical appearance, associated with significant psychosocial impairment. Individuals with BDD frequently seek aesthetic and cosmetic procedures to correct the perceived flaw, yet cosmetic treatment has traditionally been regarded as a relative contraindication in this population, often associated with unsatisfactory outcomes and symptom exacerbation. However, more recent evidence has been heterogeneous, keeping the relationship between BDD and aesthetic treatment outcomes controversial. This scoping review aimed to map the literature of the last decade on the clinical, psychological, and behavioral outcomes of surgical and non-surgical aesthetic procedures performed on individuals with BDD. Methods: This review was conducted according to the Joanna Briggs Institute (JBI) methodology for scoping reviews and reported in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR). PubMed, Scopus, and EBSCOhost were searched for studies published between 2016 and February 2026 reporting clinical, psychological, or behavioral outcomes of aesthetic procedures (surgical or minimally invasive) in samples with a formal BDD diagnosis or a positive screening result. Study selection and data charting were performed independently by two reviewers. Results: Of 419 records identified, 17 primary studies published between 2016 and 2026 met the inclusion criteria. The included studies varied considerably in design, sample size, BDD assessment methods, aesthetic procedures, outcome measures, and follow-up duration. Several studies reported improvements in BDD-related measures, changes in screening classification, or favorable postoperative satisfaction, whereas others reported less favorable findings. Psychological and behavioral outcomes were assessed inconsistently, and broader psychiatric safety outcomes were rarely investigated. The heterogeneity of the available evidence limited direct comparisons and prevented conclusions regarding treatment effectiveness or psychological safety. Conclusions: The available evidence is limited and highly heterogeneous in study design, populations, procedures, outcome measures, and follow-up duration, and most samples were identified through screening instruments rather than diagnostic interviews. Although several studies reported postoperative improvement and satisfaction in some individuals with BDD symptoms, these findings do not establish the efficacy of aesthetic treatment for BDD and should be interpreted with caution. Future research should jointly examine preoperative BDD severity and treatment expectations as potential predictors of postoperative outcomes.

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