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Body Image
I Had Cosmetic Surgery to Appease My Body Dysmorphia
One person’s struggle with body dysmorphia.
Posted July 6, 2023 Reviewed by Gary Drevitch
Key points
- Body dysmorphia causes so much shame that people often avoid talking about it, even with their therapist.
- Choosing cosmetic surgery is a difficult decision infiltrated with a mix of shame and hope.
- In the end, cosmetic surgery is more about improving one's confidence than one's looks.
- Recovering from body dysmorphia lets someone start living their life.
From research studies, we know that body dysmorphic disorder (BDD) is a serious biological disease that manifests in debilitating thoughts and behaviors. In many ways, body dysmorphia resembles a mix of obsessive compulsive disorder, anxiety, and in some cases even psychosis. Most people with BDD struggle with shame about minor or invisible features of their body, and it often leads them to avoid social situations.
While there are evidence-based therapies for BDD, many people do not receive treatment, and some even resort to cosmetic surgery. For people who have not experienced BDD, it can be difficult to comprehend why someone would go so far as to get surgery to correct an imperfection no one else can see.
For this post, I interviewed "LO," a 29-year-old woman in Germany, first one month before, and then seven weeks after, the cosmetic surgery she chose to get to address her BDD.
Looking back, she does not regret it.
One month before surgery, LO tells me what motivated her to make this decision.
“My nose was the first thing to grow to adult size, and that’s where my body dysmorphia comes from" —LO
LO has always hated her nose, and while she comes from a family lineage of large noses, hers always stood out as different. Breaking her nose later in life caused a slightly deviated septum, which further aggravated her BDD concerning it. She could see everything that was wrong with her nose: too large, too crooked, too deviated. The fact that no one else could see it was never enough to change her mind. “I am very ashamed of my nose. I feel like everyone looks at my nose and I obsess over noses, both my own and others." LO avoids cameras and cringes every time she passes a mirror. To this day, her nose takes up more space in her mind than it does on her face.
Despite being in therapy, LO never mentioned her obsession and shame with her nose. In fact, she never really thought anything was wrong with her mental health. Somehow, she separated her mental health from her nose obsession.
After years of consideration, she decided to get cosmetic surgery to address the imperfections of her nose that only she can see. She has not told most people, though, because of the stigma that cosmetic surgeries carry.
“Maybe the better option would be to get therapy first… but I do not have time to wait. I need a solution now” —LO
Choosing to get surgery was not easy. Rationally, LO understood that the only one who had issues with her nose was her, and that made it difficult to justify the financial toll of a surgery. While she had thought about nose surgery for years, it was not until she got Invisalign a few years back that she became serious about it. “Invisalign made me much more comfortable with cosmetic interference, and it has given me confidence that surgery is the right choice."
Despite reaching this level of confidence about her upcoming surgery, LO still thinks that it is sad that people, including herself, end up getting surgery rather than accepting their body as it is. “I think quirks make people beautiful. I admire people that show off their differences." This contrast between her desire (getting surgery) and her beliefs (body acceptance) has led her to question the surgery many times, but the hope of finally coming to peace with her nose eventually won. “Coming to peace with my nose will give me the confidence I need to live my life fully. It is slowing me down to dislike my nose so much...The pursuit of confidence is the reason I am doing this. That’s what it comes down to."
Seven weeks after surgery, LO tells me what life is now like.
“When I see pictures of myself with my old nose, I am grateful that I made this decision” —LO
LO used to avoid being photographed, but after her surgery that has changed. “Before [the surgery], my photos would make me feel very low, but now I think I look fine, even if something, like my hair, could be better." In addition, LO is not spending an obsessive amount of time thinking about her nose, and she is not avoiding mirrors. She confidently says that “my anxiety about my face has certainly reduced." Seven weeks after the surgery, it appears as if LO’s BDD has diminished to the extent that it no longer triggers daily anxiety or shame.
But the surgery was not a panacea: She still struggles with low self-esteem. “I would categorize myself as someone who has generally low self-esteem…but my neurosis is not specific to my body, it’s the whole world. I am always working on something that is imperfect—my career, my kitchen, my finances."
This low self-esteem and pursuit of perfection was a significant driver for her BDD and is consistent with the scientific literature showing that people with BDD tend to struggle more with anxiety and perfectionism. In some ways, one could say that correcting her nose helped LO turn her attention to other things that she could optimize about herself and her life, for better or for worse.
“I am glad I push myself to be my best version, but on the other hand I wish I did not put so much pressure on myself. I would really quite like Botox, though." —LO
Prior to her nose job, LO told me that she hoped this decision would not be a gateway to a lifetime of cosmetic surgeries. Seven weeks after her surgery, she does not have any plans for more surgeries, though she is considering Botox. Instead, her focus is on continuing to improve her self-esteem: “I hope I do not develop other big issues with my appearance and that I can accept the changes my body will go through as I age."
While speaking with LO, it was clear that she thought of her nose differently than the wrinkles and gray hair she also has started noticing. Wrinkles and gray hair are natural changes we all go through. They are things no one can escape, and that makes them easier to embrace. Her nose, on the other hand, was unique to her—something that made her stand out, in a bad way. People with BDD are often concerned with five-to-seven body parts over their lifetime; however, at any given time it is not uncommon for them to only have one or two body parts that they are concerned with.The fact that they do not obsess over every aspect of themselves does not take away the seriousness and invasiveness of their condition. BDD requires treatment, and sometimes even a surgery, before people can start living their lives fully.
