Jana Mullerova, Petr Weiss
Abstract: Background Aesthetic surgery of the female genitalia is growing and more and more popular. A variety of procedures are performed. Cosmetic treatment is often solution for individuals with unrecognized Body dysmorphic disorder (BDD). This relatively common psychiatric disorder occurs around the world and often does unrecognized in plastic surgery setting. Objectives The present review examines actual knowledge of plastic surgery in gynaecology and BDD, what is known about actual cosmetics procedures in gynaecology and about BDD in plastic surgery setting, approach to the patients seeking plastic procedures in gynaecology and screening for BDD in a gynaecologic cosmetic surgery field. Methods Data sources and searches We carried out a systematic electronic search in Medline, Web of Science and PubMed. We used a combination of relevant s to construct the search strategy including cosmetic surgery in gynaecology, female genital cosmetic surgery, cosmetics gynaecological procedures, body dysmorphic disorder, screening tools for body dysmorphic disorder, diagnosing BDD. Included studies were systematic reviews or primary studies of participants requesting gynaecological cosmetic procedures, published 1990-2016, containing either information about BDD and psychological or psychosocial measures and psychological outcome. There were retrieved total of 40 papers and 20 of them published in last ten years were used for describing cosmetics procedures in gynaecology and BDD risk. Reviewers independently assessed study eligibility, extracted data, and assessed quality, undertaking narrative synthesis. Results The recent researches revealed a variety of plastic procedures available to women. Researchers categorized them as those that may be performed alone or in combination and described them. However, some women seeking cosmetic procedures may have Body dysmorphic disorder (BDD). BDD is a psychiatric disorder that needs appropriate psychiatric treatment and patients with BDD need suitable therapeutic interventions like psychological counselling or special psychiatric treatment. The disorder is giving the markedly poor functioning and quality of life. It also could relate to high lifetime rates of psychiatric hospitalization, being housebound or suicide attempts. Cosmetic treatment is not solution for individuals with unrecognized BDD because after surgery patients are often dissatisfied and continue to obsess about their perceived flaws. Guidelines recommend screening patients for BDD prior to cosmetic surgery. Conclusions We have seen an increase in female genital cosmetic surgery. Procedures available to women to enhance genital appearance are labiaplasty of labia minora or majora, vaginoplasty/perineoplasty (vaginal rejuvenation), hymenoplasty, liposuction to mons pubis, G-spot augmentation and clitoral hood reduction. Some patients unfortunately may have Body dysmorphic disorder (BDD). Psychological evaluation of patients with BDD is not standard in clinical plastic surgery nowadays. BDD needs to be identified before surgery in patients who are seeking cosmetic corrections and it is necessary to identify those who may require further psychological assessment. There is a grooming consensus that BDD should be considered as a contraindication for cosmetic treatments. Clinicians should use a multidisciplinary approach in management, including cooperation among specialists in psychiatry, cosmetic surgery, family practice and other specialties.
Keywords: Aesthetic surgery, female genital cosmetic surgery, cosmetic gynaecological procedures, body dysmorphic disorder