Importance of Psychiatric Evaluation and Patient Selection in the Field of Cosmetic Dermatology

Cosmetics is an ever-increasing component of every-day practice for dermatologists. However, as elective procedures such as neuromodulator injections, dermal fillers, and body contouring have pushed their way into most dermatology practices, little objective research has been done to identify ideal patients to undergo these procedures. It is the opinion of these authors that objective studies to evaluate the pre and post procedural psychologic well-being are essential to identify patients who may have an underlying and undisclosed psychiatric illness that is contributing to their decision-making process. This issue is further complicated by the plethora of cosmetic day-spas that offer these services without physician oversite or ethical obligation to responsibly select candidates. One example regarding the importance of patient selection is exemplified by patients with body-dysmorphic disorder (BDD) a condition in which the subject has a fixation with one or more perceived flaws in their appearance.