Diretrizes para suspeição do Transtorno Dismórfico Corporal em adolescentes e adultos jovens candidatos à cirurgia plástica estética

Abstract

The aim of this study was to draw up orientation with guidelines for suspecting body dysmorphic disorder (BDD) in adolescents and young adults wanting to undergo aesthetic plastic surgery. Although this is a devastating psychological disorder, which usually begins during adolescence and has been little investigated in this age group, it is little known and poorly understood, something that has significant implications for personal and, social development, especially in the adolescent population. The study was conducted in two stages, quantitative and qualitative. In the quantitative stage, a longitudinal, prospective cohort study was carried out with 119 young people aged between 13 and 25, of both sexes, candidates for aesthetic plastic surgery, concerning demographic data and evaluation of body image and self-esteem. The qualitative stage involved focus groups with adolescents, some of whom were candidates for aesthetic plastic surgery, in order to evaluate the influence of cultural beauty standards on body image. BDD was suspected in 37% of the participants, and of these, 98% over-evaluated the perceived defect. There was an association between BDD symptoms and inhibited behavior in social situations, in physical activity in public and in sexuality.The more severe the BDD symptoms, the lower self-esteem was shown to be. The thematic categories resulting from the focus groups were: plastic surgery being seen as repairing self-esteem in young people discriminated against for not being attractive; plastic surgery becoming banal, shown in the reduced medical character of the procedure and reduced concern with the risks of surgery; the difficulty in achieving a perfect body as disseminated by the media was recognized; standards of beauty and looking good are linked to good physical condition; social rejection and exclusion were recognized as discrimination against those with imperfections in their appearance. In this model of the study, a guide was created for the triage of BDD in plastic surgery practices, based on degree of anguish (worry) and functional impairment (avoidance and inhibition) caused by physical appearance. The groups discourse indicated that the facilities available on the market mean many adolescents and young adults seek plastic surgery, seeing it as an means to achieving social inclusion, resulting in increased self-esteem, vanity and self-confidence. The participants recognized that the standard of perfect beauty propagated by the media influences adolescents self-esteem and consider it to be unachievable.