Brown Tim, de la Paz Jacob, Murphy Tracey, Hansen Lars
, 40-42 Clyde Road, Berwick, 3806, Australia.
, Lyndhurst, SO43 7DR, UK.
Aesthetic Plast Surg. 2025 Mar;49(5):1536-1542. doi: 10.1007/s00266-024-04447-7. Epub 2024 Oct 29.
Recent regulatory changes in Australian cosmetic surgery necessitate preoperative screening for body dysmorphic disorder (BDD). This study, which focuses on patient outcomes, evaluates the COPs tool's efficacy and examines its implications on patients undergoing cosmetic procedures. A total of 189 patients were included: 78 underwent Medicare-classified "cosmetic" surgeries, and 111 underwent "medically necessary" procedures. Patients completed the COPs assessment pre- and post-operatively, with a score >40 indicating BDD susceptibility. Results show no significant pre- to post-operative change in COPs scores across different surgical procedures (body, breast, facial, and mixed) in both "cosmetic" (p = 0.2-0.4) and "itemised" groups (p = 0.15-0.33). However, overall, there was a marked reduction in COPs scores post-operatively (p < 0.001), indicating improved self-perception. Specifically, 91% of patients initially BDD-prone showed scores < 40 post-operatively. Conversely, 3.8% of initially low-scoring patients developed BDD-prone scores post-operatively. Comparison between cosmetic and itemised groups revealed higher preoperative COPs scores in the itemised group (p = 0.006), though post-operative scores did not differ significantly (p = 0.33). Incidences of post-operative BDD-prone scores or scores < 40 did not differ between groups (p = 0.61). Complication rates and the need for revision surgery were similar between groups. These findings suggest two plausible interpretations: First, preoperative screening with the COPs tool may positively influence self-perception related to BDD among cosmetic surgery patients, potentially serving as a therapeutic adjunct for those at risk. Second, while screening tools are beneficial, they may have limitations in predicting post-operative outcomes related to BDD development. Further research should explore these dynamics to refine screening practices and optimise patient outcomes in cosmetic surgery contexts. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
澳大利亚整容手术最近的监管变化使得有必要对身体变形障碍（BDD）进行术前筛查。本研究聚焦于患者预后，评估了COPs工具的有效性，并探讨了其对接受整容手术患者的影响。总共纳入了189名患者：78名接受了医疗保险分类的“整容”手术，111名接受了“医疗必需”手术。患者在术前和术后完成了COPs评估，得分>40表明易患BDD。结果显示，在“整容”组（p = 0.2 - 0.4）和“分项”组（p = 0.15 - 0.33）中，不同手术类型（身体、乳房、面部和综合）的COPs评分从术前到术后均无显著变化。然而，总体而言，术后COPs评分有显著降低（p < 0.001），表明自我认知有所改善。具体而言，最初易患BDD的患者中有91%术后得分<40。相反，最初低分的患者中有3.8%术后出现易患BDD的得分。整容组和分项组之间的比较显示，分项组术前COPs评分更高（p = 0.006），但术后评分无显著差异（p = 0.33）。术后易患BDD的得分或得分<40的发生率在两组之间无差异（p = 0.61）。两组之间的并发症发生率和修复手术需求相似。这些发现提出了两种合理的解释：第一，使用COPs工具进行术前筛查可能会对整容手术患者中与BDD相关的自我认知产生积极影响，可能对有风险的患者起到治疗辅助作用。第二，虽然筛查工具有益，但它们在预测与BDD发展相关的术后结果方面可能存在局限性。进一步的研究应探索这些动态变化，以完善筛查方法并优化整容手术中的患者预后。证据水平III 本刊要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266 。
