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THE INDUSTRY NEVER BUILT A PROTOCOL TO CATCH THEM
The Knife Was Real
The Fix Was Not
They Came Back
Then They Came Back Again
Then Once More
The Loop Does Not Live In The Face
It Lives In The Mind That Sees The Face
THIS NEWSLETTER IS FOR INFORMATIONAL PURPOSES ONLY. NOTHING IN THIS CONTENT CONSTITUTES MEDICAL, PSYCHOLOGICAL, OR PROFESSIONAL ADVICE. ALWAYS CONSULT A QUALIFIED HEALTHCARE PROFESSIONAL BEFORE MAKING ANY HEALTH RELATED DECISIONS
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OKAY BACK FROM THE OPERATING ROOM 🔪
👇🏻
THE BOOM THAT BUILT A DOOR WITH NO LOCK 🏥
Cosmetic Surgery Exploded In The 20th Century
Post WWII, Reconstructive Techniques Refined For Battlefield Injuries Found Their Way Into Civilian Clinics
Rhinoplasty. Blepharoplasty. Breast Augmentation. Liposuction
Each Decade Added New Procedures And Lowered The Barrier To Access
By The 1980s And 1990s, Cosmetic Surgery Had Moved From Rare Luxury
To A Routinely Marketed Consumer Option
For Most Patients
This Was A Choice. A Preference. A Correction
For BDD Patients
It Looked Like Something Entirely Different
It Looked Like A Solution
The Logic Was Internally Consistent
Something Looks Wrong. Fix It
The Patient Arrived Distressed. The Patient Described A Specific Flaw In Clinical Detail
The Surgeon Saw A Standard Cosmetic Patient
There Was No Screening Protocol For BDD
Surgeons Were Not Trained To Recognize The Disorder
The Door Was Open. There Was No Lock
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WHAT THE RESEARCH FOUND 📋
The Clinical Literature Built A Clear Pattern
• Dissatisfaction Rates ☞ BDD Patients Who Received Cosmetic Procedures Reported Dissatisfaction At Extremely High Rates, Often With The Specific Feature That Had Been Treated
• The Loop Continued ☞ The Surgical Fix Did Not Interrupt The Obsession. Within Months, Many Patients Returned, Sometimes For The Same Feature, Sometimes Having Shifted The Obsession Entirely To A New Area
• No Psychological Improvement ☞ Studies Found That BDD Patients Who Underwent Surgery Were No Better Off Psychologically After The Procedure. Some Were Measurably Worse
The Obsession Did Not Live In The Nose Or The Jaw Or The Eyelids
It Lived In The Loop That Processed The Nose And The Jaw And The Eyelids
Surgery Addressed The Object Of The Loop
It Left The Loop Intact
This Is Not A Marginal Finding. It Is Consistent Across The Literature
The Research Was Published. The Pattern Was Documented
What Happened Next Is The Part Worth Paying Attention To
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THE STRUCTURAL PROBLEM THE INDUSTRY NEVER SOLVED 💰
The Cosmetic Surgery Industry Was Not Built To Screen For BDD
It Was Built To Provide A Service To Paying Patients
Return Patients
A Dissatisfied Patient Who Returns Is More Revenue. It Is Not Flagged As A Failure Metric. In Business Terms, It Is Retention
No Screening Requirement
There Is No Industry Wide BDD Screening Requirement Before Elective Cosmetic Procedures. None Is Mandated. None Is Standard
The Publication Gap
The Clinical Literature Documenting Poor Outcomes In Unscreened BDD Patients Was Published. It Was Not Acted On At Scale
The Patients Most Likely To Return Are BDD Patients
The Patients Most Likely To Be Harmed Are BDD Patients
The Patients Most Likely To Escalate
Seek More Procedures
Larger Corrections
Different Features, Are BDD Patients
These Are Also The Patients The Industry Is Structurally Incentivized To Keep Serving
That Is Not An Accusation. It Is A Description Of How The Incentives Align
The Loop Is Profitable
Nobody Designed It That Way
Nobody Had To
