Date of Award


Document Type

Doctor of Nursing Practice (DNP)

Degree Name

Doctor of Nursing Practice (DNP)



Committee Chair

Haley Hoy


Body dysmorphic disorder, Rhinoplasy--Psychological aspects


In aesthetic clinical settings, screening for body dysmorphic disorder (BDD) in rhinoplasty patients prior to surgery is not a common practice. Body dysmorphic disorder is a psychiatric illness characterized by the preoccupation and fixation of a perceived physical defect. This distortion in self-perception forces numerous individuals to seek out repeated, unnecessary cosmetic procedures. Many surgeons rely on experience and intuition alone when assessing their patients for procedure appropriateness, which may result in unnecessary cosmetic procedures on patients at risk for worsening BDD symptoms. Implementation of a validated screening tool, such as the Body Dysmorphic Disorder Questionnaire (BDDQ), offers providers an additional assessment tool. This tool, coupled with the Rhinoplasty Outcomes Evaluations (ROE) instrument, allows providers to determine if a rhinoplasty patient’s perceived outcomes were influenced by BDD. The setting for this project was one facial plastic surgery office in Tampa, Florida. Inclusion criteria included new patients aged 18 years or older interested in rhinoplasty. The design for this project was a clinical practice change which began with the completion of the BDDQ by new patients interested in rhinoplasty. Those who screened positive were further assessed by the surgeon during consultation. If the surgeon concurred with results of the screening tool, then surgical interventions were halted, and the patient was referred to a mental health provider for evaluation. Patients who screened negative on the questionnaire and underwent surgery completed a generic satisfaction survey at their one-month post-operative appointment and the ROE survey three-months post-operatively. Out of the 26 patients evaluated, the BDDQ identified 65% of participants exhibiting positive signs of BDD but were ultimately considered appropriate surgical candidates after further physician assessment. A total of six patients scored 75% or lower on their ROE. The ROE of those six patients was then compared with each corresponding patient’s BDDQ. Five of the six patients had screened positive on the BDDQ with one patient screening negative. The findings of these assessment tools were used to help improve the surgeon’s knowledge and attitude on signs of BDD, leading to more efficient assessment strategies during surgical consultation.

Available for download on Wednesday, June 11, 2025