Based on clinical impressions personality disorders (PDs) and psychiatric disorders characterized by body image disorder (BID) have been suggested to be relatively common in cosmetic surgery settings and closely associated with patient's post-operative dissatisfaction despite technically satisfactory surgical results, leading to problems for both patients and surgeons.

The study investigated the prevalence and the comorbidity between BID and PDs in patients seeking cosmetic surgery, as well as the impact of the following clinical variables on patient's post-operative dissatisfaction: number of pathological personality traits, severity of body uneasiness and worries about particular body parts and intensity of these concerns.

Two hundred fifty patients scheduled for profile, breast and body contouring cosmetic surgery from two Italian hospitals (90% F; M_age = 31.5±4.0) completed the Body Uneasiness Test (BUT), the Personality Diagnostic Questionnaire-4+ (PDQ-4) before surgery and a measure of patient satisfaction 13 months after surgery.

18.9% of subjects, had at least 1 PD (cluster B and C's in particular). Using the BUT cut-off score as a marker of clinical significance, 48.8% of subjects had a BID, and all PD patients showed comorbidity with BID. The number of pathological personality traits, the severity of body uneasiness and the intensity of worries about body parts showed a predictive power on patients’ post-operative dissatisfaction.

PDs and BID are common in cosmetic surgery settings. Our data suggest also that a thorough pre-operative clinical assessment may allow the pre-operative identification of patients with low levels of post-operative satisfaction.