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The 3 D’s of Aesthetic Medicine- Addressing Depression, Delusion, and Dysmorphism


3D in this context doesn’t refer to anything related to three-dimensional or sculpting. Instead, the three Ds stand for Depression, Delusion, and Dysmorphism, which cannot be overlooked in medical aesthetics.

Depression, a type of emotional illness, is becoming increasingly common. According to statistics, more than 300,000 people in Hong Kong are affected by depression. One patient came seeking treatment to become more beautiful, but midway through the consultation, she began weeping, stating that she felt unattractive and unwanted, leading to her low mood, lack of sleep, gastrointestinal discomfort, and loss of interest. These are typical symptoms of depression, but even her family members didn’t recognize them, so she didn’t seek help. In the end, instead of improving her facial concerns, I referred her to a psychiatrist for treatment.

Delusion refers to delusional disorder. If someone firmly believes in a wrong idea, even if it contradicts societal reality and cultural backgrounds and remains unshaken, he or she is suffering from delusional disorder. Somatic type delusional disorder – patients insist that they have an illness and frequently seek medical attention, although treatment is ineffective. Some patients say they smell, see, or feel something unusual and have tried many methods to cure it but have failed. Patients may create some bizarre treatment methods, some of which are dangerous. Over time, most patients will develop emotions such as anger, rejection, despair, and even suicidal thoughts. One patient insisted that she had warts and went to different doctors to remove the suspected “warts,” but she felt new “warts” appear a few days after each treatment, so she sought medical attention again. Even after the doctor explained the situation, she refused to compromise and insisted on her own opinion. Finally, the doctor referred her to a psychiatrist for treatment.

Dysmorphism, also known as body dysmorphic disorder, is a mental illness where patients excessively focus on their body image and have exaggerated delusions about their appearance. In most cases, the patient’s focus is on one or more minor or nonexistent defects. Due to this excessive attention, the patient’s daily life is greatly affected, and they usually feel depressed, anxious, and alienated. These patients are frequent visitors to the plastic surgery department and often request treatment or surgery for minor flaws. However, shortly after completing the treatment, they may need another form of treatment, never being satisfied.

Changing skin and contour issues is not difficult, but medical aesthetic treatments cannot change the mentality of the seeker. Doctors need to evaluate whether the seeker has abnormal psychological status or needs to be referred to a psychiatrist for treatment as soon as possible. This is one of the reasons why medical aesthetics must be regulated by doctors.