Diagnosing Culture: Body Dysmorphic Disorder and Cosmetic Surgery

A recent clinical literature on the psychology of cosmetic surgery patients is concerned with distinguishing good from bad candidates. Body Dysmorphic Disorder (BDD) - a mental disorder marked by a pathological aversion to some aspect(s) of one's appearance - is typically understood in this context as a contra-indication for cosmetic surgery, as it marks those with inappropriate motivation who are unlikely to be satisfied by the surgery's outcomes. This article uses Foucault's genealogical work to argue that both the attempt to provide diagnostic conditions for BDD itself, and the broader attempt to demarcate normal and psychopathological concern with appearance are, in part, effects of disciplinary power. Although often presented as a way of making cosmetic surgery more ethical and restrained, this epistemic project inadvertently defends cosmetic surgical interests. Specifically, it contributes to legitimizing the image of an ethically suspect sub-specialty of medicine, and supports its commercial expansion and effective profit-making by displacing its negative sequelae onto patient psyches.