Scientists in Belgium believe that a large proportion of people who request rhinoplasty, also known as a nose job, suffer from a mental illness, in particular body dysmorphic disorder.

Body dysmorphic disorder is a condition in which a person has an unnatural obsession with any slight defects in their appearance. These defects don’t have to be real, just imagined.

The finding is based on research carried out by Belgium scientists, who examined 266 patients evaluated by cosmetic surgeons over a 16 month period. Prior to any rhinoplasty operation the patients were given a questionnaire specifically designed to assess whether or not they possessed signs of body dysmorphic disorder.

Discounting a small number who were having a nose job for medical reasons (but did show signs of the disorder) researchers found a massive 43% of ‘cosmetic patients’ were also displaying signs of the problem.

Overall, 33% of those who took part in the study showed signs of the mental disorder.

This is a very high figure considering previous studies only showed that about 10% displayed signs of the mental illness.

However, despite this research doctors have been at pains to stress that people who are genuinely distressed at their misshapen nose or other defect are not necessarily dysmorphic.

Commenting on the results one psychologist in the USA, David B. Sarwer said: “We know body image dissatisfaction falls on a continuum, and there has to be some degree of dissatisfaction that leads us to see a plastic surgeon in the first place.”

He added: “It’s when it begins to interfere with daily functioning. Patients with more severe B.D.D. struggle to maintain social relationships and have difficulty getting to work or staying employed.

“Almost all of us will get up in the morning and look in the mirror and see something in our appearance we may not like or wish looked different.

But for patients with B.D.D., that thought never leaves their mind. They are chronically thinking about their nose, checking in the mirror or a reflective surface, or they avoid situations where people can see their profile. You can see that is a distraction and can make it hard to focus on jobs or studies or family.’’