A National Survey of Aesthetic Plastic Surgeons’ Experience With Mandatory Body Dysmorphic Disorder Screening in Australia

Abstract Background In 2023 the Australian Health Practitioner Regulation Agency (AHPRA) introduced mandatory psychological screening for cosmetic surgery patients with the aim to preoperatively identify individuals with body dysmorphic disorder (BDD). Objectives This study assessed the impact of mandatory psychological screening tools on Australian plastic surgeons’ practices. It evaluated surgeon confidence in screening tools, referral and diagnosis rates, and the range of specific screening tools used. Methods A 12-question electronic survey was distributed to members of the Australasian Society of Aesthetic Plastic Surgeons (ASAPS) and the Australian Society of Plastic Surgeons (ASPS). Descriptive statistical analysis was performed to summarise the results. Results 136 responses were received (27% response rate). Most respondents (81%) were male, with an average of 17 years of practice experience. The majority (84%) referred fewer than 5% of patients for psychological assessment, and 70% reported having no cases of BDD in the past year. Confidence in screening tools was low, with an average rating of 3.2/10 for both accuracy and utility. Only 30% of surgeons indicated they would continue using screening if it were not mandatory. A wide variety of screening tools were reported, with significant variability between them. Conclusions The low rates of referral for psychological assessment and BDD diagnosis rates indicate a potential discrepancy between screening tool outcomes and expected prevalence rates of the current literature. Standardisation and validation of screening tools are needed to enhance confidence in their accuracy and utility. Further research is necessary to assess the long-term impact of mandatory screening tool use in cosmetic surgery.