title: Eumorphic Plastic Surgery: Expectation Versus Satisfaction in Body Dysmorphic Disorder.
abstract: BACKGROUND
  Eumorphic Plastic Surgery aims at improving the severe psychosocial pain caused by a deformity. Dysmorphopathology is an increasingly relevant problem facing the plastic surgeon.
  
  
  OBJECTIVE
  The aim of this study is to describe the perioperative questionnaires created by the senior author and to present a cohort of plastic surgery patients suffering from dysmorphopathies. These patients were prospectively followed and evaluated with the proposed questionnaires through their surgical pathway to explore the degree of satisfaction or disappointment compared to expectations.
  
  
  METHODS
  All candidates for plastic surgery procedures between April 2011 and June 2013 were included in the study. Preoperatively, all patients completed the Patient Expectation Questionnaire (E-pgm). Twelve months postoperatively, they completed the Patient Satisfaction Questionnaire (S-pgm). The E-pgm and S-pgm were compared to evaluate the consistency between the patient's preoperative expectations and postoperative evaluations.
  
  
  RESULTS
  A total of 158 patients were included in the study. Out of them, 79 % experienced an improvement or no variation between preoperative expectations and postoperative satisfaction. With regard to the motivation for undergoing surgery, 91 % showed that the surgical procedure met the motivation. An overall positive perioperative change in life was experienced by 93 % of patients.
  
  
  CONCLUSIONS
  The E-pgm questionnaire proved to be a valid and reliable tool for the selection of suitable candidates for surgery and for identification of dysmorphophobic patients. Enhancing the doctor-patient relationship and communication can reduce ambiguity and avoid troublesome misunderstandings, litigation and other legal implications.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Department of Plastic Surgery, S Orsola-Malpighi Hospital, University of Bologna, Via Massarenti, 9, 40138, Bologna, Italy. paologiovanni.morselli@unibo.it.
authors.forename: Paolo Giovanni
authors.initials: PG
authors.lastname: Morselli
authors.affiliation: Department of Plastic Surgery, S Orsola-Malpighi Hospital, University of Bologna, Via Massarenti, 9, 40138, Bologna, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Micai
authors.affiliation: First Department, Rizzoli Institute, Bologna, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Boriani
mesh_terms: D057215:Body Dysmorphic Disorders / Q000175:diagnosis / Q000523:psychology / Q000601:surgery*; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018579:Patient Selection; D010817:Physician-Patient Relations; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013518:Surgery, Plastic / Q000379:methods*; D011795:Surveys and Questionnaires
keywords: Body dysmorphic disorder; Cosmetic surgery; Dysmorphopathy; Dysmorphophobia; Preoperative selection in plastic surgery