It is important to know why doctors administer a mental health screening before putting a BDD suspected patient under the knife. It clearly doesn't mean that the patient has lost it or is a psycho, it is just to rule out body dismorphic disorder becasue such people with BDD don’t need cosmetic surgery, they need psychiatric care & counselling. If a surgeon performs the desired surgery on a BDD affected patient without mentla counselling, it is more than sure that he/she will NOT be satisfied with the results and it will affect both (the surgeon and the patient) because it is not a matter of face/body correction, it the the mind that need fixation.
People with BDD may pick at a skin defect only perceptible to them until a real scab appears. They might lose hours in front of a mirror, meticulously working to camouflage their purported flaws, or they might compulsively avoid mirrors at all costs, terrified of what they’ll see. Some develop eating disorders or social anxiety.
Still, the psychiatric condition is surprisingly common: according to the Body Dysmorphia Disorder Foundation, one in 50 people has it. The advocacy group lists several famous names who may have had the disorder, though none were ever diagnosed, including Sylvia Plath, Michael Jackson and Franz Kafka.