In the past 20 years of surgical practice, few clinical issues have challenged me the way Body Dysmorphic Disorder (BDD) has. BDD is a body-image disorder characterized by persistent and intrusive preoccupations with an imagined or slight defect in one’s appearance. It is believed that 2% of the population is afflicted.

People with BDD can dislike any part of their body. In reality, a perceived defect may be only a slight imperfection or nonexistent. But for someone with BDD, the flaw is significant and prominent, often causing severe emotional distress and difficulties in daily functioning. Patients who have a tendency towards BDD are good at painting a picture of intelligence, research, and understanding. They research their procedures well and are often active participants in the treatment that is about to be offered. It is almost universal that they clearly understand the informed consent process and they verbalize their understanding of the limitations of what we can do as plastic surgeons.

Then, the sentinel event- Plastic Surgery. At this point a cascade of symptoms come about that makes interactions with these patients difficult at best. Slightest imperfections become heightened and the patient become socially reclusive and faults the procedure and us as the culprit of their “Dysmorphic” appearance. Financial issues are often brought up, and we are blamed for wasting their money.

Most of my colleagues agree that such scenario is the most challenging and can be somewhat dangerous for the patient and the practitioner’s well being.

As qualified board certified plastic surgeons we have an obligation to see patients who are there fro our advice. But, we also have a moral and clinical obligation to say “NO”. If a patient is demonstrating some of the signs and symptoms of BDD we must do whatever it takes to dissuade the patient to have any operative procedure. No amount of genuine interest for providing service, or no amount of money is worth the trouble of an irrational patient who will simply not accept the “beauty” of his or her imperfections.

I try so very hard to turn people away from my practice at the slightest hint of a tendency for BDD. As, my private practice experience is reaching its 15-year mark, and as it reaches its time tested experiential maturity, I am more inclined to err on the side of safety and will turn these patients away. It’s the right thing to do. It’s the safe thing to do.

“Have no fear of perfection – you’ll never reach it.”

Salvador Dali

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We have been fully operational since May of 2020. With patience and with care, we all are returning to normalcy. Our office continues to use safety protocols, and we are eager to see you.


For patients who desire a virtual consultation, this option is available.
Our virtual web consultations can be done right in the comfort of your own home. All you need is a secure Internet connection and a computer, tablet, or smartphone.
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Updated May 2022
We have been fully operational since May of 2020. This includes skincare and our non-invasive center (ENIC).
We know that so much of this pandemic caused an inconvenience for you, but we are delighted to see a return to normalcy. 
We will continue to be vigilant in our approach to Covid 19. For over two decades, we have considered safety as our most important prerogative — and there has never been a more important time to put that to use.
Here are some things we’re doing to ensure you are protected and that we maintain this facility as a Non-Covid Care (NCC) zone:

Patient Flow and Clinical Office Space

We now have a well-tested protocol of texting patients for control of flow for consultations.
We are assigning everyone to hourly wipe-downs of high-use areas with approved sanitizing wipes.
We are asking that no one wait in the waiting area.
We are coming up with protocols for room wipe-downs after each patient visit.
Every staff member will always wear a mask while in the office.
Every staff member will sanitize or wash hands after every interaction.
Implementation of virtual pre-ops, nursing visits, and questions.

Operating Room Experience

Similar precautions and questionnaires will be provided to establish Covid-19 Clear Status.
All staff will always wear a mask. All staff will always wear gloves.
Hand washing will be done for any patient interaction.
Specific wipe-down of our operating room, recovery, and pre-op areas will be performed.
We will minimize accompanying caretakers to only one. Those caretakers will be treated just like the patients.
Anesthesia Experience
Every anesthesia staff will wear goggles and other protective equipment during intubation.
Our anesthesiologists have been fully trained and are implementing all precautions for prevention of Covid-19 spread.
All circuits will be changed between each patient.
Full wipe-down of surfaces and floors will be performed.
We will implement a time-out protocol to confirm the Covid-19 Clear Status of every patient.

As you can see, we are taking this very seriously. We fully understand that this will cause some inconvenience in the short term, but realize that it is for the best.
Although Covid-19 has been a serious issue, we are seeing a resumption of normalcy. We continue to monitor this situation on a real-time basis, and we will not sit back until we know that we have done everything possible to avoid unnecessary exposure.
When you see us in action, you’ll realize that you have put your trust in the right practice.
Here are some links that might be useful:
State of Washington Department of Health
Centers for Disease Control and Prevention (CDC)
World Health Organization (WHO)
Please do not hesitate to contact us. We are always here to answer your questions!
Call us at (425) 827-7878
Email us at [email protected]

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