A study published in Plastic and Reconstructive Surgery found that patients who complain about the size or shape of their noses often have signs of mental illness. The study found that one in three people seeking rhinoplasty show signs of body dysmorphic disorder.

The study included 266 patients who were evaluated by plastic surgeons in Belgium over 16 months.  The patients were given a questionnaire to assess symptoms of body dysmorphic disorder, a preoccupation with a slight or imagined physical anomaly. Patients with the mental health condition are typically only able to focus on body imperfections and imagined "ugliness,"  the study said.

One to two percent of the general population are affected by the condition and patients who suffer from the disorder are more than twice as likely to commit suicide as those with major depression and three to four times more likely than those with bipolar disorder. Eighty percent of sufferers have recurrent thoughts about suicide.

Compulsions such as mirror checking and avoidance perpetuate the distortions.