This article by two expert authors within the field of anxiety disorders covers a highly poignant subject of growing interest within aesthetic medicine. It covers the definition and manifestation of body dysmorphic disorder (BDD), underpinned by robust and current references, including marked differences in the presentation between male and female patients. Current statistics are described to demonstrate the prevalence of BDD in the population of patients seeking cosmetic procedures, both surgical and non-surgical. A detailed discussion is presented for recommendations for aesthetic practice and referral for specialist management and assessment is reinforced, as well as an overview of available treatment options. In spite of the growing need for aesthetic clinicians to develop an awareness of BDD, the authors acknowledge that the dearth of scientific research proves challenging in exploring the subject in detail and that ultimately a multidisciplinary team approach (comprising a psychologist, psychiatrist, occupational therapist, among others) is required to diagnose and manage this complex and chronic condition.