Body dysmorphic disorder (BDD) consists of a preoccupation with a perceived defect or ugliness, usually around the face. The ‘flaw(s)’ is not noticeable to others, or appears only slight, yet causes enormous shame, depression, or interference in life and there is a high risk of suicide. Often at the core of BDD is a distorted image from an ‘observer perspective’ and there is a high degree of self-consciousness. People with BDD often avoid public situations and spend hours mirror gazing. BDD is treatable by specialised cognitive behaviour therapy or SSRI antidepressants in maximum dose (not by antipsychotics or cosmetic procedures).