Concerns about appearance, cosmetic procedures and distress can be complex. A careful assessment can explore the person’s experience, safety, goals and any relevant medical or specialist support without assuming what a procedure means, why it was sought or what outcome will follow. BDD is a mental health condition that can involve distressing appearance preoccupations and repetitive behaviours. Only an appropriate clinician can assess whether a person’s experience meets diagnostic criteria or whether another explanation needs consideration. Appearance distress does not itself confirm BDD, and a guide cannot make that distinction for an individual. Cosmetic procedure decisions can also involve physical health, informed consent, finances, relationships, cultural expectations and practical pressures. This guide is not medical, surgical, dermatological, financial or legal advice. Questions about a procedure, physical symptoms, complications or medical suitability should be discussed with the appropriate regulated health professional. CBT based work may consider attention, checking, comparison, reassurance, avoidance and the impact of appearance concerns after assessment. Mirror exposure or other behavioural work should not be copied from an online guide or attempted without appropriate clinical planning. A clinician may need to consider safety, mental health history, medical care and any current specialist involvement. Urgent appropriate help is needed if you feel unable to stay safe, have thoughts of suicide or self harm, experience psychosis, a sudden marked change in mental state or acute physical symptoms. For related information, see body dysmorphic disorder support at lyceumclinic.co.uk/therapy/body dysmorphic disorder/ and mental health, weight, diet and movement at lyceumclinic.co.uk/guides/mental health weight diet movement/. Research and clinical guidance can inform discussion of psychological, medical and specialist support options. Their suitability and likely effect depend on individual assessment. Current arrangements can be checked directly before making an enquiry.