This is a somewhat strange question, and I apologize in advance. We have been looking for answers for years now, and are getting desperate and beginning to lose hope, so I would really appreciate any advice or information you may have.
My fiance has severe body dysmorphic disorder. It has gotten steadily more severe over the years. His obsession is with his fingernails and toenails - keeping them in perfect condition and holding them to an ever-increasing "standard." The amount of time his life loses to this obsession is astronomical. I assure you he has been to dozens of psychiatrists and tried dozens of medications and therapies, and absolutely nothing has worked. At this point, he is absolutely certain that he wants to get his nails professionally removed by a dermatologist. We know that this procedure is never done for this purpose, but we are of the prevailing opinion that if people can do tummytucks and breast implants for cosmetic reasons, then he should be able to find someone willing to remove his nails for cosmetic reasons.
We have tried dermatologists, and they said they'd be willing to do this with a psychologist's recommendation. We have tried psychologists, and they have said they don't know enough about dermatological procedures to recommend a surgery. All of them have been concerned about malpractice, even though my fiance knows this is what he wants and completely understands the risks associated with it. We have tried some cosmetic surgeons also, but none of them have known enough about nail surgery to be of help. Money is not an issue and we understand it would likely not be covered by insurance.
We don't know what to do anymore and are looking for any professionals that might have an idea of how to proceed. Do you know of any possible way that it might be possible to get him this surgery?
First, I doubt that you will find anyone to agree to do this. Are the nails to be removed so they can grow back, or does the entire nail matrix need to be destroyed so that no future nail growth occurs (a very difficult proposition, and one for a hand surgeon, not a dermatologist). Second, even if you were to accomplish this task, it is my experience that in body dysmorphic patients, they will then focus on another area (who knows what) to obsess about. In spite of your lack of success with psychiatrists, I actually believe you will find an expert in this field, particularly if "money is not an issue", as you state, who can help him.
Seriously? Nails do serve a purpose and removing them is not the answer. He really needs to get over it, so how? He has to want to first, and second find a Dr as describ ed above and third find something else to focus on. Hopefully something less destructive. Like abs and how to get them :) you have a tough one to deal with but alllwing him to hurt himslef through removing is nails is not the answer. It will leave him deformed for the rest of his life. Don't let him hurt himself this way please.
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