The disorder may be under diagnosed because many of the patients with somatic delusions present to other specialists such as dermatologists or plastic surgeons, more often than to psychiatrists in the unremitting search for curative cosmetic procedures which they are usually denied. But if the surgeon does not perceive the illogicality of the complaint an operation may take place. While some successes have been reported, the general consensus is that most cases need psychiatric rather than surgical intervention and that surgery may seriously worsen the mental disorder in the longer term