Body dysmorphic disorder (BDD, previously called dysmorphophobia) is an excessive preoccupation with trivial or non-existent physical abnormalities, perceived to be deformities. BDD causes significant distress or functional impairment and is both time-consuming and difficult to control. Feelings of low self-esteem, shame, embarrassment and unworthiness are common, as is fear of rejection. This report presents a case of BDD in a young male who sought surgery abroad in an effort to ameliorate his perceived deformity. His suicidal ideation, low mood and anxiety symptoms responded well to venlafaxine, olanzapine and cognitive behavioural therapy; however his overvalued ideas with regard to his physical appearance were slow to improve.