This EEG study compared attentional bias toward highly attractive (HA), lowly attractive (LA), and dento-maxillofacial deformity (DD) faces in 17 orthognathic surgery patients vs. 17 healthy controls, using an oddball task with both ERP waveform (P300) and time-frequency (alpha/beta oscillation) analyses.
Controls showed greater P300 amplitude to HA faces, indicating attention capture by attractiveness. Orthognathic patients showed the opposite pattern: DD faces elicited stronger early alpha-band power (attentional bias toward deformity-related faces), while HA faces induced stronger beta-band suppression (active suppression of attractive faces) — neither pattern appeared in controls.
Very small sample (n=17 per group) limits generalizability. All patients had DD and were pre-surgery, so findings may not apply to other body image conditions. The study is cross-sectional and cannot establish whether these neural patterns are cause or consequence of appearance-related concerns.
Orthognathic patients appear to have a neural attentional bias toward deformity-related faces and actively suppress attractive ones — a pattern consistent with BDD-like cognitive biases. Clinicians treating these patients should consider screening for appearance-related cognitive distortions and body dysmorphic disorder before and after surgery.
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