Body dysmorphic disorder (BDD), is characterized by a distressing or impairing preoccupation with an imagined or slight defect in appearance. The preoccupation with perceived appearance şaws (which usually focus on the face or head) typically occurs for many hours a day, and most patients perform repetitive behaviors such as mirror checking, excessive grooming, and skin picking. BDD is associated with markedly impaired psychosocial functioning, notably poor quality of life, and a high rate of suicidal ideation and suicide attempts they often have needless dermatological treatment and cosmetic surgery. The condition is easily trivialised and stigmatised. We report a case that was diagnosed as body dysmorphic disorder and his medical treatment was planned accordingly. The 16-years-old male has been suffering for about 2 years from the belief that his nose was like a pig nose, such that everyone would stare at and talk about it. The boy could not remember a particular occurrence which had brought the symptoms to the surface and had no insight about its psychological nature. He was totally convinced that he could only be helped by a surgical correction of his nose. Appearance concerns have affected his life dramatically by often upsetting him a lot, often getting in the way of doing things with friends and dates. This situation affected his school and led him to avoid social activities. We prescribed Fluoxetine 40 mg a day as a starting dose and titrated up by 40 mg increments in two weeks. Two months later his symptoms relieved by %70 and he gave up the idea of surgical operation. His pharmacotherapy has been ongoing successfully for 6 months. No cognitive behavioural therapy was required; supportive psychoeducation about his body image and his own identity is maintained. In recent years it is known that BDD rapidly responds to pharmacotherapy as it is in our case. Selective serotonin reuptake inhibitors (SSRIs) are often efficacious for this disorder. Approaching treatment-resistant BDD have received little investigation, but available data indicate that switching to another SSRI and several SSRI-augmentation strategies may be helpful.