Good question.

Nevertheless, I see this as quite normal in general, not just in BID. After a major operation, I believe it is part of the damage control process. Ideally, in BID, it should appear as if the limb had simply stopped growing. Of course, this is not the case after an amputation, and everyone should recognize that achieving a perfectly aesthetic result is not always possible. It is simply the nature of the situation, and a scar will inevitably remain.
Additionally, a poorly shaped stump can cause not only aesthetic concerns but also issues with the prosthetic socket’s fit, ultimately affecting the we arability of a prosthesis and causing additional pain. In the best-case scenario, the stump would appear as if it had naturally stopped growing and never fully formed—like a perfect dysmelia but without a scar. However, that is wishful thinking, as the limb did develop.

If the appearance of the surgical site bothers me too much or unnecessarily limits my ability to wear a prosthesis, then the issue should be addressed. I would opt for an additional operation to prevent unnecessary skin problems and avoidable pain. That’s why I would choose the most comprehensive solution from the start.I also don’t see your example as merely an aesthetic correction, like cosmetic surgery. Who wouldn’t want to go out in shorts and a T-shirt on warm days without feeling self-conscious because it looks unusual and inevitably attracts extra attention at the beach or pool? Feeling watched is already an uncomfortable sensation, and unfortunately, an amputation naturally draws attention. Visually, one no longer conforms to the usual norm. A perfectly amputated limb that appears as if it had never grown, or as if nature had predetermined the separation point, seems somewhat utopian when aiming for a flawless result. Perhaps it is human nature to strive for perfection, or perhaps societal expectations have made it a necessity.

My wife was quickly stitched up after her accident with an electric fence or a ship rope. Years later, she underwent several plastic surgeries because she was frustrated by people staring at her whenever she wore a T-shirt, and it affected her psychologically. Of course, the results weren’t perfect, but they brought some improvement. 

In elective surgeries, a significantly better outcome can be expected compared to emergency procedures, even if it is not entirely flawless. From an aesthetic perspective, I consider this completely acceptable. Therefore, it should not be hastily equated with body dysmorphic disorder, even though it was unfortunately often perceived that way at first.