Patient Selection, Outcome, and Unhappy Patients in Rhinoplasty

Abstract

This article discusses the process of patient selection for rhinoplasties and the many different psychological aspects that come into play. It is important to identify the warning signs and apply a multidisciplinary approach to the surgeons practice, in collaboration with specialist rhinoplasty psychologists. Patients' motivations and surgeon factors are also discussed, as this can lead to unhappy and unsatisfactory postoperative outcomes. Potential reasons for adverse outcomes throughout the pre- and postoperative periods are also described. Finally, a brief guide is provided to reduce the risks of an unhappy patient.

Keywords

rhinoplasty - patient selection - unhappy - adverse outcomes - psychology

Publication History

Accepted Manuscript online:
08 August 2024

Article published online:
13 September 2024

• References

• 1 Adamson PA, Chen T. The dangerous dozen–avoiding potential problem patients in cosmetic surgery. Facial Plast Surg Clin North Am 2008; 16 (02) 195-202 , vii
• 2 Chatham DR. Reducing risks for a dissatisfied patient in facial cosmetic surgery. Facial Plast Surg Clin North Am 2023; 31 (02) 183-193
• 3 Haraldsson P. Psychosocial impact of cosmetic rhinoplasty. Aesthetic Plast Surg 1999; 23 (03) 170-174
• 4 Rennie C, Saleh HA. Assessment and the psychological aspects for septorhinoplasty. Int J Head Neck Surg 2018; 9 (01) 38-45
• 5 Golshani S, Mani A, Toubaei S, Farnia V, Sepehry AA, Alikhani M. Personality and psychological aspects of cosmetic surgery. Aesthetic Plast Surg 2016; 40 (01) 38-47
• 6 Rajanala S, Maymone MBC, Vashi NA. Selfies-living in the era of filtered photographs. JAMA Facial Plast Surg 2018; 20 (06) 443-444
• 7 Rice SM, Graber E, Kourosh AS. A pandemic of dysmorphia: “zooming” in the perception of our appearance. Facial Plast Surg Aesthet Med 2020; 22 (06) 401-402
• 8 The Australian Psychological Society. Psychological Evaluation of Patients Undergoing Cosmetic Procedures. Melbourne, Victoria, Australia; 2023.
• 9 Kumar AR, Ishii LE. How you see yourself: cultural considerations and self-image for rhinoplasty patients. Otolaryngol Clin North Am 2020; 53 (02) 209-212
• 10 Kaw E. Medicalization of racial features: Asian American women and cosmetic surgery. Med Anthropol Q 1993; (07) 74-89
• 11 Gorney M, Martello J. Patient selection criteria. Clin Plast Surg 1999; 26 (01) 37-40 , vi
• 12 Wright MR. Management of patient dissatisfaction with results of cosmetic procedures. Arch Otolaryngol 1980; 106 (08) 466-471
• 13 Wever CCC, Wever AMEA, Constantian M. Psychiatric disorders in facial plastic surgery. Facial Plast Surg Clin North Am 2020; 28 (04) 451-460
• 14 Greenberg JL, Limoncelli KE, Wilhelm S. Body Dysmorphic Disorder: Advances in Clinical Practice. Oxford University Press; 2017
• 15 Sykes JM. Patient selection in facial plastic surgery. Facial Plast Surg Clin North Am 2008; 16 (02) 173-176 , v
• 16 Wilhelm S, Philips KA, Steketee G. Cognitive Behavioural Therapy for Body Dysmorphic Disorder: A Treatment Manual. The Guildford Press; 2013
• 17 Herruer JM, Prins JB, van Heerbeek N, Verhage-Damen GWJA, Ingels KJAO. Negative predictors for satisfaction in patients seeking facial cosmetic surgery: a systematic review. Plast Reconstr Surg 2015; 135 (06) 1596-1605
• 18 Van Der Kolk B. The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma. Allen Lane; 2014
• 19 Shemirani NL, Castrillon J. Negative and positive online reviews of physicians-1 vs 5 stars. JAMA Facial Plast Surg 2017; 19 (05) 435-436
• 20 Clarke A, Thompson AR, Jenkinson E, Rumsey N, Newell R. CBT for Appearance Anxiety Psychosocial Interventions for Anxiety Due to Visible Difference. Wiley Blackwell; 2014
• 21 Payne H, Brooks S. The body mind approach as a learning tool for patients with medically unexplained symptoms to self-manage. Front Psychol 2018; 9: 2222
• 22 Bulut OC, Plinkert PK, Wallner F, Baumann I. Quality of life in functional rhinoplasty: rhinoplasty outcomes evaluation German version (ROE-D). Eur Arch Otorhinolaryngol 2016; 273 (09) 2569-2573
• 23 van Zijl FVWJ, Mokkink LB, Haagsma JA, Datema FR. Evaluation of measurement properties of patient-reported outcome measures after rhinoplasty: a systematic review. JAMA Facial Plast Surg 2019; 21 (02) 152-162
• 24 Barone M, Cogliandro A, Di Stefano N, Tambone V, Persichetti P. A systematic review of patient-reported outcome measures after rhinoplasty. Eur Arch Otorhinolaryngol 2017; 274 (04) 1807-1811
• 25 Moubayed SP, Ioannidis JPA, Saltychev M, Most SP. The 10-Item Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) for functional and cosmetic rhinoplasty. JAMA Facial Plast Surg 2018; 20 (01) 37-42
• 26 Saleh HA, Beegun I, Apaydin F. Outcomes in rhinoplasty. Facial Plast Surg 2019; 35 (01) 47-52
• 27 Tobin HA. What makes a patient unhappy. Facial Plast Surg Clin North Am 2008; 16 (02) 157-163 , v
• 28 Pfifferling JH. Healing the perfectionist surgeon. Facial Plast Surg Clin North Am 2008; 16 (02) 239-244 , viii