Psychological Considerations in Revision Rhinoplasty

ABSTRACT

Revision rhinoplasty is a unique challenge. In addition to the technical considerations that are inherently more difficult than those of primary cases, the surgeon must also be mindful of the psychological considerations that revision rhinoplasty presents. These patients are by definition unhappy with their prior rhinoplasty experience, and this perception of a suboptimal result is both legitimate and real, even if the surgeon is not in agreement. Tantamount to any intraoperative technique, the preoperative ability of the surgeon to sift through the myriad psychological and psychosocial issues is critical to achieving satisfactory outcomes for both patient and surgeon. Reasons for dissatisfaction with a primary surgery, reasons for seeking revision surgery, and the psychological profiles of revision rhinoplasty patients can differ from those related to other facial cosmetic procedures. This article attempts to provide the reader with a better understanding of the complex interplay of these issues and with this understanding help the reader to distinguish one who is a favorable surgical candidate from one who is best left unrevised.

KEYWORDS

Revision rhinoplasty - psychology - problem patient

REFERENCES

• 1 MacCurdy E Transl. The Notebooks of Leonardo Da Vinci. New York; Modern Library 1957
• 2 Andretto Amodeo C A. The central role of the nose in the face and the psyche: review of the nose and the psyche.  Aesthetic Plast Surg. 2007;  31 406-410
• 3 Kamer F M, McQuown S A. Revision rhinoplasty.  Arch Otolaryngol Head Neck Surg. 1988;  114 257-266
• 4 Honigman R J, Phillips K A, Castle D J. A review of psychosocial outcomes for patients seeking cosmetic surgery.  Plast Reconstr Surg. 2004;  113 1229-1237
• 5 Guyuron B, Bokhari F. Patient satisfaction following rhinoplasty.  Aesthetic Plast Surg. 1996;  20 153-157
• 6 Haraldsson P. Psychosocial impact of cosmetic rhinoplasty.  Aesthetic Plast Surg. 1999;  23 170-174
• 7 Meningaud J P. Depression, anxiety and quality of life: outcome 9 months after facial cosmetic surgery.  J Craniomaxillofac Surg. 2003;  31 46-50
• 8 Ozgür F, Tuncali D, Güler Gürsu K. Life satisfaction, self-esteem, and body image: a psychosocial evaluation of aesthetic and reconstructive surgery candidates.  Aesthetic Plast Surg. 1998;  22 412-419
• 9 Zojaji R, Javanbakht M, Ghanadan A, Hosien H, Sadeghi H. High prevalence of personality abnormalities in patients seeking rhinoplasty.  Otolaryngol Head Neck Surg. 2007;  137 83-87
• 10 Ercolani M, Baldaro B, Rossi N, Trombini G. Five-year follow-up of cosmetic rhinoplasty.  J Psychosom Res. 1999;  47 283-286
• 11 Wright M R. How to recognize and control the problem patient.  J Dermatol Surg Oncol. 1984;  10 389-395
• 12 Rohrich R J, Janis J E, Kenkel J M. Male rhinoplasty.  Plast Reconstr Surg. 2003;  112 1071-1085
• 13 Wright M R. The male aesthetic patient.  Arch Otolaryngol Head Neck Surg. 1987;  113 724-727
• 14 Moore D P, Jefferson J W. Handbook of Medical Psychiatry, 2nd ed. Philadelphia, PA; Mosby 2004