Psychological Considerations in the Revision Rhinoplasty Patient

Abstract

The nose contributes greatly to the facial aesthetic. Derangements in nasal cosmesis, whether from surgery, trauma, or natural causes, have a plethora of implications for the emotional well-being of the individual. Rhinoplasty and revision rhinoplasty are both facial cosmetic operations that have potentially profound cosmetic, and therefore psychological, implications for the patient. Although many revision rhinoplasty patients have hopeful yet realistic surgical expectations, there is a subset of revision rhinoplasty patients having underlying psychological disturbances that may negatively affect the surgical outcome, no matter how favorable the surgical improvement. In this article, the various psychological disorders impacting revision rhinoplasty patients will be discussed. In addition, this article will familiarize the revision rhinoplasty surgeon with many of the hallmark characteristics of psychopathology, as well as the typical emotional presentation of the well-adjusted revision rhinoplasty patient, to facilitate differentiation between these seemingly similar, but distinctly different patient groups.

Morphing as a Selection Tool in the Rhinoplasty Consult: A Cross-Sectional Study

“…For overly hesitant patients, frank education coupled with a thorough analysis of motives and goals will often dictate the best approach. 22 In agreement with other authors, 18 refusing to perform rhinoplasty on such patients is a sensitive issue. Deselection, however, remains an important option, as disregarding patient motives and expectations for cosmetic nasal surgery equals opening the door for potential patient dissatisfaction.…”

“…Deselection, however, remains an important option, as disregarding patient motives and expectations for cosmetic nasal surgery equals opening the door for potential patient dissatisfaction. 22 Notably, not all patients who received the green light from the surgeon for rhinoplasty following computer imaging proceeded with their intervention. There were 38 patients (11%) who fitted the criteria for surgery, had their procedure scheduled, and later declined their rhinoplasty.…”

“…24 Moreover revision rhinoplasty patients find selecting the "right" surgeon a daunting process, which frequently leads to anxiety and uncertainty. 22 During this phase of physician selection and to compensate for their lack of knowledge, these patients often pursue multiple consultations. Therefore, surgeons must devote greater time to provide context, and broker information to these patients.…”

“…25 A trusting relationship can be difficult to achieve and may take considerable time and effort, but it is highly improbable that a revision rhinoplasty patient will progress to surgical treatment without it. 22 According to others, to really uncover all aspects of the revision patient, a long or multistage consult should be considered. 5 Although patients who seek secondary rhinoplasty might constitute poor candidates, there is always a category of individuals who are in a sincere need for revision following one or more unsuccessful procedures elsewhere, 26 calling for several maneuvers during computer imaging.…”

Revision rhinoplasty: measurement of patient-reported outcomes and analysis of predictive factors

“…In addition, revision patients are generally stressed and traumatized from the previous surgery, which aids in complicating the psychological sides of an already complex task (Davis and Bublik 2012). Therefore, each subsequent surgery becomes more difficult, rendering perfection a difficult goal.…”