Short report
Short-term outcome of rhinoplasty for medical or cosmetic indication

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Abstract

Psychological effects of rhinoplastic operations were evaluated in male and female patients who had sought surgical correction because of psychological distress caused by the appearance of the nose or because of a medical referral to correct functional disorders. Seventy-two patients selected by gender and operation motivation were asked to fill out the MPI and the IPAT Anxiety scale 2–3 months before and 8 months after the operation. Results at follow-up highlighted a significant decrease of the mean Neuroticism and Anxiety scores and an increase in Extroversion scores in the group as a whole. The psychological benefits gained by the female patients were greater than those of the males. Patients whose motivation was exclusively aesthetic were, overall, more psychologically distressed than those with a functional motivation.

Introduction

In recent years, physical, social, and cultural factors, combined with the improvement of surgical techniques, have led to a growing demand for rhinoplasty. The literature indicates that this demand is frequently the consequence of psychological distress [1], and it is well known that there is a high incidence of psychopathology in patients seeking rhinoplasty, which has been confirmed in recent controlled studies 2, 3. Faced with these facts, psychological and psychiatric research has long sought to investigate the psychological future of these patients: research projects with short- and long-term follow-up did not confirm concerns about potential psychopathological imbalances after the operation, but, on the contrary, highlighted the fact that a majority of the patients improved psychologically after the operation even though previous psychopathological disturbances did not change substantially 4, 5, 6, 7. Some studies suggest that the benefit is at least partly conditioned by the motivation for having the operation, and the gender of the patient. In particular, Connolly and Gipson [8], who tested patients some years after rhinoplasty, noted a significantly higher incidence of severe psychological disturbance in patients who had requested the operation for aesthetic reasons compared with those operated for traumas. In regard to patient gender, Thomson et al. [1], in their exhaustive review of the psychiatric problems of patients seeking rhinoplasty, noted that male patients are normally more psychologically disturbed than female patients. This conclusion was reaffirmed, although without supporting statistics, by Robin et al. [7], who also pointed out that male patients gain fewer benefits from rhinoplasty as shown by a drop in the average score in psychometric testing.

To determine the importance of these factors for the psychological future of rhinoplasty patients, we conducted a pre- and postoperative psychometric evaluation of male and female patients with different motivations for wanting surgery.

Section snippets

Method

A group of 72 patients (36 males and 36 females, mean age 21.6 years, range 16 to 47 years) was studied. All were without traumatic lesions to the nose and had sought rhinoplasty for aesthetic and functional purposes. As standard practice, they were referred to the Department of Psychology, University of Bologna, for psychological evaluation. We selected the sample in order to obtain four subgroups of 18 patients representing the four combinations of the two genders and the two motivations

Results

Table I details the patient pre- and postoperative psychometric scores for the individual scales of the questionnaires used. Statistical analysis of the data highlighted a significant difference in the mean pre- and postoperative results for the group as a whole in both the MPI and the IPAT Anxiety scale. There was a decrease in Neuroticism [F(1,68)=11.60; p<0.001] and in Anxiety scores [F(1,68)=10.45; p<0.002] and an increase in Extroversion mean scores [F(1,68)=15.09; p<0.0002] at follow-up.

Discussion

Pre- and postoperative psychometric evaluation of male and female patients undergoing rhinoplasty with aesthetic or functional motivation at 8 months follow-up highlighted an improvement in the emotional health in the group as a whole. This improvement involved all three personality factors considered, with a significant decrease in mean Neuroticism and Anxiety scores and an increase in Extroversion score. In regard to Neuroticism, the psychological improvement was greater for females than

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