Government Research on Psychological and Psychosocial Reactions to Rhinoplasty

How can we predict and prevent negative responses to rhinoplasty procedures?Most patients who decide to undergo rhinoplasty procedures do not do so lightly. They seek the surgery because they are dissatisfied with their facial appearance and have been dissatisfied for a long time. They view rhinoplasty as a positive, life-altering operation which will increase their self-esteem, self-confidence, general satisfaction and quality of life. The majority are extremely pleased with the results. Many wonder why they didn’t take the plunge sooner.A recent government study, however, confirms that some patients are troubled by the outcomes of their rhinoplasty procedures. This is why it is so important for patients and their doctors to evaluate whether nasal cosmetic surgery is appropriate in each individual case. The government research zeroed in on particular characteristics which may predispose patients to dissatisfaction.What distinguishes patients who tend to be dissatisfied after surgery?The research study has delineated several risk factors associated with poor psychological and psychosocial reactions to nasal plastic surgery, including:

• Being male
• Being young
• Having unrealistic expectations of procedure results
• Having had a previous, unsatisfactory plastic surgery
• Having only minimal deformity to begin with
• Expecting the surgery to “fix” a dysfunctional relationship or personal issue
• Having a history of depression, anxiety, or personality disorder
• Having body dysmorphic disorder, being narcissistic, being psychotic

Clearly, patients with certain serious psychiatric disorders are not good candidates for cosmetic surgery. This is particularly true of patients with body dysmorphic disorder who obsess about a perceived defect in their bodies. Patients who are constantly self-assessing their reflection and feel almost paralyzed by their obsession with a bodily defect, such as a nasal hump, are very unlikely to be pleased with the results of rhinoplasty or any other cosmetic procedure.Why does being young or male predispose patients to dissatisfaction with surgery?It has not yet become clear through research studies why being young or being male predisposes rhinoplasty patients to dissatisfaction. It has been speculated, however, that younger patients are more likely to have unrealistic expectations about what rhinoplasty will accomplish.Males in our culture are more likely to base their self-esteem on their success in the workplace and their virility and for this reason may be more prone to expect that rhinoplasty will change not only their facial appearance, but help their careers and be more successful socially and romantically. They may also be more impatient than women, since women are more used to spending time and expending energy to improve their appearances.How Dr. Tobias Prevents Patient Dissatisfaction Clearly, no doctors or patients want any rhinoplasty procedure to be unsuccessful, either in terms of artistic results or psychological outcome. This is why Dr. Geoffrey Tobias makes it a top priority both to screen for potential difficulties and to be carefully attuned to his patients’ desires. For many years he has focused only on rhinoplasty, making it his life’s work to perfect this particular surgical procedure. The vast majority of Dr. Tobias’s patients report not only satisfaction, but delight, in their new appearances. Here are some of the methods he uses to ensure positive outcomes:

• Assessing each patient’s facial features individually, never producing a “cookie cutter” nose
• Focusing on the patient’s facial contours and proportions to produce natural results
• Tuning in to the patient’s particular desires regarding final outcome
• Using his expertise and experience to explain what will work best aesthetically

Dr. Tobias knows well the joyful, revitalized responses of happy customers. Because he encourages his patients to have realistic expectations, and because he is as talented and skilled as a surgeon can be, he is able to produce postsurgical exhilaration in almost all cases.