In this article the authors discuss the assessment of patients undergoing septorhinoplasty emphasing the importance of psychological assessement in the preoperative work up. Patients motivations, anxieties and expectations are reviewed, key points to help identify problem patients are highlighted and specific questions to identfy those that may be suffering BDD are recommended. Facial proportions and the ideal angles of the facial esthetic triangle are described. A framework is presented to enable systematic analysis and examination of the face and nose to promote appropriate patient selection and facilitate surgical planning.
Sperry S, Thompson JK, Sarwer DB, Cash TF. Cosmetic surgery reality TV viewership: relations with cosmetic surgery attitudes, body image, and disordered eating. Ann Plast Surg 2009 Jan;62(1):7-11.
Rankin M, Borah GL, Perry AW, Wey PD. Quality-of-life outcomes after cosmetic surgery. Plast Reconstr Surg 1998 Nov;102(6):2139-2145.
Shulman O, Westreich M, Shulman J. Motivation for rhinoplasty: changes in 5970 cases, in three groups, 1964 to 1997. Aesthetic Plast Surg 1998 Nov;22(6):420-424.
Napoleon A, Lewis CM. Psychological considerations in lipoplasty: the problematic or “special care” patient. Ann Plast Surg 1989 Nov;23(5):430-432.
Tasman AJ. Rhinoplasty – indications and techniques. GMS Curr Top Otorhinolaryngol Head Neck Surg 2007;6:Doc09.
Adamson PA, Chen T. The dangerous dozen--avoiding potential problem patients in cosmetic surgery. Facial Plast Surg Clin North Am 2008 May;16(2):195-202.
Rohrich RJ. Streamlining cosmetic surgery patient selection– just say no! Plast Reconstr Surg 1999 Jul;104(1):220-221.
Tardy, ME Jr. Rhinoplasty: the art and the science. Philidelphia (PA): Saunders; 1997.
Jakubietz M, Jakubietz RJ, Kloss DF, Gruenert JJ. Body dysmorphic disorder: diagnosis and approach. Plast Reconstr Surg 2007 May;119(6):1924-1930.
Picavet VA, Prokopakis EP, Gabriels L, Jorissen M, Hellings PW. High prevalence of body dysmorphic disorder symptoms in patients seeking rhinoplasty. Plast Reconstr Surg 2011 Aug;128(2):509-517.
Joseph J, Randhawa P, Hannan SA, Long J, Goh S, O'Shea N, Saleh H, Hansen E, Veale D, Andrews P. Body dysmorphic disorder in patients undergoing septorhinoplasty surgery: should we be performing routine screening? Clin Otolaryngol 2017 Jun;42(3):508-513.
Phillips KA. Body dysmorphic disorder: recognizing and treating imagined ugliness. World Psychiatry 2004 Feb;3(1):12-17.
Palma P, Khodaei I, Tasman AJ. A guide to the assessment and analysis of the rhinoplasty patient. Facial Plast Surg 2011 Apr;27(2):146-159.
Alsarraf R. Outcomes research in facial plastic surgery: a review and new directions. Aesthetic Plast Surg 2000 May-Jun;24(3):192-197.
Alsarraf R, Larrabee WF, Anderson S, Murakami CS, Johnson CM. Measuring cosmetic facial plastic surgery outcomes: a pilot study. Arch Facial Plast Surg 2001 Jul-Sep;3(3):198-201.
Picavet VA, Gabriels L, Grietens J, Jorissen M, Prokopakis EP, Hellings PW. Preoperative symptoms of body dysmorphic disorder determine postoperative satisfaction and quality of life in aesthetic rhinoplasty. Plast Reconstr Surg 2013 Apr;131(4):861-868.
Gunel C, Omurlu IK. The effect of rhinoplasty on psychosocial distress level and quality of life. Eur Arch Otorhinolaryngol 2015 Aug;272(8):1931-1935.
Lekakis G, Picavet VA, Gabriels L, Grietens J, Hellings PW. Body Dysmorphic Disorder in aesthetic rhinoplasty: validating a new screening tool. Laryngoscope 2016 Aug;126(8): 1739-1745.
Joseph AW, Ishii L, Joseph SS, Smith JI, Su P, Bater K, Byrne P, Boahene K, Papel I, Kontis T, et al. Prevalence of body dysmorphic disorder and surgeon diagnostic accuracy in facial plastic and oculoplastic surgery clinics. JAMA Facial Plast Surg 2017 Jul;19(4):269-274.
Veale D, Ellison N, Werner TG, Dodhia R, Serfaty MA, Clarke A. Development of a cosmetic procedure screening questionnaire (COPS) for body dysmorphic disorder. J Plast Reconstr Aesthet Surg 2012 Apr;65(4):530-532.
Carr T, Moss T, Harris D. The DAS24: a short form of the Derriford Appearance Scale DAS59 to measure individual responses to living with problems of appearance. Br J Health Psychol 2005 May;10(Pt 2):285-298.
Herruer JM, Prins JB, van Heerbeek N, Verhage-Damen G, Ingels K. Does self-consciousness of appearance influence postoperative satisfaction in rhinoplasty? J Plast Reconstr Aesthet Surg 2018 Jan;71(1):79-84.
Naraghi M, Atari M. Development and Validation of the Expectations of Aesthetic Rhinoplasty Scale. Arch Plast Surg 2016 Jul;43(4):365-370.
Phillips, KA. The broken mirror: understanding and treating body dysmorphic disorder. Revised and Expanded Edition. New York: Oxford University Press; 2005.
Lohuis PJ, Hakim S, Duivesteijn W, Knobbe A, Tasman AJ. Benefits of a short, practical questionnaire to measure subjective perception of nasal appearance after aesthetic rhinoplasty. Plast Reconstr Surg 2013 Dec;132(6):913e-923e.
Lee MK, Most SP. A comprehensive quality-of-life instrument for aesthetic and functional rhinoplasty: the RHINO scale. Plast Reconstr Surg Glob Open 2016 Feb;4(2):e611.
Mancuso SG, Knoesen NP, Castle DJ. The dysmorphic concern questionnaire: a screening measure for body dysmorphic disorder. Aust N Z J Psychiatry 2010 Jun;44(6):535-542.
Robinson K, Gatehouse S, Browning GG. Measuring patient benefit from otorhinolaryngological surgery and therapy. Ann Otol Rhinol Laryngol 1996 Jun;105(6):415-422.
Kosowski TR, McCarthy C, Reavey PL, Scott AM, Wilkins EG, Cano SJ, Klassen AF, Carr N, Cordeiro PG, Pusic AL. A systematic review of patient-reported outcome measures after facial cosmetic surgery and/or nonsurgical facial rejuvenation. Plast Reconstr Surg 2009 Jun;123(6):1819-1827.
Hendry J, Chin A, Swan IR, Akeroyd MA, Browning GG. The Glasgow Benefit Inventory: a systematic review of the use and value of an otorhinolaryngological generic patient-recorded outcome measure. Clin Otolaryngol 2016 Jun;41(3):259-275.
Herruer JM, Prins JB, van Heerbeek N, Verhage-Damen GW, Ingels KJ. Negative predictors for satisfaction in patients seeking facial cosmetic surgery: a systematic review. Plast Reconstr Surg 2015 Jun;135(6):1596-1605.
Kotzampasakis D, Piniara A, Themelis S, Kotzampasakis S, Gabriel E, Maroudias N, Nikolopoulos T. Quality of life of patients who underwent aesthetic rhinoplasty: 100 cases assessed with the Glascow Benefit Inventory. Laryngoscope 2017 Sep;127(9):2017-2025.
Schwitzer JA, Klassen AF, Cano SJ, Baker SB, East C, Pusic AL. Measuring satisfaction with appearance: validation of the FACE-Q Scales for the nose, forehead, cheekbones, and chin. Plast Reconstr Surg 2015 Oct;136(4 Suppl):140-141.
Klassen AF, Cano SJ, Schwitzer JA, Scott AM, Pusic AL. FACE-Q scales for health-related quality of life, early life impact, satisfaction with outcomes, and decision to have treatment: development and validation. Plast Reconstr Surg 2015 Feb;135(2):375-386.
Klassen AF, Cano SJ, East CA, Baker SB, Badia L, Schwitzer JA, Pusic AL. Development and psychometric evaluation of the FACE-Q scales for patients undergoing rhinoplasty. JAMA Facial Plast Surg 2016 Jan-Feb;18(1):27-35.
Schwitzer JA, Albino FP, Mathis RK, Scott AM, Gamble L, Baker SB. Assessing demographic differences in patientperceived improvement in facial appearance and quality of life following rhinoplasty. Aesthet Surg J 2015 Sep;35(7): 784-793.
Schwitzer JA, Sher SR, Fan KL, Scott AM, Gamble L, Baker SB. Assessing patient-reported satisfaction with appearance and quality of life following rhinoplasty using the FACE-Q appraisal scales. Plast Reconstr Surg 2015 May;135(5):830e-837e.
Radulesco T, Mancini J, Penicaud M, Dessi P, Michel J. Assessing normal values for the FACE-Q rhinoplasty module: an observational study. Clin Otolaryngol 2018 Feb.
Golshani S, Mani A, Toubaei S, Farnia V, Sepehry AA, Alikhani M. Personality and psychological aspects of cosmetic surgery. Aesthetic Plast Surg 2016 Feb;40(1):38-47.
Baykal B, Erdim I, Ozbay I, Oghan F, Oncu F, Erdogdu Z, Kayhan FT. Evaluation of relationship between body dysmorphic disorder and self-esteem in rhinoplasty candidates. J Craniofac Surg 2015 Nov;26(8):2339-2341.
American Psychiatric Association. Somatoform disorders. Diagnostic and statistical manual of mental disorders: DSM-5. DSM-5 ed. Washington (DC): American Psychiatric Press Inc; 2013.
Goin MK, Rees TD. A prospective study of patients’ psychological reactions to rhinoplasty. Ann Plast Surg 1991 Sep;27(3):210-215.
Atalay, B. Math and the Mona Lisa: the art and science of Leonardo da Vinci. New York: Haper Collins; 2006.
Lines PA, Lines RR, Lines CA. Profilemetrics and facial esthetics. Am J Orthod 1978 Jun;73(6):648-657.
Gunter, JP.; Rohrich, RJ.; Adams, WP. Dallas rhinoplasty: nasal surgery by the masters. St. Louis (MO): Quality Medical Publishing; 2002.
Powell, N.; Humphrey, B. Proportions of the aesthetic face. In: Byrd HS, Hobar PC, editors. Rhinoplasty: a practical guide. New York: Thieme-Stratton; 1984.
Zaidel DW, Cohen JA. The face, beauty, and symmetry: perceiving asymmetry in beautiful faces. Int J Neurosci 2005 Aug;115(8):1165-1173.
Chatrath P, De Cordova J, Nouraei SA, Ahmed J, Saleh HA. Objective assessment of facial asymmetry in rhinoplasty patients. Arch Facial Plast Surg 2007 May-Jun;9(3):184-187.
Nouraei SA, Pulido MA, Saleh HA. Impact of rhinoplasty on objective measurement and psychophysical appreciation of facial symmetry. Arch Facial Plast Surg 2009 May-Jun;11(3):198-202.
Fang F, Clapham PJ, Chung KC. A systematic review of interethnic variability in facial dimensions. Plast Reconstr Surg 2011 Feb;127(2):874-881.
Monheit, GD. Combination chemical peelings. In: Lowe NJ, editor. Textbook of facial rejuvenation: the art of minimally invasive combination therapy. London: Martin Dunitz; 2002.
Glogau RG, Matarasso SL. Chemical face peeling: patient and peeling agent selection. Facial Plast Surg 1995 Jan;11(1):1-8.
Aufricht G. Combined plastic surgery of the nose and chin; resume of twenty-seven years’ experience. Am J Surg 1958 Feb;95(2):231-236.
Guyuron B, Raszewski RL. A critical comparison of osteoplastic and alloplastic augmentation genioplasty. Aesthetic Plast Surg 1990 Summer;14(3):199-206.
Farkas, LG. Anthropometry of the head and face. 2nd ed. New York: Raven Press; 1994.
Boahene, KD.; Orten, SS.; Hilger, PA. Facial analysis of the rhinoplasty patient. In: Papel ID, Frodel JL, Holt GR, Larrabee WF, Nachlas NE, Park SS, Sykes JM, Toriumi DM, editors. Facial plastic and reconstructive surgery. 3rd ed. New York: Thieme;
Tardy ME. Rhinoplasty tip ptosis: etiology and prevention. Laryngoscope 1973 Jun;83(6):923-929.
Sulsenti G, Palma P. Tailored nasal surgery for normalization of nasal resistance. Facial Plast Surg 1996 Oct;12(4):333-345.
Tardy, ME Jr.; Broen, M. Principles of photography in facial plastic surgery. New York: Thieme; 1992.
Bond, M.; Bell, A. The IMI National Guidelines for rhinoplasty and septorhinoplasty photography. London: IMI; 2006.
Tardy ME, Dayan S, Hecht D. Preoperative rhinoplasty: evaluation and analysis. Otolaryngol Clin North Am 2002 Feb;35(1):1-27.
Ozkul T, Ozkul MH. Computer simulation tool for rhinoplasty planning. Comput Biol Med 2004 Dec;34(8):697-718.
Ende KH, Lewis DL, Kabaker SS. Body dysmorphic disorder. Facial Plast Surg Clin North Am 2008 May;16(2):217-223.
Lekakis G, Claes P, Hamilton GS, Hellings PW. Threedimensional surface imaging and the continuous evolution of preoperative and postoperative assessment in rhinoplasty. Facial Plast Surg 2016 Feb;32(1):88-94.
Durer A. “Hierinn sind begriffen vier Bucher von menschlicher Proportion durch Albrechten Durer von Nurerberg”. Hieronymus Andreae Formschneider. Available on https://archive.org/details/hierinnsindbegri00dure/page/n3; accessed on 6 August 2018.