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Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Scientific Oral Presentations 2 - Facial Plastic and Reconstructive Surgery

Role of Psychiatric History on Trends in Rhinoplasty Outcomes

Monday, September 30, 2024
9:30 AM – 9:36 AM EDT
Location: MBCC, 232
Disclosure(s):
Kathryn L. Nunes, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Neha Garg, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Uche G. Nwagu, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Alana M. Platukus:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Meredith L. Summa, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Howard D. Krein, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ryan N. Heffelfinger, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Prior research has suggested that facial plastic surgery in patients with psychiatric history may be associated with variable postoperative satisfaction and revisions. This study aims to evaluate the impact of psychological determinants on postoperative rhinoplasty satisfaction and likelihood of revision rhinoplasty.

Methods: Retrospective chart review was conducted in patients who underwent rhinoplasty from 2015 to 2023 at a tertiary care institution. Demographics, medical and psychiatric history, outcome data, and revision procedures were collected from charts. Patients were sent a questionnaire with items relevant to postoperative nasal appearance satisfaction, rated on a Likert scale of 1 (not at all) to 5 (completely).

Results: Of 385 included patients, 131 had a psychiatric history (PH). The PH cohort had an average of 1.4 conditions, 85% with anxiety, 49% depression, 2% each with PTSD and bipolar/mania. The PH cohort was significantly older and female (p < 0.013). Indication for rhinoplasty (functional, cosmetic, both) was comparable between cohorts, but there was noted significant history of facial trauma in the no psychiatric history cohort (NPH) (p = 0.024). PH was associated with significantly higher rates of intraoperative or in office revision (p = 0.022). This finding persisted in both functional and cosmetic rhinoplasties (p < 0.05) despite no significant difference in postoperative deformity between PH and NPH cohorts. For cosmetic rhinoplasties, 15.4% (2/13) with PH reported being not satisfied compared to 8.0% (3/38) with NPH (p = 0.59).

Conclusions: Psychiatric history was associated with significantly higher odds of revision despite no significant difference in postoperative deformity. Psychiatric history was also associated with higher rates of dissatisfaction with cosmetic rhinoplasty. Understanding the influence of patient history, particularly psychiatric history, on post-operative satisfaction and desire for revision is crucial in providing appropriate preoperative counseling, comprehensive care and adequate support to patients.

    Presenting Author(s)

  • Kathryn L. Nunes, BA

    Medical Student
    Thomas Jefferson University Department of Otolaryngology
    Plymouth Meeting, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Jefferson J. DeKloe, BS

    Medical Student
    Thomas Jefferson University Department of Otolaryngology
    Philadelphia, Pennsylvania, United States

    Disclosure information not submitted.

  • Neha Garg, BA

    Medical Student
    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
    Philadelphia, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • UN

    Uche G. Nwagu, MD

    Resident
    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • AP

    Alana M. Platukus

    Medical Student
    Sidney Kimmel Medical College at Thomas Jefferson University
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • MS

    Meredith L. Summa, BA

    Medical Student
    Sidney Kimmel Medical College at Thomas Jefferson University
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • AM

    Adam McCann, MD

    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital, United States

    Disclosure information not submitted.

  • Howard D. Krein, MD, PhD

    Professor
    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Ryan N. Heffelfinger, MD

    Professor, Department of OTO-HNS
    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.