Psychological considerations in the revision rhinoplasty patient

Davis RE, Bublik M.

What this paper says

This review describes the psychological disorders that can undermine a revision rhinoplasty result no matter how good the surgery, and contrasts their warning signs with the emotional presentation of the well-adjusted revision patient; the abstract reports no counts.

Overview

A nose changed by surgery, injury or nature affects how a person feels about the whole face. Most revision patients hope for improvement and have realistic expectations, but a subset carry psychological disturbances that can leave them unhappy with a technically good result. The authors set out to help surgeons tell the two groups apart.

Sections of note

Review article; no patient series, prevalence figures or screening data appear in the abstract.
The nose is described as contributing greatly to facial aesthetics, with emotional consequences when its appearance is disturbed.
Many revision patients are described as hopeful yet realistic.
A subset has underlying psychological disturbances that may negatively affect the outcome regardless of surgical improvement.
The article discusses the psychological disorders that affect revision patients, the hallmark features of psychopathology, and the typical emotional presentation of the well-adjusted patient.

What it means for a patient

Surgeons are trained to look for signs that a patient's distress about the nose is out of proportion to what surgery can change.
Being anxious or upset about a failed first operation is normal and is not the same as a psychological disorder.
The abstract gives no numbers on how common these conditions are among revision patients.

Why this paper matters

Revision patients have the highest rates of body dysmorphic symptoms in rhinoplasty populations, as other studies in this period reported. This article gives surgeons a clinical framework for recognizing them. It offers no validated screening tool or outcome data.

Terms

Revision rhinoplasty: a repeat operation on a nose that has already had surgery.
Psychopathology: features of a mental disorder.
Body dysmorphic disorder: preoccupation with a slight or imagined appearance flaw.
Nasal cosmesis: the appearance of the nose.
Surgical expectations: what a patient believes the operation will achieve.
Well-adjusted patient: a patient whose concerns and expectations match what surgery can deliver.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the 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…”

Excerpt; the full abstract is on PubMed.