FPS Facial Plastic Surgery · 2019

Perspectives of Facial Plastic Surgeons on Opioid Dependence in Rhinoplasty Patients

Levin M, Roskies MG, Asaria J.

What this paper says

In a survey of 164 facial plastic surgeons, 86.96 percent said opioid dependence is not a problem in rhinoplasty patients, and 25.17 percent prescribe more than 25 opioid tablets after the operation.

Overview

Prescription opioid overuse is a recognized public health problem, and surgeons' beliefs shape how much they prescribe. This prospective survey asked members of a national facial plastic surgery body about their views on dependence in rhinoplasty patients and about their own prescribing.

Sections of note

A nine-question survey was sent to all members of the American Academy of Facial Plastic and Reconstructive Surgery in July 2018; analysis completed August 2018.
164 surgeons responded, a response rate of 6.6 percent.
61.96 percent had been in practice more than 10 years; 84.15 percent perform fewer than five rhinoplasties per week.
89.51 percent prescribe some form of opioid following rhinoplasty.
86.96 percent believe opioid dependence is not a problem in rhinoplasty patients, while 61.11 percent believe it is a problem among surgical patients in general.
52.45 percent prescribe between 11 and 25 opioid tablets after rhinoplasty; 25.17 percent prescribe more than 25.
The authors call for surgeon education and for rhinoplasty-specific opioid prescribing guidelines.

What it means for a patient

Nearly nine in ten of these surgeons prescribe opioids after rhinoplasty, and a quarter prescribe more than 25 tablets.
Published studies of actual use report patients taking under 10 tablets on average, so prescribed amounts here exceed typical consumption.
Surgeons saw dependence as a general surgical problem but not one affecting their own rhinoplasty patients.
Limits: 6.6 percent response rate, so respondents may not represent the membership, and prescribing was self-reported.

Why this paper matters

Leftover opioids from surgical prescriptions are a documented route into misuse, and the gap between surgeon belief and prescribing volume is where guidelines would act. Documenting that belief gap is the study's contribution. The very low response rate limits how far the figures generalize.

Terms

Opioid: A class of strong pain medication carrying dependence risk.
Opioid dependence: Physical or psychological reliance on opioid medication.
Prescribing pattern: What quantity and duration of medication a clinician typically prescribes.
Response rate: The proportion of those surveyed who replied.
Prospective survey: A survey administered and analyzed as a planned study.

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

From the abstract

“Understanding the perspectives and opinions of facial plastic surgeons on opioid dependence is critical in a national epidemic of opioid overuse. Findings may encourage surgeon education so that facial plastic surgeons may be able to judiciously prescribe opioids, improving patient outcomes and reducing healthcare…”

Excerpt; the full abstract is on PubMed.