PRS-GO Plastic and Reconstructive Surgery Global Open · 2020

Assessment of Wellbeing and Anxiety-related Disorders in Those Seeking Rhinoplasty: A Crowdsourcing-based Study

Shauly O, Calvert J, Stevens G, Rohrich R, Villanueva N, Gould DJ.

PubMed 32440408 Publisher (DOI)Free full text (PMC)

What this paper says

Among 298 online survey volunteers, 57.84 percent of those interested in rhinoplasty screened positive for a psychological disorder, and interest was highest among women and adults aged 18 to 24.

Overview

Psychological concerns are proposed as a driver of demand for cosmetic rhinoplasty, and outcomes may disappoint patients with significant depression, anxiety or other disorders. This cross-sectional study surveyed the general public online to estimate how common such disorders are among those interested in the operation.

Sections of note

Prospective cross-sectional study of 298 random volunteers recruited through Amazon Mechanical Turk.
Each participant completed a 10-item standardized nasal outcomes scale and a 26-question PRIME-MD questionnaire.
Those instruments assessed functional and aesthetic need for rhinoplasty and the presence of psychological disorders respectively.
38.95 percent of female participants reported willingness to undergo aesthetic rhinoplasty, versus 27.78 percent of men, P 0.042.
Adults aged 18 to 24 were most willing at 52.92 percent, more than any other age group, P below 0.01.
57.84 percent of those interested in surgery screened positive for a psychological disorder on PRIME-MD.
The authors name major depressive disorder, generalized anxiety disorder and body dysmorphic disorder, and recommend mental health assessment before treatment.

What it means for a patient

These are members of the public asked hypothetically, not patients who sought surgery, so the figures describe interest rather than demand.
A screening questionnaire indicates possible disorder; it is not a diagnosis.
Roughly a third of the general sample expressed willingness to have rhinoplasty.
Limits: 298 crowdsourced respondents, self-reported, hypothetical willingness, and no clinical assessment or follow-up.

Why this paper matters

Screening before cosmetic surgery is widely recommended, and this estimates how large the affected group might be. Crowdsourcing reaches people who never present to a clinic. Hypothetical interest is a weak proxy for actually seeking surgery, so the prevalence figure should not be read as applying to surgical patients.

Terms

Crowdsourcing: Recruiting survey respondents through an online platform.
PRIME-MD: A questionnaire screening for common mental health disorders in primary care.
Body dysmorphic disorder: A psychiatric condition of distressing preoccupation with a perceived appearance flaw.
Cross-sectional study: A study measuring a group at one point in time.
Screening instrument: A short test identifying who may need fuller assessment.

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

Abstract

Background: Recently, it has been proposed that psychosocial concerns may motivate the demand for aesthetic rhinoplasty. Although successful operations often improve the quality of life and self-esteem symptoms in patients with sound mental health, they may actually result in unsatisfactory outcomes in those patients with significant depression, anxiety, or other severe psychological disorders. The purpose of this study was to assess the incidence of psychological disorders in patients seeking rhinoplasty.

Methods: A prospective cross-sectional study of 298 random volunteers was conducted, with each participant completing a survey instrument that was administered through an internet crowd-sourcing service (Amazon Mechanical Turk). Participants were asked to complete a 10-item standardized SHNOS scale, and a 26-question PRIME-MD questionnaire in order to assess functional and aesthetic need for rhinoplasty, and the incidence of psychological disorders respectively.

Results: 38.95% of female participants reported a willingness to undergo aesthetic rhinoplasty, with a significantly lower number of men reporting the same (27.78%, P = 0.042). Adults between the ages of 18-24 (52.92%) were more willing to undergo aesthetic rhinoplasty, as compared to any other age group (P < 0.01). It was found that 57.84% of patients interested in surgery reported a psychological disorder as determined by the PRIME-MD questionnaire.

Conclusions: Those suffering from major depressive disorder, generalized anxiety disorder, or body dysmorphic disorder may seek aesthetic rhinoplasty as a solution. It is important that surgeons assess patient mental health prior to treatment in order to avoid unsuccessful outcomes secondary to psychosocial illness.

Abstract as indexed by PubMed; the article is open access (PubMed Central).