A Multidisciplinary Approach to Rhinoplasty: The Facial Plastic Surgeon and the Psychologist

Auer D, Saroha S, Unadkat SN, Saleh HA.

PubMed 41248892 Publisher (DOI)Free full text (PMC)

What this paper says

A narrative review from a high-volume London rhinoplasty centre arguing that routine psychological assessment integrated into the surgical service improves patient selection, manages expectations and reduces revisions.

Overview

A subset of rhinoplasty candidates has psychological profiles that undermine outcomes. Saleh's group reviewed PubMed/MEDLINE, PsycINFO, Embase and Scopus to June 2025 on rhinoplasty, psychology, body dysmorphic disorder, screening and multidisciplinary care, combined with their own clinical experience. No new patient data are reported.

Sections of note

Hypothesis: early psychological input improves selection, expectation management and revision rates.
Reported findings: integrated assessment can identify patients at risk of dissatisfaction, enhance selection and reduce revisions.
The conclusion frames psychological screening as supporting the ethical principle of nonmaleficence (do no harm).
Sources included peer-reviewed studies, reviews and guidelines.

What it means for a patient

Being referred to a psychologist before rhinoplasty is increasingly standard at leading centres and is not a judgment on the patient.
The aim is to avoid surgery that will not help, particularly in body dysmorphic disorder.
The review states benefits in general terms without quantifying them.

Why this paper matters

It describes the model of care at a major UK centre and argues for it from the literature. Limits: narrative review, no outcome numbers.

Terms

Body dysmorphic disorder (BDD): preoccupation with a perceived flaw, associated with poor surgical outcomes.
Multidisciplinary: care involving more than one specialty, here surgery and psychology.
Nonmaleficence: the ethical duty to avoid causing harm.
Patient selection: deciding who is a suitable candidate.

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

Abstract

Introduction: Rhinoplasty is one of the most frequently requested aesthetic procedures. However, a subset of patients presents with complex psychological profiles that can adversely impact surgical outcomes. Early psychological assessment is crucial to optimizing patient safety and satisfaction.

Objectives And Hypotheses: This narrative review aims to explore the role of integrated psychological assessment within multidisciplinary facial plastic surgery services. It hypothesizes that early psychological input improves patient selection, manages expectations, and reduces revision rates.

Study Design: Narrative review.

Methods: We conducted a structured narrative review of PubMed/MEDLINE, PsycINFO, Embase, and Scopus (from inception to June 2025), supplemented by clinical experience from a high-volume United Kingdom rhinoplasty center. Search terms included rhinoplasty, psychology, BDD, screening, and multidisciplinary care. Eligible sources comprised peer-reviewed studies, reviews, and guidelines on psychological assessment or outcomes in aesthetic rhinoplasty.

Results: Integrated psychological assessment can identify patients at risk of dissatisfaction, enhance patient selection, reduce revision surgeries, and improve overall outcomes.

Conclusion: Multidisciplinary collaboration between surgeons and psychologists improves rhinoplasty outcomes, enhances patient safety, and supports the ethical principle of nonmaleficence.

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