Psychological Red Flags in Rhinoplasty: Predictors of Malpractice Claims

Oduncu M, Çelik M, Boylu ME, Turan Ş, Atan Y.

PubMed 41419223 Publisher (DOI)

What this paper says

Comparing 55 rhinoplasty patients who filed malpractice claims with 85 who did not, litigants were older, less educated, more often treated by non-professor specialists in private hospitals, and scored worse on body-image quality of life, self-esteem and somatisation.

Overview

Rhinoplasty has the highest litigation risk among aesthetic procedures, and claims often stem from selection rather than technical error. The Turkish authors used a case-control design: 55 patients referred for forensic evaluation after malpractice claims versus 85 non-litigating rhinoplasty patients, with endoscopy, standardised photographs and psychometric testing (SCL-90-R, BIQLI, Rosenberg Self-Esteem, SWAS).

Sections of note

Litigants were older (P = .002), less educated (P < .05), more often operated by specialists than professors (P < .001) and in private hospitals (P = .010).
Higher somatisation prevalence in litigants (P = .019).
Lower BIQLI, SWAS and RSES scores in litigants (all P < .05).
Logistic regression: low BIQLI and specialist-level surgery were independent predictors.
Level of Evidence 3.

What it means for a patient

Dissatisfaction leading to legal action was linked more to psychological profile than to the technical result in this study.
Low body-image quality of life before surgery is a warning sign that surgery may not deliver the hoped-for relief.
Screening questionnaires before surgery protect patients as well as surgeons.

Why this paper matters

It is a rare direct study of litigants with objective examination and psychometrics. Limits: Turkish medico-legal context, case-control design, and litigation as an outcome reflects the legal system as well as the patient.

Terms

Body dysmorphic disorder (BDD): preoccupation with a perceived minor or absent flaw.
Somatisation: experiencing psychological distress as physical symptoms.
BIQLI: Body Image Quality of Life Inventory.
SCL-90-R: a 90-item symptom checklist for psychological distress.
Case-control study: comparing people with an outcome against similar people without it.

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

From the abstract

“Rhinoplasty is among the most frequently performed aesthetic procedures worldwide and also carries the highest litigation risk. Malpractice claims often arise less from surgical error than from poor patient selection and overlooked psychological comorbidities. Objectives: This study aimed to identify clinical and…”

Excerpt; the full abstract is on PubMed.