APS Aesthetic Plastic Surgery · 2026

Impact of Rhinoplasty on Female Sexual Function, Self-esteem, and Depressive Symptoms, in Sexually Active Married Women

Yazır M, Sonbahar AE, Bektaş MC, Başkır İ.

PubMed 42380309 Publisher (DOI)Free full text (PMC)

What this paper says

Six months after cosmetic rhinoplasty, 64 married women showed improved sexual function scores (FSFI 24.20 to 27.22), fewer depressive symptoms (PHQ-9 8.81 to 4.97) and a higher proportion with high self-esteem (53.1% to 65.6%), though the mean self-esteem change was not significant.

Overview

The Turkish authors prospectively enrolled 70 sexually active married women aged 22-48 having primary cosmetic rhinoplasty by one surgeon, and administered the Female Sexual Function Index, the PHQ-9 depression questionnaire and the Rosenberg Self-Esteem Scale before surgery and at six months.

Sections of note

64 of 70 completed follow-up; mean age 35 (SD 6).
FSFI rose from 24.20 (SD 7.75) to 27.22 (SD 6.84), p = 0.021; high-function category from 21.9% to 37.5% (p < 0.001).
PHQ-9 fell from 8.81 (SD 6.34) to 4.97 (SD 3.96), p < 0.001; non-depressive proportion rose from 31.3% to 56.3%.
RSES mean 22.86 to 24.61 (p = 0.113, not significant); high self-esteem proportion 53.1% to 65.6% (p < 0.001).
Level of Evidence III.

What it means for a patient

In this group, rhinoplasty was followed by measurable gains in mood and intimate well-being at six months.
Self-esteem changes were mixed and the study cannot separate the effect of surgery from other life changes.
The authors still recommend structured psychological assessment before surgery.

Why this paper matters

It measures psychosocial outcomes rarely studied in rhinoplasty with validated instruments. Limits: single surgeon, no control group, six-month follow-up, a culturally specific sample.

Terms

Female Sexual Function Index (FSFI): a validated questionnaire on sexual function; higher is better.
PHQ-9: a nine-item depression screening questionnaire; lower is better.
Rosenberg Self-Esteem Scale (RSES): a ten-item measure of self-worth.
McNemar test: a statistical test for paired before-and-after categorical data.

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

Abstract

Background: Cosmetic rhinoplasty may influence psychosocial well-being; however, evidence regarding postoperative sexual function remains mixed. This study evaluated changes in female sexual function, depressive symptoms, and self-esteem before and 6 months after primary cosmetic rhinoplasty in sexually active married women.

Methods: This prospective cohort enrolled married women (22-48 years) undergoing primary cosmetic rhinoplasty by a single surgeon. Participants completed the Female Sexual Function Index (FSFI), Patient Health Questionnaire-9 (PHQ-9), and Rosenberg Self-Esteem Scale (RSES) preoperatively (T0) and at 6 months (T1). Categorical shifts between T0 and T1 were analyzed using the McNemar test (two-sided p<0.05).

Results: Of 70 enrolled women, 64 completed follow-up (mean age 35 ± 6 years). Sexual function improved, with FSFI increasing from 24.20 ± 7.75 to 27.22 ± 6.84 (p=0.021) and a shift toward higher FSFI categories (high function: 21.9-37.5%, p<0.001). Depressive symptoms decreased, with PHQ-9 falling from 8.81 ± 6.34 to 4.97 ± 3.96 (p<0.001) and an increased proportion classified as nondepressive (31.3-56.3%, p<0.001). Mean RSES increased from 22.86 ± 6.79 to 24.61 ± 5.57 (p=0.113), while the proportion with high self-esteem rose from 53.1 to 65.6% (p<0.001).

Conclusions: Primary cosmetic rhinoplasty was associated with improved depressive symptom burden and favorable shifts in sexual function categories at 6 months, with mixed findings for self-esteem. Psychosocial outcomes should be interpreted within a biopsychosocial framework, supporting structured preoperative psychological assessment and referral when indicated.

Level Of Evidence Iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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