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Comparison of Aesthetic and Functional Rhinoplasty Outcomes Between Patients with Body Dysmorphic Disorder and Normal Individuals

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  • Rhinoplasty
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Abstract

Background

Rhinoplasty is among the top five most popular cosmetic surgical procedures worldwide. Among rhinoplasty candidates, the most common mental health disorder is body dysmorphic disorder. (BDD). The present study aimed to assess the prevalence of BDD among rhinoplasty candidates, its association with the patient’s self-assessment of aesthetic outcome and nasal functional, post-rhinoplasty compared to applicants with negative screening for BDD.

Methods

The following study is a cross-sectional, comparative study. Out of the 209 rhinoplasty candidates screened by the BDDQ questionnaire, 39 were positive for BDD. From the remaining 170 patients who screened negative for BDD, 39 participants were randomly selected as the control group for the comparative analysis. Rhinoplasty outcome evaluation (ROE) and standardized cosmesis and health nasal outcomes survey-cosmetic (SCHNOS-C) questionnaires were used for assessment of patient satisfaction with the cosmetic outcome of rhinoplasty. Nasal obstruction symptom evaluation (NOSE) and standardized cosmesis and health nasal outcomes survey-obstruction (SCHNOS-O) were used for the assessment of satisfaction with functional outcomes between groups of patients screened positive and negative for BDD.

Results

The prevalence of BDD was 18.66% among rhinoplasty candidates. The average age of patients screened positive for BDD was 31.41. The mean ROE score was significantly lower (i.e. lower satisfaction) in patients screened positive for BDD (15.69 versus 19.08, P = 0.001), regardless of confounding variables, such as age, sex, and marital status. SCHNOS-C score was higher (i.e. less satisfaction) among patients with BDD (47.01 versus 34.96, P = 0.021) and was significantly associated with higher odds of severe aesthetic concern post-rhinoplasty (OR (95%CI) = 5.000 (1.135–22.022), P = 0.033). Patients screened positive for BDD had significantly higher NOSE scores (i.e. less satisfaction with functional outcome) compared to participants negative for BDD (49.74 versus 37.82, P = 0.012). SCHNOS-O score had no significant association with BDD (P = 0.053). Furthermore, there was no significant association between BDD and NOSE or SCHNOS-O score after adjustment for the confounders.

Conclusion

Patients screened positive for BDD were significantly less satisfied with the cosmetic outcome of the rhinoplasty compared to those screened negative for BDD. Assessment of BDD among rhinoplasty candidates before surgery, could potentially be beneficial for both patients and surgeons.

Level of Evidence III

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Funding

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Authors and Affiliations

  1. Otolaryngology Department, Tehran University of Medical Sciences, Tehran, Iran

    Fatemeh Moosaie, Sepide Javankiani, Sara Rahavi, Sara Mohammadi & Babak Saedi

  2. International Surgical Research Association (ISRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran

    Fatemeh Moosaie, Sepide Javankiani, Zainab Julia Najeeb & Sara Mohammadi

  3. Psychosomatic medicine research center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Dr. Qarib St, Keshavarz Blvd, Tehran, 1419733141, Iran

    Fatemeh Moosaie & Babak Saedi

  4. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad Ali Mansournia

Authors
  1. Fatemeh Moosaie
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  2. Sepide Javankiani
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  4. Sara Rahavi
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  5. Zainab Julia Najeeb
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Contributions

Study concept and design was conducted by F.M. and B.S., Data extraction was performed by F.M., Drafting of the manuscript was done by F.M., S.J. and S.M., Critical revision of the manuscript was conducted by B.S., F.M, Z.J.N. and S.R.

Corresponding author

Correspondence to Babak Saedi.

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Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the Ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Institutional Review Board (IRB) of Tehran University of Medical Sciences, Tehran with the ethics code “IR.TUMS.IKHC.REC.1400.451”.

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Informed consent was obtained from all individual participants included in the study.

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Moosaie, F., Javankiani, S., Mansournia, M.A. et al. Comparison of Aesthetic and Functional Rhinoplasty Outcomes Between Patients with Body Dysmorphic Disorder and Normal Individuals. Aesth Plast Surg (2024). https://doi.org/10.1007/s00266-024-03961-y

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