In patients seeking aesthetic rhinoplasty, a high prevalence of body dysmorphic disorder symptoms has recently been reported. However, the impact of these symptoms on the outcomes after rhinoplasty remains elusive. This large-scale study determines the influence of preoperative body dysmorphic disorder symptoms on patients' postoperative satisfaction and quality of life, using validated questionnaires.
A 1-year prospective study of 166 adult patients undergoing cosmetic rhinoplasty in a tertiary referral center was performed. Severity of body dysmorphic disorder symptoms was assessed by the modified Yale-Brown Obsessive Compulsive Scale. Postoperative satisfaction was evaluated using a visual analog scale for patients' appraisal of nasal shape and the Rhinoplasty Outcome Evaluation. Generic quality of life was quantified by the Sheehan Disability Scale, whereas the appearance-related disruption of everyday life was measured by the Derriford Appearance Scale-59.
Preoperative body dysmorphic disorder symptom scores inversely correlated with postoperative satisfaction at 3 months (visual analog scale nasal shape: rho = −0.43, p < 0.001; Rhinoplasty Outcome Evaluation: rho = −0.48, p < 0.001) and 12 months (rho = −0.40, p < 0.001; and rho = −0.41, p < 0.001, respectively) after surgery. In addition, body dysmorphic disorder symptom scores positively correlated with Sheehan Disability Scale scores and Derriford Appearance Scale-59 scores at 3 months (rho = 0.43, p < 0.001 and rho = 0.48, p < 0.001, respectively) and 12 months (rho = 0.32, p < 0.001, and rho = 0.48, p < 0.001, respectively) postoperatively.
This study provides the first evidence of the negative impact of preoperative body dysmorphic disorder symptoms on subjective outcomes after rhinoplasty, hence unveiling a crucial factor in patient dissatisfaction after aesthetic rhinoplasty.
Leuven, Belgium; Ulm, Germany; and Crete, Greece
From the Departments of Otorhinolaryngology, Head and Neck Surgery, and Psychiatry, University Hospitals Leuven; the Department of Otorhinolaryngology, Ulm University; the Department of Neurosciences, KU Leuven; and the Department of Otorhinolaryngology, University of Crete School of Medicine.
Received for publication August 28, 2012; accepted October 24, 2012.
Presented at Nose and Face World, in Rome, Italy, May 9 through 12, 2012.
Disclosure:The authors have no financial interest to declare in relation to the content of this article. No outside funding was received.
Prof. Dr. Peter W. Hellings, M.D., Ph.D.; Ear, Nose, and Throat Department, University Hospitals Leuven, Campus Sint-Rafaël, Kapucijnenvoer 33, B-3000 Leuven, Belgium, email@example.com