title: Psychological impact of self-image dissatisfaction after orthognathic surgery: a case report.
abstract: OBJECTIVE
  The number of patients who need treatment for dentofacial abnormalities has increased over the past 30 years. Facial alterations can influence both the patient's self-confidence and his interpersonal relationships, possibly generating emotional or physical handicaps. This qualitative study discusses a patient's psychological dissatisfaction with a postoperative outcome, despite the esthetic and functional success of the treatment.
  
  
  METHODS
  The Oral Health Status Questionnaire, Post Surgical Satisfaction Questionnaire, Illness Behavior Questionnaire, and a clinical interview were used for the research methodology.
  
  
  RESULTS
  Oral surgeons are encouraged to identify, presurgery, the patient's true motivation. An efficacious behavioral model is proposed that might help the patient transition through the consequences stages of the psychosocial changes associated with facial reconstructive surgery.
  
  
  CONCLUSIONS
  Orthognathic surgery involves more than the correction of a physical problem. The psychological needs of the patient must be recognized and acknowledged, and communication between surgeons and patients is essential. It is important to understand that any surgical treatment that modifies body image could generate psychological disorders for some patients. Early surgical intervention and a referral for psychological counseling may reduce long-term morbidity. This case report should alert attending surgeons and orthodontists to possible unfavorable psychological sequelae.
authors.affiliation: Department of Neurological Sciences, Faculty of Medicine, University of Florence, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Pavone
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rispoli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Acocella
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Scott
authors.forename: Paolo
authors.initials: P
authors.lastname: Nardi
mesh_terms: D000328:Adult; D001828:Body Image; D005260:Female; D006801:Humans; D007063:Identity Crisis; D008313:Malocclusion, Angle Class III / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000523:psychology*; D017060:Patient Satisfaction; D012649:Self Concept; D020377:Self Efficacy; D011795:Surveys and Questionnaires