The psychological aspects of rhinoplasty.
OBJECTIVE
Literature on the psychological aspects of rhinoplasty is sparse compared with publications on methods and instrumentation. Understanding the psychological aspects of rhinoplasty and, more importantly, recognizing the patient who may have an unfavorable postoperative course regardless of the objective outcome is of fundamental importance to the surgeon.


RESULTS
Several profiles of patients with a high risk of postoperative dissatisfaction have been described and the important role of body dysmorphic disorder and its treatment has been stressed. Still, these criteria can be insufficient when facing the individual patient, as reliable screening instruments for clinical practice have not been developed and the question when not to operate is subject to controversy. The role of computer imaging as a safeguard in preoperative counseling has been highlighted.


CONCLUSIONS
The surgeon must rely on instinct and experience to avoid overlooking any signs of psychological imbalance in the patient that may herald adversity. Archetypes described in the literature should be recognized and computer imaging should be used during the preoperative consultation.
Tasman
Abel-Jan
AJ
ENT Department, Cantonal Hospital St. Gallen, St. Gallen, Switzerland. abel-jan.tasman@kssg.ch
D001007:Anxiety; D057215:Body Dysmorphic Disorders / Q000523:psychology; D003142:Communication; D000075202:Contraindications; D006801:Humans; D007091:Image Processing, Computer-Assisted; D009042:Motivation; D017060:Patient Satisfaction; D018579:Patient Selection; D010817:Physician-Patient Relations; D011182:Postoperative Care; D012225:Rhinoplasty / Q000523:psychology*