title: Rhinoplasty as a medicalized phenomenon: a 25-center survey on quality of life before and after cosmetic rhinoplasty.
abstract: BACKGROUND
  Cosmetic surgery, including rhinoplasty, has been dramatically increasing in Iran through the last two decades. It is performed mainly on the youth for the purpose of beauty, an area not directly related to medicine but strongly medicalized. This study aimed to explore the effects of rhinoplasty on the quality of life experienced by individuals who have undergone the surgery.
  
  
  METHODS
  From all the plastic surgery clinics in Teheran, 25 were selected randomly as sites for the study. In the next step, 110 patients who had undergone rhinoplasty were selected randomly from these clinics. Only patients whose surgery had been performed 3 to 18 months before the interview were included in the statistical population. Data were collected through a Likert-type questionnaire that queries three major quality-of-life dimensions: general benefit, social support, and physical health. The collected data were analyzed by SPSS.
  
  
  RESULTS
  The mean scores for quality of life before and after surgery were 66.54 and 61.11, respectively. The difference was statistically significant (P = 0.008), showing a decline in quality of life after rhinoplasty. Whereas the mean score for social support and physical health decreased, the score for general benefit increased after the surgery. The main motivating factors for surgery were external factors (e.g., friends, family). In addition, the date of the surgery and the time of the interview were positively correlated. In other words, the longer the time since surgery, the greater was the increase in the patients' satisfaction and quality of life.
  
  
  CONCLUSIONS
  The overall quality of life among the statistical population decreased. This could be attributed to unnecessary surgeries, medical errors, and performance of rhinoplasty because of its recognized popularity. The reduction in social support may have resulted from unacceptable consequences of rhinoplasty, particularly in terms of appearance, and reactions of family and peer group. The physical health of the respondents was negatively affected by rhinoplasty. Malfunction of the upper respiratory system after rhinoplasty is a known main reason for the negative effect of rhinoplasty on the quality of life. Correlations between the times of the surgery and the interview suggest a long-term rather than an immediate assessment of effects that such surgeries have on the quality of life.
  
  
  METHODS
  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 http://www.springer.com/00266.
authors.affiliation: Department of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Marita
authors.initials: M
authors.lastname: Mohammadshahi
authors.forename: Abolghasem
authors.initials: A
authors.lastname: Pourreza
authors.forename: Parvaneh Heidari
authors.initials: PH
authors.lastname: Orojlo
authors.forename: Mahmood
authors.initials: M
authors.lastname: Mahmoodi
authors.forename: Feizallah
authors.initials: F
authors.lastname: Akbari
mesh_terms: D005260:Female; D006306:Health Surveys; D006801:Humans; D007492:Iran; D008297:Male; D009042:Motivation; D011788:Quality of Life; D012225:Rhinoplasty / Q000523:psychology; D012944:Social Support; D055815:Young Adult