title: Columellar Scar Perception in Open Rhinoplasty. Interplay of Scar Awareness, Body Cathexis and Patient Satisfaction.
abstract: BACKGROUND
  Open and closed approaches for rhinoplasty have individual advantages and disadvantages; however, the resultant columellar scar of the open approach is directly considered as a disadvantage. This study focuses on the columellar scar awareness and its implications on overall satisfaction of the patients after open rhinoplasty.
  
  
  METHODS
  A total of 91 patients who have undergone open rhinoplasty were included in this study. A written questionnaire algorithm consisting of 4 sequential questions was applied. Except for the first question [Do you have any scar(s) caused by any trauma, operation or any other reason on your face?], every question was answered on a scale from 1 to 5. The respondents were given the 25-question "Modified Body Cathexis Scale (MBCS)"and their scars graded using the "Columellar Scar Assessment Scale" (CSAS). The data were statistically interpreted.
  
  
  RESULTS
  Of the 91 open rhinoplasty patients, 12 of them responded with a "yes" to the first question reporting their columellar scars. There was no significant difference with regards to patient satisfaction regarding these patients (p > 0.05). However, those who reported the scar yielded a significantly lower MBCS scores. 9 patients declared that they exerted effort to conceal their scars. Those who concealed their scars and those who did not yielded a significant difference in patient satisfaction. The CSAS scores of those who reported the columellar scar were significantly higher than those who did not.
  
  
  CONCLUSIONS
  Our study suggests that MBSC can be a valuable tool for determining the impact of outcomes from the patient's standpoint, and awareness of the columellar scar is not related to patient satisfaction but with bodily perception.
  
  
  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 www.springer.com/00266 .
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Ondokuz Mayıs University Faculty of Medicine, Kurupelit, 55200, Samsun, Turkey. caglayanyagmur@gmail.com.
authors.forename: Çağlayan
authors.initials: Ç
authors.lastname: Yağmur
authors.affiliation: Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Sertaç
authors.initials: S
authors.lastname: Ak
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Ondokuz Mayıs University Faculty of Medicine, Kurupelit, 55200, Samsun, Turkey.
authors.forename: Murat Sinan
authors.initials: MS
authors.lastname: Engin
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Selçuk University Faculty of Medicine, Konya, Turkey.
authors.forename: Nuh
authors.initials: N
authors.lastname: Evin
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, i Bezm-i Alem Vakıf University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Kelahmetoğlu
authors.affiliation: FBM Aesthetic Surgery Clinic, Samsun, Turkey.
authors.forename: Hayati
authors.initials: H
authors.lastname: Akbaş
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Ondokuz Mayıs University Faculty of Medicine, Kurupelit, 55200, Samsun, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Demir
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D001364:Awareness; D002409:Cathexis; D016009:Chi-Square Distribution; D002921:Cicatrix / Q000503:physiopathology* / Q000523:psychology; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010465:Perception; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment; D012737:Sex Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D055815:Young Adult
keywords: Columellar incision; Open approach; Patient satisfaction; Rhinoplasty; Scar; Scar awareness