Is Mental Health Status Associated With Patient Satisfaction With Rhinoplasty?

A dermatologist examining a woman's nose
A dermatologist examining a woman’s nose
The investigators sought to determine whether preoperative mental health is linked to patient satisfaction with functional outcomes of rhinoplasty procedures.

Differences in preoperative mental health status do not appear to affect patient-reported nasal function or objective airflow benefits associated with rhinoplasty, according to the results of a case-control study conducted in Sydney, Australia, and published in JAMA Facial Plastic Surgery.

The investigators sought to determine whether preoperative mental health is linked to patient satisfaction with functional outcomes of rhinoplasty procedures.

Baseline nasal function and postoperative functional outcomes in a total of 88 consecutive patients who were undergoing rhinoplasty were evaluated with respect to both cosmetic and functional goals.

Patient-reported outcome measures, including visual analog scale, the Nasal Obstruction Symptom Evaluation Scale, the 22-item Sinonasal Outcome Test, and Likert scales, were used to assess nasal function. Nasal airway resistance, nasal peak inspiratory flow, and minimum cross-sectional area comprised the objective outcomes evaluated. 

All the study outcomes were assessed before surgery and at 6 months postsurgery. Patients’ mental well-being was rated according to the 36-item Optum SF-36v2 Health Survey mental component summary, with a score of <40 indicative of poor mental health and a score of ≥40 indicative of normal well-being.

Of the participants, 60.2% were women; mean age was 37.6±12.9 years. On the basis of the mental component summary, impaired well-being was indicated in 24 participants (cases), and normal well-being in 64 participants (controls). Both groups reported improvements in most nasal function parameters. After rhinoplasty, both groups reported a significantly decreased sensation of nasal obstruction, as assessed by visual analog scale on the left side (mean change, 18±30; P <.001) and on the right side (mean change, 24±30; P <.001).

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Significantly lower scores in disease-specific quality-of-life measures were also reported (Nasal Obstruction Symptom Evaluation Scale, mean change, 1.35±1.21 [P <.001]; 22-item Sinonasal Outcome Test: mean change, 0.81±0.88 [P <.001]). Moreover, significantly improved scores were reported in nasal obstruction symptoms in 84.4% (74 of 88; P <.001) of participants, and nasal function anchor scores in 90.9% (80 of 88; P <.001) of participants.

Nasal peak inspiratory flow improved significantly for both groups (mean change, 32±45 L/minute; P <.001), whereas nasal airway resistance and minimum cross-sectional area remained similar. Overall, patients with poor mental health experienced similar improvements in nasal function compared with control patients.

The investigators concluded that rhinoplasty imparts similar benefits in nasal function regardless of an individual’s presurgical mental well-being. Patients’ functional status after rhinoplasty is apparently not a product of impaired preoperative mental health.


Strazdins E, Nie YF, Ramli R, et al. Association between mental health status and patient satisfaction with the functional outcomes of rhinoplasty [published online February 15, 2018]. JAMA Facial Plast Surg. doi: 10.1001/jamafacial.2018.0001