Otolaryngology Department, Tehran University of Medical Sciences, Tehran, Iran.
International Surgical Research Association (ISRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Aesthetic Plast Surg. 2024 Oct;48(20):4121-4129. doi: 10.1007/s00266-024-03961-y. Epub 2024 Apr 4.
Rhinoplasty is among the top five most popular cosmetic surgical procedures worldwide. Among rhinoplasty candidates, the most common mental health disorder is body dysmorphic disorder. (BDD). The present study aimed to assess the prevalence of BDD among rhinoplasty candidates, its association with the patient's self-assessment of aesthetic outcome and nasal functional, post-rhinoplasty compared to applicants with negative screening for BDD.
The following study is a cross-sectional, comparative study. Out of the 209 rhinoplasty candidates screened by the BDDQ questionnaire, 39 were positive for BDD. From the remaining 170 patients who screened negative for BDD, 39 participants were randomly selected as the control group for the comparative analysis. Rhinoplasty outcome evaluation (ROE) and standardized cosmesis and health nasal outcomes survey-cosmetic (SCHNOS-C) questionnaires were used for assessment of patient satisfaction with the cosmetic outcome of rhinoplasty. Nasal obstruction symptom evaluation (NOSE) and standardized cosmesis and health nasal outcomes survey-obstruction (SCHNOS-O) were used for the assessment of satisfaction with functional outcomes between groups of patients screened positive and negative for BDD.
The prevalence of BDD was 18.66% among rhinoplasty candidates. The average age of patients screened positive for BDD was 31.41. The mean ROE score was significantly lower (i.e. lower satisfaction) in patients screened positive for BDD (15.69 versus 19.08, P = 0.001), regardless of confounding variables, such as age, sex, and marital status. SCHNOS-C score was higher (i.e. less satisfaction) among patients with BDD (47.01 versus 34.96, P = 0.021) and was significantly associated with higher odds of severe aesthetic concern post-rhinoplasty (OR (95%CI) = 5.000 (1.135-22.022), P = 0.033). Patients screened positive for BDD had significantly higher NOSE scores (i.e. less satisfaction with functional outcome) compared to participants negative for BDD (49.74 versus 37.82, P = 0.012). SCHNOS-O score had no significant association with BDD (P = 0.053). Furthermore, there was no significant association between BDD and NOSE or SCHNOS-O score after adjustment for the confounders.
Patients screened positive for BDD were significantly less satisfied with the cosmetic outcome of the rhinoplasty compared to those screened negative for BDD. Assessment of BDD among rhinoplasty candidates before surgery, could potentially be beneficial for both patients and surgeons.
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隆鼻术是全球最受欢迎的五大美容手术之一。在隆鼻术患者中，最常见的心理健康障碍是躯体变形障碍（BDD）。本研究旨在评估隆鼻术患者中 BDD 的患病率，以及与患者对美学结果和术后鼻部功能的自我评估相比，BDD 阳性患者与 BDD 阴性患者的相关性。
本研究为横断面、对照研究。通过 BDDQ 问卷对 209 名隆鼻术患者进行筛查，其中 39 名患者 BDD 阳性。在其余 170 名 BDD 筛查阴性的患者中，随机选取 39 名患者作为对照组进行对比分析。采用隆鼻术后评估量表（ROE）和标准化美容和健康鼻结局调查-美容（SCHNOS-C）问卷评估患者对隆鼻术美容效果的满意度。采用鼻部阻塞症状评估量表（NOSE）和标准化美容和健康鼻结局调查-阻塞（SCHNOS-O）评估 BDD 阳性和阴性患者对功能结果的满意度。
隆鼻术患者中 BDD 的患病率为 18.66%。BDD 阳性患者的平均年龄为 31.41 岁。BDD 阳性患者的 ROE 评分明显较低（即满意度较低）（15.69 分比 19.08 分，P=0.001），无论年龄、性别和婚姻状况等混杂因素如何。BDD 阳性患者的 SCHNOS-C 评分较高（即满意度较低）（47.01 分比 34.96 分，P=0.021），与术后严重美学关注的几率显著相关（OR（95%CI）=5.000（1.135-22.022），P=0.033）。BDD 阳性患者的 NOSE 评分明显高于 BDD 阴性患者（即对功能结果的满意度较低）（49.74 分比 37.82 分，P=0.012）。SCHNOS-O 评分与 BDD 无显著相关性（P=0.053）。此外，在调整混杂因素后，BDD 与 NOSE 或 SCHNOS-O 评分之间也无显著相关性。
与 BDD 阴性患者相比，BDD 阳性患者对隆鼻术的美容效果明显不满意。在手术前对隆鼻术患者进行 BDD 评估，对患者和医生都可能有益。
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