Question: How do you determine whether or not someone is a good candidate for a revision rhinoplasty? Is any sort of psychological testing done? My sister had a nose job several years ago. In the first place I didn’t really think she needed it, but now her nose looks great. However, she is convinced that there are several things wrong with it and wants to have revision rhinoplasty. I think her nose is perfect and this is more in her head, but I fear that a doctor will do surgery and jeopardize her nose and her health.
Answer: Cosmetic surgery is very unique in a sense that the surgery does not need to be done for life-saving reason. The surgery is not done for physical pain or disease. Cosmetic surgery is done so that the patient will feel better about himself. This is a psychological benefit; therefore, in a real sense of the word, a cosmetic surgeon is really a psychologist with a scalpel. By that, I mean that the cosmetic surgeon uses surgical tools to obtain a psychological result. This is very unique in cosmetic surgery. It really brings great joy to the patients when it is successful. However, because of this dynamic, there are certain challenges in the procedures and in patient selection. All experienced cosmetic surgeons know that it is very important to make sure that the patient’s expectations are appropriate and that their psychological health is evaluated. Whether or not this is done with a formal psychological test or by a series of questions, most experienced surgeons can quite quickly determine whether or not the patient has the psychological fitness to undergo the procedure. It is very important to determine what the appropriate management is for a patient with a medical problem. If the patient is complaining of her nose and unreasonably spending a lot of time looking at their nose and this is affecting their daily activities or lifestyle, the appropriate management may not be a revision rhinoplasty. It may be a referral to a psychologist, someone who can help with this.