Adolescent rhinoplasty: challenges and psychosocial and clinical outcomes

The adolescent patient subset represents a challenging demographic for the rhinoplasty surgeon due to the complex interplay of psychological, social, and physiologic influences. This study aimed to assess the authors' experience dealing with the adolescent patient demographic using a defined set of decision-making criteria and to evaluate outcomes using validated methods with this patient population.

The patient population comprised a consecutive series of 30 patients who underwent aesthetic nasal surgery at the ages of 13 to 19 years between 2005 and 2008. In addition to the standard indications for aesthetic rhinoplasty, including patient desire and surgical appropriateness, the following criteria also were required for this age group before surgery: 1-year postmenarche status, stable growth for at least 1 year as reported by parents, and parental support. The main outcome measure was the 18-item Glasgow Benefit Inventory (GBI), a validated and reliable postinterventional questionnaire aimed at detecting changes in health status produced by surgical interventions. The potential GBI score ranges from -100 (maximal harm) through 0 (no change) to +100 (maximal benefit).

Enhanced quality of life and patient benefit after rhinoplasty were evident in this patient population. Positive benefit is evident in the General subscale (mean GBI score, 68.2), the Physical Health scale (mean GBI score, 18.3), the Social Support scale (mean GBI score, 32.2), and the Total scale (mean GBI score, 53.8). Although no statistically significant difference in satisfaction was observed between the early postoperative period (<30 months) and the later postoperative period (>30 months), the means were higher for the Social Support and Physical Health scales among the patients surveyed later, trending toward significance. The patient population showed no evidence of a gender- or age-based effect.

Quality of life was enhanced by aesthetic and functional rhinoplasty in this patient population according to the authors' defined set of preoperative criteria and evaluation. The adolescent subgroup represents a unique demographic to treat based on a combination of social, cultural, and psychological variables. Aesthetic rhinoplasty is an undeniably effective tool for correcting psychologically impairing features that adolescents perceive as undesirable. Postoperatively, these patients demonstrate positive changes in behavior and interpersonal relations. With proper preoperative assessment and selection, excellent aesthetic and psychosocial outcomes can be expected.