Association Between Psychiatric Diagnoses and Revision Cosmetic Rhinoplasty

Background: Limited evidence exists regarding the incidence of revision cosmetic rhinoplasty in patients with psychiatric diagnoses. Objective: To assess the rate of revision cosmetic rhinoplasty in patients with psychiatric diagnoses. Methods: Adult patients at a single institution who underwent rhinoplasty were queried between December 1, 1979, and June 1, 2024. Exclusion criteria were noncosmetic rhinoplasties (e.g., functional) or history of nasal trauma, nasal tumor, cleft lip/palate, or congenital nasal deformities. Patients were split into those with psychiatric diagnoses (PD group) and those without (control group). Outcomes include proportion who underwent ≥1 secondary cosmetic rhinoplasty, mean secondary rhinoplasties per patient, patient satisfaction after secondary rhinoplasty, and breakdown of secondary rhinoplasties by psychiatric diagnosis. Results: The initial query found 1110 patients, leaving 961 patients (PD 135, control 826) after exclusion criteria. The cohort was 75% female (724/961) with a mean age of 48 years (standard deviation: 15). The proportion of patients with ≥1 revision rhinoplasty was higher in PD (24/135, 18%) than controls (95/826, 12%; p = 0.04). Age ≥46 and female gender were found to predict revision cosmetic rhinoplasty. Conclusion: In our cohort, patients with PD had higher rates of revision cosmetic rhinoplasty compared to those without PD.