Psychological Red Flags in Rhinoplasty: Predictors of Malpractice Claims

Area of Science:

• Plastic Surgery
• Forensic Psychiatry
• Psychology

Background:

• Rhinoplasty is a common cosmetic procedure with a high litigation risk.
• Malpractice claims often stem from poor patient selection and undiagnosed psychological issues rather than surgical errors.

Purpose of the Study:

• To pinpoint clinical and psychological indicators of malpractice litigation following rhinoplasty.
• To emphasize the critical role of meticulous patient selection in mitigating legal risks.

Main Methods:

• A case-control study compared 55 patients with malpractice claims to 85 without.
• Forensic assessments included endoscopy, photographic analysis, and psychometric testing (SCL-90-R, BIQLI, RSES, SWAS).

Main Results:

• Litigation patients were older, less educated, and more likely operated on by specialists in private hospitals.
• Psychologically, they exhibited higher somatization and lower scores on body image, self-esteem, and appearance satisfaction.
• Low Body Image Quality of Life Inventory (BIQLI) scores and specialist surgery independently predicted litigation.

Conclusions:

• Undiagnosed body dysmorphic disorder traits, somatization, or unrealistic expectations increase malpractice risk.
• Rigorous preoperative screening, clear communication, and multidisciplinary assessments are vital for prevention.
• Prioritizing correct patient selection safeguards outcomes, professional reputation, and minimizes litigation.