Beyond Aesthetic Improvement: Long-Term Psychological Outcomes Following Septorhinoplasty

Abstract

Objectives:
Septorhinoplasty (SRP), especially cosmetic rhinoplasty, is one of the most commonly performed cosmetic surgical procedures worldwide. Beyond surgical skill, experience, and knowledge of operative techniques, the surgeon must carefully select a psychologically suitable candidate for septorhinoplasty. This is crucial because even with technically successful surgery and a satisfied surgeon, a patient may still experience inadequate psychological responses that can negatively affect both the surgeon’s professional work and psychological well-being.
This study aimed to establish a reliable psychological profile to help select patients for septorhinoplasty.
Methods:
This prospective study included 140 patients diagnosed with nasal septal deviation (deviatio septi nasi), either isolated or associated with other nasal deformities. We followed patients scheduled for septorhinoplasty at the Clinic for Ear, Nose, and Throat, University ENT Hospital, Medical Faculty in Skopje, North Macedonia, for five years (2018–2025). We conducted a psychological evaluation using the Brief Symptom Inventory (BSI), a standardized instrument. A total of 108 patients completed the questionnaires. We assessed psychological status both preoperatively and during postoperative follow-up.
Results:
Most patients expected greater self-confidence after surgery. Thirty-two patients (29.6%) anticipated significant life changes, and nine (8.3%) believed others would treat them differently afterward. According to the surgeon’s assessment, 69.4% of patients were psychologically suitable candidates for septorhinoplasty, 10.2% were deemed psychologically unsuitable, and 20.4% required further observation before surgery. Postoperative analysis showed significant improvement in self-confidence and social functioning.
Conclusion:
Psychological assessment with structured questionnaires plays a key role in selecting patients for septorhinoplasty. These tools help patients set realistic expectations and help surgeons select appropriate surgical methods, leading to higher postoperative satisfaction.

Authors

Gabriela Kopacheva Barsova, Biljana Gagachovska, Igor Kamsikoski

Keywords

Septorhinoplasty, patient selection, psychological profile, body image

Publication Information

Publication Date

16.10.2026

Submission Date

11.10.2026

Accepted Date

13.10.2026

Volume

1

Issue

1

Year

2026

Pages

32-37

Language

English

Status

Published

Views

7

Downloads

0

DOI

10.67186/joafs.v1.i20261.5

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