Psychosomatic Medicine 11:307-314 (1949)
© 1949 American Psychosomatic Society

Psychiatric Observations Concerning Rhinoplasty

¹ Psychiatric Department and the Rhinoplasty Department of the Mount Sinai Hospital, New York City

Data are presented based on a psychiatric study of 58 rhinoplasty patients.

With few exceptions the patients who presented themselves for rhinoplasty were ill from a psychiatric point of view. This illness varied from minor neurotic disturbances to overt schizophrenic psychoses.

Along with the basic psychiatric disorder there was present a special group of symptoms which we have designated as the syndrome of the rhinoplasty patient. As a result of an excessive selfconsciousness relating to the nose these patients become constricted in their bodily movements, in their dress, in the flow of their attention, in their ability to relate warmly to other human beings, and in their capacity to concentrate on their work.

In the immediate reaction to rhinoplasty the foregoing syndrome is reversed and a period of marked psychiatric improvement occurs. This is a temporary change. It is followed by a period of stabilization during which fundamental changes of a beneficial character may occur in the basic psychiatric disorder.

The theoretical basis for the observed psychologic changes is presented in terms of the body-image concept. The special significance of the nose in the structure of the body-image is discussed.

The psychologic changes following plastic surgery were contrasted with those seen as "magical" effects following other surgical procedures.

Contrary to general opinion, rhinoplasty is not a hazardous procedure from a psychiatric standpoint. The danger of precipitating a psychosis, for example, where none existed before is minimal.

Rhinoplasty is an adjuvant to psychotherapy. Every patient should be told to expect new psychologic problems following rhinoplasty. Every patient should have psychiatric assistance during the period of personality reorganization following rhinoplasty. Many patients will require deep and prolonged psychotherapy in addition to the rhinoplasty to achieve maximal happiness and effectiveness. It is our belief that the psychologic changes initiated by rhinoplasty facilitate psychotherapy.

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