LAUSR

BACKGROUND It would be useful if existing tools or outcomes measures could predict which patients are at greater risk of revision surgery following rhinoplasty. OBJECTIVE We aim to determine if a single question assessing nasal self-esteem could be used to predict which patients are at greatest risk of revision surgery following rhinoplasty. METHODS Retrospective chart review of 148 patients who underwent cosmetic rhinoplasty. Results of pre- and postoperative Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) questionnaires, and rates of revision or patient-initiated revision discussions (RD) were collected. Patients were stratified based on answers to SCHNOS Question five (SQ5), "Decreased mood and self-esteem due to my nose." RESULTS Of the 148 patients included in the analysis, 72.9% were women, and the mean age was 30.9 (15-59, SD 10.3) years. Those patients who selected 4 or 5 on SQ5 had an overall revision rate of 16.7% and 18.8%, respectively, and a RD rate of 27.8% and 31.25%, respectively. Those patients who selected 0 through 3 on SQ5 had an overall revision rate of 0%, and an overall RD rate of 10.4%. Only SQ5 was predictive of revision and RD on logistic regression analysis (p = 0.0484 and p = 0.0257) after Bonferroni correction. CONCLUSION SQ5 appears to offer a useful adjunct to guide surgical management of the cosmetic rhinoplasty patient. Those patients who reported worse nasal self-esteem and associated mood preoperatively were more likely to request and undergo revision.