Both rational and irrational forces prompt the request for rhinoplasty. It is important to recognize when these subconscious irrational movies predominate because in this small group, concern over the shape of the nose is only a cover-up for other problems, and even a successful rhinoplasty may result in a disturbed or litigious patient. Often this situation arises in two identifiable populations: (1) the overly-sensitive, blaming male with poor adaptation occupationally and socially (paranoid personality) and (2) middle-aged or menopausal women who, on closer assessment, are found to be depressed. Psychiatric consultation should be arranged for the management of these people. Psychiatric treatment and rhinoplasty, for some of these people, are not necessarily mutually exclusive.
Book HE. Psychiatric Assessment for Rhinoplasty. Arch Otolaryngol. 1971;94(1):51–55. doi:10.1001/archotol.1971.00770070087009
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