“Association of Anxiety and Depression with Patient-Reported Outcomes After Functional and Aesthetic Rhinoplasty”

Background: Body dysmorphic disorder is a well-established predictor of decreased patient satisfaction after rhinoplasty. However, the effect of anxiety and depression on rhinoplasty-specific patient reported outcomes is largely unknown. This study evaluates the association of anxiety and depression with patient satisfaction after functional and aesthetic septorhinoplasty. Methods: This single-center retrospective cohort study included patients undergoing functional or aesthetic septorhinoplasty from 2019-2024. Preoperative and postoperative Nasal Obstruction Symptom Evaluation (NOSE) and Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) scores were extracted from the electronic medical record. Patients with anxiety and/or depression were compared to those without these diagnoses within functional and aesthetic cohorts. Multivariable logistic regression was performed to assess revision rates. Results: Regarding functional septorhinoplasty (n=490), both the control and anxiety/depression group demonstrated improved NOSE (-44.7 and -32.5, p<0.001) and SCHNOS-Obstructive (-44.9 and -46.9, p<0.001) scores postoperatively. Compared to the control group, the anxiety/depression group reported higher (less favorable) postoperative NOSE (35.3 vs 24.1, p<0.001) and SCHNOS-Obstructive (32.1 vs. 24.1, p=0.027) scores, and higher odds of revision surgery (OR 2.56, 95% CI 1.51–4.39, p<0.001). Regarding aesthetic septorhinoplasty (n=179), both the control and anxiety/depression group demonstrated improved SCHNOS-Cosmetic scores postoperatively (-32.3 and -39.6, p<0.001), with no difference in preoperative or postoperative SCHNOS-Cosmetic scores or revision rates between groups. Conclusion: Patients with anxiety or depression undergoing functional septorhinoplasty reported lower postoperative satisfaction and experienced higher revision rates. In contrast, individuals with anxiety or depression undergoing aesthetic septorhinoplasty demonstrated no significant differences in postoperative satisfaction or revision surgery compared to controls.