Background & Aims: Cosmetic surgery is considered a kind of voluntary or elective surgery to improve the appearance of people, which can lead to an increase in self-esteem and self-confidence. Rhinoplasty is one of the most challenging facial procedures, which is among the five most popular cosmetic procedures. In recent years, rhinoplasty has become more popular among Iranian people, and currently, Iran has the highest number of rhinoplasty in the world. Although thousands of people apply for rhinoplasty every year, only 10% of them have abnormal nose function, and other nose surgeries are performed to improve the shape of the nose and the overall beauty of the face. Psychological factors play an important role in cosmetic surgeries as well as post-operative satisfaction. Psychological problems including low self-esteem, anxiety, and personality disorders such as perfectionism, practical obsession, bipolar disorder, and even psychotic symptoms may lead people to undergo cosmetic surgery. In this regard, some researchers believe that a person's perception of his appearance plays a vital role in his self-esteem. Therefore, people seek rhinoplasty just to increase their self-confidence. On the contrary, other researchers consider these people to be completely psychologically healthy. They are eager for cosmetic surgery just for more beauty. Previous studies have shown significant psychological problems in cosmetic surgery volunteers, and about 70% of participants had a series of psychological disorders such as depression, neuroticism, and passive-aggressive personality. Women who underwent cosmetic surgery had a self-centered personality with childish, active, impulsive, competitive, reactive, perfectionist, seductive, and superficial emotions. Young people need to be noticed in society and therefore they try to improve their appearance with cosmetic surgeries. Therefore, the feeling of dissatisfaction with body image and anxiety leads to a tendency towards cosmetic surgeries. Psychological assessment of rhinoplasty candidates should focus on their self-esteem, body image, and satisfaction. Therefore, assessing the psychological health and motivation of people is the most important action after completing the patient history and physical examination. Therefore, the present study was conducted to investigate the psychological and psychosocial causes of the tendency to plastic nose surgery in the Iranian population. Psychological, social and behavioral factors can influence the applicants' willingness for cosmetic surgeries. This study aimed to investigate the socio-psychological causes of tendency towards cosmetic rhinoplasty.
Methods: This cross-sectional study was conducted on 100 participants planned to undergo rhinoplasty in Shahid Rajaee Hospital, Shiraz, Iran, during 2023-2024. Data were collected using the Millon personality questionnaire, the Likert scale questionnaire, the multidimensional body-self relations questionnaire (MBSRQ), and a researcher-made questionnaire on psychological aspects of rhinoplasty.
Results: Single females with an education level higher than a diploma tend more to cosmetic rhinoplasty. Females earning less than 50 million Rials per month had more willingness to undergo cosmetic rhinoplasty than those earning more than 50 million Rials per month. The MBSRQ showed no statistically significant differences between the mean score of perfectionism, body satisfaction, others' opinions, and the media effects with respect to demographic factors (marital status, job status, education level, and income) (p>0.05). However, the MBSRQ showed a significant difference in the MBSR mean score between the low-income and high-income groups (p=0.013).
Conclusion: In general, older people may try to manage or change their physical appearance. They try to fight to age with cosmetic surgery. The results of this study showed that the age of applicants has no significant negative correlation with MBSR and perfectionism. In addition, the age of the applicants had no significant positive correlation with the opinions of others and satisfaction with their bodies. Also, with increasing age, the influence of the media on the desire for rhinoplasty increased, but this correlation was not statistically significant, which does not agree with the findings of previous studies. This study has limitations due to important methodological flaws such as the lack of prior estimation of the sample size, although the researchers used the maximum possible number of subjects. However, due to the relatively small number of participants in this study and limited reports from Iran, conducting future studies with a larger sample size and using more comprehensive questionnaires seems necessary. Regarding the role of socio-psychological factors in a tendency towards cosmetic rhinoplasty and its effects on the general health, preoperative psychiatric assessment and psychological counseling of applicants before cosmetic rhinoplasty is highly recommended.