Günümüzde artan kozmetik cerrahi girişimlerin arasında rinoplasti en çok tercih edilen, yüzle ilgili kozmetik operasyonlardan biri olarak yerini korumaktadır. Klinik deneyim ve araştırmalar, rinoplasti hastalarının operasyon motivasyonları ve sonuca yönelik memnuniyetlerinde psikolojik süreçlerin etkili olabileceğini göstermektedir. Beden algısına yönelik problemler başta olmak üzere çeşitli psikopatolojiler, eş tanılar ve benliğe yönelik tutumlar operasyonların istenen hedefe ulaşmasını ve klinik pratikteki süreçleri etkileyebilmektedir. Operasyonun doğası gereği olan beden bölgesinde değişiklik motivasyonu ve bununla ilgili kaygılar, psikopatolojik tedavi ihtiyaçlarıyla çakışabilmekte, böylece hem hastayı hem de cerrahı zor durumda bırakabilmektedir. Bu makalenin amacı, rinoplasti hastalarındaki psikolojik süreçlerin araştırıldığı çalışmaları sistematik bir biçimde derlemek ve ilgili bulguları bütüncül bir biçimde yorumlamaktır. PubMed/Medline ve Cochrane Library arama motorlarından 9 Temmuz 2020 tarihine dek yayımlanmış konu ile ilgili çalışmalar sistematik olarak taranmış ve kriterleri karşılayan toplam 24 çalışma incelenmiştir. Kozmetik rinoplastide yer alan psikolojik süreçlerde; psikopatoloji, yaşam kalitesi, beden ve benlikle ilgili tutumlar, kişilik özellikleri ve kişiler arası ilişkiler ana temalar olarak öne çıkmıştır. Söz konusu temaların birbiriyle olan ilişkileri ve karıştırıcı etkileri ele alınmış özellikle beden dismorfik bozuklukla ilgili belirtilerin diğer temalarla olan etkileşimleri incelenmiştir. Rinoplasti hastalarında ameliyat öncesi ve takip görüşmelerinin kapsamlı psikolojik değerlendirmeleri içermesinin klinik anlamda faydalarına değinilmiş ve alanyazındaki boşluklar ileri çalışmalara yol göstermek üzere tartışılmıştır.
Anahtar Kelimeler: Rinoplasti; kozmetik cerrahi; psikoloji; psikopatoloji
Rhinoplasty is one of the most popular type of facial cosmetic surgery. Both clinical experience and research have showed that psychological factors are involved operation-related motivation and satisfaction of rhinoplasty patients. Achievement of the operation goals and clinical practices are likely to be affected negatively by psychopathologies (mainly related to body image), comorbid psychiatric conditions and self-image. The expected motivation to change the body part and related anxiety might conflict with the need for psychiatric treatment, yet cause difficulties for both patients and surgeons. This systematic review aims to define and interpret findings of studies investigating psychological mechanisms in rhinoplasty patients. A systematic search was performed at PubMed/Medline and Cochrane Library search engines by July, 9th 2020. Total 24 studies met the inclusion criteria were examined. Main themes of the selected studies were psychopathology, quality of life, body and self-image, personality and inter-personal relationships. Associations among the defined themes and possible confounding effects were investigated. Specifically, interaction of symptoms related to body dismorphic disorder with other themes has been identified. Advantages of pre- and post-operative psychological evaluation of rhinoplast patients and directions for future research have been discussed.
Keywords: Rhinoplasty; cosmetic surgery; psychology; psychopathology
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