Fully 90 percent of revision rhinoplasty patients have appropriate cosmetic or functional reasons for repeat rhinoplasty, according to a new study in the September issue of Plastic and Reconstructive Surgery®.

Of 150 revision rhinoplasty patients, 41 percent opted for a repeat surgery to correct a new deformity, and 33 percent opted for a revision because the first rhinoplasty failed to correct the original deformity. Another 15 percent perceived the loss of desired "personal, familial, or ethnic characteristics, and one percent had new or continued problems with airflow obstruction.

"[T]he motivations of secondary rhinoplasty patients resemble those of most other aesthetic and reconstructive patients," concludes study author Mark Constantian, MD, of St. Joseph Hospital and Southern NH Medical Center, Nashua, NH. Constantian performed the secondary procedures over a 16-month period in 2007 to 2008. The patients were 121 women and 29 men with a median age if 42 years. They had undergone one to eight previous surgeries, with an average of 3.6 per patient.

Only 10 percent of patients were seeking further improvement in an "already acceptable result," as judged by Constantian. He rated this group of patients as having an average score of about 1 on a 5-point deformity scale, compared to 3 or higher in the other groups.

Previous reports have suggested high rates of body dysmorphic disorder (BDD) among patients undergoing multiple plastic surgery procedures, but just three patients met criteria for BDD, the study showed.