The Effectiveness of Rhinoplasty and Combined Rhinoplasty with Positive Psychotherapy on Rejection Sensitivity and Self-Esteem in Women Seeking Cosmetic Surgery
Journal of Otorhinolaryngology and Facial Plastic Surgery,
Vol. 11 No. 1 (2025),
5 May 2025
,
Page 1-11
https://doi.org/10.22037/orlfps.v11i1.50112
Abstract
Background: The prevalence of individuals seeking cosmetic surgery necessitates a comprehensive understanding of the psychological factors influencing this decision and the potential for therapeutic interventions to enhance outcomes beyond surgical correction.
Aim: This study investigated the effectiveness of rhinoplasty alone and in conjunction with positive psychotherapy in ameliorating rejection sensitivity and improving self-esteem among women who had sought cosmetic surgery.
Methods: This clinical trial investigated 34 women seeking rhinoplasty in Ahvaz in 2023. Participants were randomly assigned to either a cosmetic surgery group (rhinoplasty alone) or a combined treatment group (rhinoplasty + positive psychology group therapy) (n=17). The positive psychology group therapy involved eight weekly, 90-minute sessions. Key measures included the Rejection Sensitivity Questionnaire (RSQ) and the Rosenberg Self-Esteem Scale (RSES). Data analysis involved Repeated Measures ANOVA in SPSS version 26.
Results: Both groups showed significant reductions in rejection sensitivity from pre-test to post-test (P=0.002), with slight increases at follow-up. Self-esteem significantly improved over time (P=0.001), with the combined treatment group demonstrating higher scores (P=0.009) and significant gains from pre-test to post-test (P=0.016) and follow-up (P=0.001), unlike the cosmetic surgery group (P=0.014 at follow-up only).
Conclusion: Rhinoplasty alone along with its combination with positive psychology group therapy significantly reduced rejection sensitivity and enhanced self-esteem among women undergoing cosmetic surgery, with the combined approach yielding superior and sustained self-esteem outcomes. While rejection sensitivity improvements were comparable across both groups, these findings underscore the value of integrating psychological interventions to optimize self-esteem benefits for cosmetic surgery candidates.
- Rhinoplasty; Positive psychotherapy; Rejection sensitivity; Self-esteem; Cosmetic surgery.
How to Cite
References
Bingham Thomas E, Edwards NM, Haug JD, Horsburgh KA. Advances in Biocultural Approaches to Understanding Stress in Humans. Humans. 2024; 4(4):321–39. doi: 10.3390/humans4040021.
Marano G, Anesini MB, Sfratta G, d’Abate C, Traversi G, Rossi S, et al. Aesthetic Gynecology and Mental Health: What Does It Really Mean for Women? Cosmetics. 2025; 12(1). doi: 10.3390/cosmetics12010028.
Triana L, Palacios Huatuco RM, Campilgio G, Liscano E. Trends in Surgical and Nonsurgical Aesthetic Procedures: A 14-Year Analysis of the International Society of Aesthetic Plastic Surgery-ISAPS. Aesthetic Plast Surg. 2024;48(20):4217–27. doi: 10.1007/s00266-024-04260-2.
Arkoubi AY, Aldaghri F, Salati SA, Mortada H, Almughira AI, Abuharb AI, et al. Barriers and Factors Influencing Cosmetic Surgery Desire Among Saudi College Students: A Cross-sectional Study on Perception and Knowledge. Plast Reconstr Surg Glob Open. 2025;13(3):e6235. doi: 10.1097/gox.0000000000006235.
Jahandideh H, Javadinejad K, Roomiani M. Validity and Reliability of the Persian Version of the Rhinoplasty Outcomes Evaluation (ROE) Questionnaire. Journal of Otorhinolaryngology and Facial Plastic Surgery. 2024;9(1). doi: 10.22037/orlfps.v9i1.44348.
Ziade G, Abikanaan G, Daou D, Karam D, Keyrouz E, Saade R. Impact of surgical consultation and counseling on patients perspectives regarding nasal shape and expectations from rhinoplasty. Advances in Oral and Maxillofacial Surgery. 2025;18:100540. doi: 10.1016/j.adoms.2025.100540.
Mohammadshahi M, Pourreza A, Orojlo PH, Mahmoodi M, Akbari F. Rhinoplasty as a Medicalized Phenomenon: A 25-Center Survey on Quality of Life Before and After Cosmetic Rhinoplasty. Aesthetic Plastic Surgery. 2014;38(4):615–9. doi: 10.1007/s00266-014-0323-5.
Chowdhury S, Verma S, Debnath T. Self-Esteem in Rhinoplasty Patients: A Comparative Study. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 2):1571–5. doi: 10.1007/s12070-021-02734-2.
Emrani R, Akhoundi M. Investigating Psychosocial Causes of the Tendency for Rhinoplasty in Qazvin City, Iran, in 2023: A Descriptive Analytical Study. Iran J Health Sci. 2024;12(3):223. doi: 10.32598/ijhs.12.3.979.1.
Downey G, Feldman SI. Implications of rejection sensitivity for intimate relationships. J Pers Soc Psychol. 1996 Jun;70(6):1327-43. doi: 10.1037//0022-3514.70.6.1327.
Farahani HA, Aghamohamadi S, Kazemi Z, Bakhtiarvand F, Ansari M. Examining the relationship between sensitivity to rejection and using Facebook in university students. Procedia - Social and Behavioral Sciences. 2011;28:807–10. doi: 10.1016/j.sbspro.2011.11.147.
Rosenberg M. Rosenberg Self-Esteem Scale (RSES) [Database record]. APA PsycTests. 1965. doi: 10.1037/t01038-000.
Shapurian R, Hojat M, Nayerahmadi H. Psychometric characteristics and dimensionality of a Persian version of Rosenberg Self-esteem Scale. Percept Mot Skills. 1987;65(1):27-34. doi: 10.2466/pms.1987.65.1.27.
Nguyen ND, Ngoc NK, Quang DP, and Pham DT. Physical appearance comparison mediates the relationship between passive social network use and body image: mitigating effects of sense of self. Behaviour & Information Technology. 1–12. doi: 10.1080/0144929X.2025.2453566.
Naraghi M, Atari M, Asadollahi H. When Aesthetics, Surgery, and Psychology Meet: Aesthetic Nasal Proportions in Patients Having Rhinoplasty and Normal Adults. Surg J (N Y). 2016;2(1):e44–e8. doi: 10.1055/s-0036-1579658.
Merino M, Tornero-Aguilera JF, Rubio-Zarapuz A, Villanueva-Tobaldo CV, Martín-Rodríguez A, Clemente-Suárez VJ. Body Perceptions and Psychological Well-Being: A Review of the Impact of Social Media and Physical Measurements on Self-Esteem and Mental Health with a Focus on Body Image Satisfaction and Its Relationship with Cultural and Gender Factors. Healthcare (Basel). 2024;12(14). doi: 10.3390/healthcare12141396.
Agırnaslıgıl MO, Gul Amuk N, Kılıc E, Kutuk N, Demırbas AE, Alkan A. The changes of self-esteem, sensitivity to criticism, and social appearance anxiety in orthognathic surgery patients: A controlled study. Am J Orthod Dentofacial Orthop. 2019;155(4):482–9.e2. doi: 10.1016/j.ajodo.2018.05.019.
Bicaker E, Schell SE, Racine SE. The role of self-compassion in the relationship between rejection and unhealthy eating: An ecological momentary assessment study. Appetite. 2023;186:106568. doi: 10.1016/j.appet.2023.106568.
Rashid T, Summers RF, Seligman MEP. Positive Psychology Model of Mental Function and Behavior. In: Tasman A, Riba MB, Alarcón RD, Alfonso CA, Kanba S, Ndetei DM, et al., editors. Tasman’s Psychiatry. Cham: Springer International Publishing; 2020. p. 1–24.
Abu Omar D, Kirkman A, Scott C, Babicova I, Irons Y. Positive Psychology Interventions to Increase Self-Esteem, Self-Efficacy, and Confidence and Decrease Anxiety among Students with Dyslexia: A Narrative Review. Youth. 2024;4(2):835-853. doi: 10.3390/youth4020055.
Seligman MEP. Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment. New York: Free Press; 2002.
Lăzărescu GM, Vintilă M. The relationship between personality traits and willingness to undergo cosmetic surgery in the non-clinical population - a systematic review and meta-analysis. Front Psychol. 2023;14:1241952. doi: 10.3389/fpsyg.2023.1241952.
Hemmatpour B, Heydari MB, Rabieenia M. Psychometric evaluation of the perfectionism scale's characteristics regarding physical appearance in patients seeking rhinoplasty surgery. JPRAS Open. 2024;41:194–202. doi: 10.1016/j.jpra.2024.05.004.
Namadmaliani Zadeh Z, Johari Fard R, Talebzadeh Shoushtari M. The Relationship between Body Dysmorphic Disorder and Emotion Regulation in Individuals Seeking Cosmetic Surgery: The Mediating Role of Self-Concept. Journal of Otorhinolaryngology and Facial Plastic Surgery. 2025;9(1):1–9. doi: 10.22037/orlfps.v9i1.47251.
Coopersmith S. The antecedents of self-esteem. San Francisco: W.H. Freeman; 1967.
Leary MR, Baumeister RF. The nature and function of self-esteem: Sociometer theory. Adv Exp Soc Psychol. 2000;32:1-62. doi: 10.1016/S0065-2601(00)80003-9.
Kazeminia M, Salari N, Heydari M, Akbari H, Mohammadi M. The effect of cosmetic surgery on self-esteem and body image: a systematic review and meta-analysis of clinical trial studies. European Journal of Plastic Surgery. 2023;46(1):25–33. doi: 10.1007/s00238-022-01987-6.
Al Ghadeer HA, AlAlwan MA, AlAmer MA, Alali FJ, Alkhars GA, Alabdrabulrida SA, et al. Impact of Self-Esteem and Self-Perceived Body Image on the Acceptance of Cosmetic Surgery. Cureus. 2021;13(10):e18825. doi: 10.7759/cureus.18825.
Mohammed DI, Ibrahim RH. Exploring the impact of psychological factors on cosmetic surgery acceptance: A cross-sectional study. Informatics in Medicine Unlocked. 2023;39:101231. doi: 10.1016/j.imu.2023.101231.
Castle DJ, Honigman RJ, Phillips KA. Does cosmetic surgery improve psychosocial wellbeing? Med J Aust. 2002;176(12):601–4. doi: 10.5694/j.1326-5377.2002.tb04593.x.
Marmarosh CL, Sandage S, Wade N, Captari LE, Crabtree S. New horizons in group psychotherapy research and practice from third wave positive psychology: a practice-friendly review. Res Psychother. 2022;25(3). doi: 10.4081/ripppo.2022.643.
Kulbaş E, Özabacı N. The Effects of the Positive Psychology-Based Online Group Counselling Program on Mothers Having Children with Intellectual Disabilities. J Happiness Stud. 2022;23(5):1817–45. doi: 10.1007/s10902-021-00472-4.
- Abstract Viewed: 187 times
- PDF Downloaded: 148 times