| Preventing postsurgical dissatisfaction syndrome after rhinoplasty with propranolol: a pilot study. | |
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MedLine Citation:
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PMID: 19319076 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Rhinoplasty patients are commonly anxious about their result when the splint is removed. A small group of them, however, are overtly unhappy with their appearance despite objectively satisfactory early results, cannot be reassured about their favorable long-term prognosis, and remain dissatisfied despite objectively satisfactory end results. The authors have termed this symptom complex "postsurgical dissatisfaction syndrome." In these patients, it seems that persistence of the original negative image of their appearance at the time of splint removal fails to yield to an improved self-image as healing progresses. METHODS: The authors theorized that the syndrome is analogous to the persistence of negative emotional memories seen in posttraumatic stress disorder. In trauma-exposed patients, the beta-adrenergic blocker propranolol, when given within a few hours of the traumatic event, may reduce the subsequent emotional strength of the traumatic memory. The authors hypothesized that giving propranolol to postrhinoplasty patients with the above early symptomatology would reduce the likelihood of postsurgical dissatisfaction syndrome. RESULTS: A retrospective review of 1000 consecutive rhinoplasty patients identified 11 with early symptomatology. Of these 11 (not taking propranolol), nine (82 percent) developed postsurgical dissatisfaction syndrome. In addition, a prospective study was performed of nine additional patients with the same early symptomatology who were immediately treated with propranolol. In contrast, only three developed postsurgical dissatisfaction syndrome (p < 0.04). Results of a randomized, double-blind, placebo-controlled study of 50 additional postrhinoplasty patients suggests that propranolol's effect is not due to anxiolysis. CONCLUSIONS: Propranolol given immediately after splint removal in anxious, unhappy cosmetic surgery patients may prevent postsurgical dissatisfaction syndrome. A double-blind study appears warranted. |
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Authors:
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Ronald P Gruber; Christa Roberts; Wesley Schooler; Roger K Pitman |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Plastic and reconstructive surgery Volume: 123 ISSN: 1529-4242 ISO Abbreviation: Plast. Reconstr. Surg. Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-03-25 Completed Date: 2009-05-05 Revised Date: 2011-02-16 |
Medline Journal Info:
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Nlm Unique ID: 1306050 Medline TA: Plast Reconstr Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1072-8 Citation Subset: AIM; IM |
Affiliation:
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Division of Plastic and Reconstructive Surgery, Stanford University, Palo Alto, Calif., USA. rgrubermd@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anxiety
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etiology*,
prevention & control* Body Image Depression / etiology*, prevention & control* Double-Blind Method Humans Patient Satisfaction Pilot Projects Propranolol / therapeutic use* Retrospective Studies Rhinoplasty / adverse effects*, psychology* Syndrome |
| Chemical | |
Reg. No./Substance:
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525-66-6/Propranolol |
| Comments/Corrections | |
Erratum In:
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Plast Reconstr Surg. 2009 Apr;123(4):1402 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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