BACKGROUND: Patients with symptoms of body dysmorphia often seek consultation for aesthetic rhinoplasty. While body dysmorphic disorder is a formal psychiatric diagnosis, recent evidence indicates that patients with symptoms of this condition who seek rhinoplasty may experience increased satisfaction with their appearance following surgery. OBJECTIVES: To determine the psychological impact of rhinoplasty in patients screened pre-/postoperatively with a body dysmorphia screening questionnaire. METHODS: Retrospective chart review of patients who underwent aesthetic and/or functional rhinoplasty by a single surgeon (S.P.M.) from 6/2021- 4/2023. Adult patients with a complete pre- and postoperative body dysmorphic disorder-aesthetic surgery questionnaire (BDDQ-AS), Standardized Cosmesis and Health Nasal Outcomes Survey-Obstruction and Cosmesis (SCHNOS), and Visual Analog Scale (VAS) were included. Patient characteristics and outcomes were analyzed stratifying by BDDQ-AS screen. RESULTS: One-hundred fifteen patients (88% female) met criteria for inclusion. There was an 83% resolution rate in BDDQ-AS positive screening following rhinoplasty. Positive BDDQ-AS screening status pre- and postoperatively correlated with worse aesthetic satisfaction (all p<0.002). No patient reported outcome measures were indicative of which patients with a BDDQ-AS positive screen preoperatively would experience 'resolution' postoperatively. CONCLUSIONS: Body dysmorphia screening resolution following surgical intervention correlated with improved patient aesthetic satisfaction, pointing to a potential positive psychological impact of undergoing rhinoplasty.
Directly displaying the spatial coherence of photoacoustic signals (i.e., coherence-based photoacoustic imaging) remarkably improves image contrast, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and imaging depth when compared to conventional amplitude-based reconstruction techniques (e.g., backprojection, delay-and-sum beamforming, and Fourier-based reconstruction). We recently developed photoacoustic-specific theory to describe the spatial coherence process as a function of the element spacing on a receive acoustic aperture to enable photoacoustic image optimization without requiring experiments. However, this theory lacked noise models, which contributed to significant departures in coherence measurements when compared to experimental data, particularly at higher values of element separation. In this paper, we develop and implement two models based on experimental observations of noise in photoacoustic spatial coherence measurements to improve our existing spatial coherence theory. These models were derived to describe the effects of incident fluence variations, low-energy light sources (e.g., pulsed laser diodes and light-emitting diodes), averaging multiple signals from low-energy light sources, and imaging with light sources that are > 5mm from photoacoustic targets. Results qualitatively match experimental coherence functions and provide similar contrast, SNR, and CNR to experimental SLSC images. In particular, the added noise affects image quality metrics by introducing large variations in target contrast and significantly reducing target CNR and SNR when compared to minimal-noise cases. These results provide insight into additional requirements for optimization of coherence-based photoacoustic image quality.
