7
Figure 1. Algorithm
Rhinoplasty candidate ≥15 y/o
Are
expectations
realistic?
Bleeding
disorders, intranasal
vasoconstrictors?
Reassess
appropriateness of
surgery
NO
Preventative OSA
counseling
Document
motivations and
expectations
KAS1
END
NO
YES
Assess for body
dysmorphic disorder
(BDD), obstructive
sleep apnea
(OSA), bleeding
disorders, intranasal
vasoconstrictors
Reassess
appropriateness of
surgery and modify
planning as needed
YES NO
Psychiatric
evaluation
Known
or suspected
OSA?
Further assess
patient to confirm
or exclude OSA
Counseling for pain
and discomfort
Do not routinely
place nasal packing
Preoperative
education
Document at 6-12
months patient
satisfaction with nasal
appearance and function
Evaluate for nasal
airway obstruction
Nasal airway
obstruction?
Option to administer
perioperative steroids
Surgeon chooses to
administer perioperative
antibiotics
Do not routinely
give antibiotics
more than 24
hours after surgery
Incorporate into
surgical planning to
correct obstruction
KAS2
NO
YES
NO
Suspicion
of BDD?
NO
YES
YES
YES
NO
YES
Known
OSA?
KAS5
KAS3
KAS4
KAS6
KAS10
KAS9
KAS8
KAS7
