Staging system to explain complexity, manage expectations in revision rhinoplasty

Can a staging system - much like one used to classify cancerous tumors - help facial plastic surgery patients understand the complexity of their revision rhinoplasty and help to manage their expectations?

In a new review article published online by JAMA Facial Plastic Surgery, Regina Rodman, M.D., and Russell Kridel, M.D., of the University of Texas Health Science Center at Houston, propose the PGS Staging System.

The PGS system uses three components - problem, graft and previous surgical procedures - to determine the overall difficulty of the revision rhinoplasty. An additional component, "E" for patient expectations, is used after the staging determination. The "E" classification should be decided jointly by patients and surgeons because patient expectations should be discussed preoperatively.

"Rhinoplasty is a difficult procedure with a relatively high rate of revision compared with other cosmetic surgical procedures. At present, physicians lack a system for evaluating the patient who presents for revision rhinoplasty," the article notes.