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Background <p>Patient dissatisfaction after rhinoplasty is often unrelated to surgical outcomes but rather to unrecognized psychological and ethical variables. Despite advances in technique, instruments, and aesthetic analysis, the emotional dimension of patient selection remains underexplored. The&#xa0;Azabache Protocol®&#xa0;was conceived as an integrated framework for psychological and ethical evaluation prior to rhinoplasty, aiming to improve preoperative decision-making and reduce postoperative conflicts.</p> Methods <p>Based on more than a decade of clinical observation, the protocol combines emotional typology, subjective evaluation tools, standardized aesthetic and emotional scales, and ethical criteria. It provides surgeons with a structured, surgeon-friendly algorithm to identify risk profiles, guide communication, and support ethical surgical decisions.</p> Results <p>Clinical application of the&#xa0;Azabache Protocol®&#xa0;has demonstrated a decrease in emotional dissatisfaction and postoperative complaints, even in technically successful cases. The framework enhances patient–surgeon understanding and reinforces the ethical dimension of aesthetic surgery by transforming preoperative evaluation into a multidimensional process.</p> Conclusions <p>The&#xa0;Azabache Protocol®&#xa0;introduces a pragmatic, structured, and ethically grounded approach to psychological assessment in rhinoplasty. By systematizing preoperative emotional analysis, it complements traditional aesthetic planning and contributes to a more responsible, human-centered practice of facial surgery.</p> Level of Evidence V <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>

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Azabache Protocol®: An Integrated Psychological and Ethical Evaluation Framework for Rhinoplasty Candidates

  • 期刊论文

  • 发表日期：

    2025年12月8日

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  • Ronny Azabache Díaz,
  • Jaime Robles

摘要

Background

Patient dissatisfaction after rhinoplasty is often unrelated to surgical outcomes but rather to unrecognized psychological and ethical variables. Despite advances in technique, instruments, and aesthetic analysis, the emotional dimension of patient selection remains underexplored. The Azabache Protocol® was conceived as an integrated framework for psychological and ethical evaluation prior to rhinoplasty, aiming to improve preoperative decision-making and reduce postoperative conflicts.

Methods

Based on more than a decade of clinical observation, the protocol combines emotional typology, subjective evaluation tools, standardized aesthetic and emotional scales, and ethical criteria. It provides surgeons with a structured, surgeon-friendly algorithm to identify risk profiles, guide communication, and support ethical surgical decisions.

Results

Clinical application of the Azabache Protocol® has demonstrated a decrease in emotional dissatisfaction and postoperative complaints, even in technically successful cases. The framework enhances patient–surgeon understanding and reinforces the ethical dimension of aesthetic surgery by transforming preoperative evaluation into a multidimensional process.

Conclusions

The Azabache Protocol® introduces a pragmatic, structured, and ethically grounded approach to psychological assessment in rhinoplasty. By systematizing preoperative emotional analysis, it complements traditional aesthetic planning and contributes to a more responsible, human-centered practice of facial surgery.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.