Public Release: 

Staging system to explain complexity, manage expectations in revision rhinoplasty

The JAMA Network Journals

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.


Please visit the For The Media website to read the full article and the related commentary and to preview the author audio interview.

(JAMA Facial Plast Surg. Published May 5, 2016. doi:10.1001/jamafacial.2016.0249. Available pre-embargo to the media at

Editor's Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Media advisory: To contact study corresponding author Russell Kridel, M.D., call Stephanie Shepard at 713-526-5665 or email

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