Rhinoplasty patients and matched elective-surgery controls completed the Facial Appearance Sorting Test, the General Health Questionnaire, a Repertory Grid and the Masculinity/Femininity Scale. Rhinoplasty applicants perceived appearance similarly to, and downrated their own appearance to the same extent as, controls. Impaired appearance and psychiatric symptoms are integral parts of the 'rhinoplasty applicant syndrome', but the degree to which they occur is not positively correlated. Interviews and tests were repeated 6 months after operation, when marked improvement in appearance was reported by the rhinoplasty patients, associated with the reduction of psychiatric-symptom scores. Control subjects showed no change.

The morbidity and mortality rates of African American men consistently rank among the lowest across all groups in the United States. African American men have one of the highest mortality rates for heart disease, cancer, stroke unintentional injuries and homicide (Gilbert et al., 2016). The leading cause of death in African American men age 24-34 years old is homicide (CDC, 2011). A majority of the health disparities experienced by African American men are the result of socioeconomic disadvantage, racism and residing in resource-poor communities (Bharmal et al., 2011). With disproportionate access to care and community stressors, there is a critical need to explore the health of African American men in high violent neighbourhoods. Many African American men live in disadvantaged communities marked by strenuous poverty, residential instability, joblessness, violent crime and educational shortages (Simning, Wijngaarden, & Conwell, 2012). African American men are also more likely not to have regular care, live in food deserts, work in unsafe environments and engage in unhealthy behaviours like tobacco use and alcohol consumption (Metzl, 2013). Dwelling in these communities, leave African American men at risk for adverse experiences that impact their health behaviours and outcomes. Community violence is an important consideration of the physical environment. Community violence is characterised by physical assault, sexual assault, homicide, mugging, gang violence, unnecessary force by authorities, theft and family violence (Walling, Eriksson, Putman, & Foy, 2011). Additionally, community violence exposure has been linked to higher rates of weapon involvement especially in African Americans, potentially due to self-defence, fear of violence or association with delinquency and aggression (Shetgiri, Boots, Lin, & Cheng, 2016). In particular, gun violence disproportionately impacts communities with social and economic inequities (Santilli et al., 2017). Inequities in communities of colour are due to structural racism such as segregation. Communities plagued with