Abstract
The inherent subjectivity in aesthetic outcomes presents a unique challenge in assessing rhinoplasty. Crowdsourcing has provided a new metric for objective analysis. The authors designed a retrospective study to compare the aesthetic outcomes of dorsal preservation rhinoplasty versus structural rhinoplasty. We aim to objectively quantify the relative aesthetic advantages of performing a dorsal preservation technique. Additionally, we aim to demonstrate the efficacy of using crowdsourcing as an efficient and reliable method for evaluating any plastic surgery aesthetic outcome. Patients' preoperative and postoperative photos were divided two cohorts. Photos were evaluated by crowdworkers using a secure online rating platform on the overall nasal appearance, the dorsal profile, the dorsal aesthetic line symmetry, the dorsal contour, and rate their confidence on whether a patient had undergone surgery. A "delta" was calculated by comparing preoperative to postoperative states to represent an absolute value of improvement after surgery. Each cohort was compared using non-paired T-tests. The structural rhinoplasty cohort included 34 patients. The dorsal preservation cohort included 30 patients. Both cohorts demonstrated improved aesthetic outcomes (dorsal preservation [0.300, 95% CI 0.047]; structural [0.377, 95% CI 0.055]). When raters were asked to predict whether a patient had surgery, the correlation coefficient of the structural cohort (0.74) suggested that a crowdworker was better able to identify whether a patient had surgery. The correlation coefficient in the dorsal preservation cohort (-0.0554) suggested the raters were unable to identify which patients had surgery. We found significant improvements in overall aesthetic outcomes with both techniques, while a more natural "unoperated" outcome was achieved when performing a dorsal preservation technique. We also provide evidence of the efficacy of using crowdsourcing as an efficient and reliable method for evaluating aesthetic outcomes.
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