Rhinoplasty Outcome Evaluation Questionnaire Research Articles

Bridging the Gap: Understanding Appalachian Patient Satisfaction in Cosmetic Rhinoplasty.

Rhinoplasty is a surgical procedure aimed at correcting both functional and aesthetic nasal deformities, addressing issues such as trauma-induced disfigurements and patient dissatisfaction with nasal appearance. Patient satisfaction is a critical outcome measure in rhinoplasty, reflecting the success of the procedure and the quality of care provided. This study investigates factors influencing patient satisfaction among Appalachian patients undergoing rhinoplasty for aesthetic reasons, considering the unique healthcare challenges faced by rural populations. A modified Rhinoplasty Outcome Evaluation questionnaire was utilized to assess patient satisfaction. Descriptive statistics and regression analyses were performed to analyze demographic characteristics, complications, re-operations, and satisfaction scores among rural and urban participants. While no significant differences were found in demographic characteristics, trends in satisfaction scores suggest potential disparities between rural and urban populations. Rural patients exhibited marginally lower satisfaction scores and higher rates of complications and re-operations, highlighting the need for targeted interventions in rural healthcare settings. Addressing geographic barriers, enhancing preoperative education and postoperative support, and fostering interdisciplinary collaboration are essential strategies to improve patient satisfaction and outcomes in rhinoplasty procedures, particularly in rural communities. Further research with larger sample sizes and qualitative methods is warranted to explore the underlying factors contributing to patient satisfaction disparities and to inform evidence-based interventions aimed at narrowing healthcare disparities and advancing health equity in rhinoplasty care.

Comparison of 1 Year Nasal Tip Projection Results of Triple Cartilage Combining Suture (Flexible Tongue-in-Groove) and Classical Tongue-in-Groove Techniques.

Objectives: In the present study, we compared patient satisfaction with classical tongue-in-groove (TIG) technique and triple cartilage combining suture (TCCS; flexible tongue-in-groove) techniques applied to the nasal tip in rhinoplasty. Methods: In this retrospective study, 80 patients who underwent rhinoplasty operations with TIG or TCCS techniques applied to the tip region were included. There were 40 patients in both groups. All patients in groups 1 and 2 were evaluated by the criteria written below at preoperative, postoperative first month, and postoperative first year: (1) Rhinoplasty Outcomes Evaluation Questionnaire (ROE), (2) tip projection (cm), (3) nasal dorsum length (cm), (4) tip projection ratio (Goode), (5) nasofrontal angle, and (6) nasolabial angle. Results: The patients were followed up at 84.32 ± 19.38 months in the TIG group and 87.47 ± 18.01 months in the TCCS group. Our results showed that preoperative, postoperative first-month, and first-year tip projection (P = .013, P = .022, and P = .020, respectively), and nasal dorsum length values (P = .009, P = .020, and P = .020, respectively) of the TCCS group were significantly lower than those in the TIG group. There was a positive correlation between the postoperative first month and postoperative first year ROE scores. Lower preoperative tip projection ratio (Goode) values and higher nasolabial angle values were related to higher ROE scores showing patient satisfaction. Conclusion: For the patient satisfaction after tip rhinoplasty, lower projection ratio (Goode) and higher nasolabial angle values were related to ROE scores. Although there are no significant results, lower tip projection results in the TCCS group may be related to more patient satisfaction due to natural appearance.

Nasal axis lateralization suture technique in crooked nose.

The aim of the present study was to objectively and subjectively compare the preoperative and postoperative aesthetic and functional outcomes of the correction of crooked noses using a suture technique we call "nasal axis lateralization suture (NALS)". A total of 36 patients who had preoperative and postoperative photographs taken and who completed the Rhinoplasty Outcome Evaluation (ROE) questionnaire were included in the study. Crooked noses were divided into two groups: C-shaped (17 patients) and I-shaped (19 patients). The preoperative and postoperative nasal axis angles were 145.3 ± 11.9 and 178.5 ± 3.3, respectively, in C-shaped nasal deviation. In I-shaped nasal deviation, on the other hand, the preoperative nasal axis angle was 8.8 ± 2.8, while the postoperative nasal axis angle was 1.4 ± 2.4. In terms of the ideal axis percentage before and after surgery, a significant difference was found between the C-shaped and I-shaped nasal deviation patient groups (p < 0.05). While there was a significant improvement in both groups in the evaluation based on the ROE questionnaire, satisfaction was much higher in the C-shaped nasal deviation group. In both groups, the ROE values of functional and aesthetic outcomes were significantly different compared to the preoperative values of both groups (p < 0.005). NALS can be used as an alternative technique to correct both I-shaped and C-shaped nasal axis deviations.

Does being a healthcare professional affect satisfaction after septorhinoplasty?

This study aims to determine the differences in satisfaction levels after septorhinoplasty between patients who are healthcare workers and those who are not. The study includes patients who underwent primary septorhinoplasty surgery, divided into two groups: healthcare workers and non-healthcare workers. The Rhinoplasty Outcome Evaluation (ROE) questionnaire was administered to the patients at the 6th postoperative month. Among the 37 patients, 18 were healthcare workers, and 19 were non-healthcare workers. The mean Rhinoplasty Outcome Evaluation score for healthcare workers at the 6th postoperative month was 75.69 ± 16.06, while in the non-healthcare worker group, the ROE scores were 60.31 ± 27.69. The findings from our study indicated that individuals in the healthcare profession exhibited significantly greater satisfaction rates following septorhinoplasty in comparison to those in the non-healthcare worker group, with a statistically significant difference noted (p: 0.046). Having more knowledge about septorhinoplasty surgery and its complications among healthcare workers may allow for more realistic expectations regarding the surgical intervention. Simultaneously, it may facilitate better communication with the surgeon and the expression of expectations. Clinicians should pay attention not only to the patient's intellectual level but also to their health literacy in communication with the patient.

The comparison of 1-year results for mini and wide-size cap grafts applied to nasal tips.

In the present study, we evaluated patient satisfaction with cap grafts by Rhinoplasty Outcomes Evaluation (ROE) scores. Mini cap and wide cap grafts were applied. A total of 80 patients who underwent a rhinoplasty operation with cap graft application to the tip region were included in the study. According to the cap graft size, there were two groups: Group 1 consisted of 40 patients with cap graft size ≤7 cm (mini cap group). Group 2 comprised 40 patients with cap grafts ≥8 cm (wide cap group). Patients in groups 1 and 2 underwent evaluations based on the following criteria at preoperative, postoperative-1st month, and postoperative-1st year intervals: (1) Rhinoplasty Outcomes Evaluation Questionnaire (ROE), (2) tip projection (cm), (3) nasal dorsum length (cm), (4) tip projection ratio (Goode), (5) nasofrontal angle, and (6) nasolabial angle. Postoperative 1st-month and 1st-year ROE scores of the wide cap group were significantly higher than those in the mini cap group (p<0.05). Preoperative tip projection ratio (Goode) values of the wide cap group were considerably higher than those in the mini cap group (p<0.05). There were no significant differences between tip projection, nasal dorsum length, nasofrontal angle, and nasolabial angle values of the mini cap and wide cap groups (p>0.05). Correlation tests showed that as preoperative ROE scores decreased, postoperative-1st month and 1st-year ROE scores increased (p<0.05). Postoperative 1st-month and postoperative 1st-year's ROE scores increased together (p<0.05). In the wide cap group, postoperative 1st-month and postoperative 1st-year's ROE scores increased compared to the mini cap group (p<0.05). As postoperative 1st-year nasolabial angle values increased, postoperative 1st-year ROE scores also increased (p<0.05). We found that patients who received wide-cap rhinoplasty had increased postoperative ROE scores and higher satisfaction rates during the first month and first year. Postoperative higher nasolabial angle values were related to higher ROE scores and patient satisfaction in the postoperative 1st year.

Ethnic rhinoplasty: Preliminary results of our technique in the pursuit of the harmonious nose

According to the American Society of Plastic Surgery, cosmetic surgery procedures for "ethnic patients" are annually increasing. Ethnic rhinoplasty traditionally represents a difficult challenge for plastic surgeons. Herein, we describe our personal technique to ethnic rhinoplasty to achieve a harmonious nose maintaining the characteristics of individual ethnicity and identity. In this study, we retrospectively reviewed ethnic patients treated with rhinoplasty at our institution between January 2019 and October 2022. We described our personal rhinoplasty technique step by step. At a minimum follow-up time of six months, postoperative pictures were taken, and patients were reassessed, evaluating aspects such as global symmetry and shape and contour of the nose. Finally, patient satisfaction was investigated according to rhinoplasty outcomes evaluation (ROE) questionnaire. A total of 1321 patients were included in the study. They reported a significant satisfactory aesthetic result in nasal image, as indicated by the mean postoperative ROE score (92.12). No cases of nasal contracture were recorded. None of the grafts was extruded or collapsed. Wounds healed without reported major infection. This study demonstrated that our approach is a safe procedure that contributes to improved functional outcomes with a high patient satisfaction rate and a low rate of postoperative complication. The creation of a solid base structure, nasal skin preparation, and an integrated patient approach are key elements of this surgery.

Let-Down Rhinoplasty in Patients With Cleft Lip Nose.

Rhinoplasty in patients with cleft lip nose (CLN) deformity is challenging. Cleft lip nose deformity primarily affects the nasal tip, columella, nostrils, alar base, floor, and septum. The needs of patients with CLN are quite different from those of patients who undergo primary rhinoplasty. Recently, the dorsal preservation rhinoplasty technique has gained popularity. We applied this technique to patients with CLN deformity to obtain better aesthetic and functional results. Ten consecutive patients with indication for primary CLN reconstruction underwent let-down rhinoplasty. Rhinoplasties were performed using either the closed or open approach, with costal cartilage grafts and full-thickness skin grafts. A rhinoplasty outcome evaluation questionnaire was used to assess the results. Moreover, the use of the same questionnaire in prior patients allowed us to compare results between our previous and new techniques. The study included 6 female and 4 male patients, with ages ranging from 18 to 25 years. Only 1 patient had a history of bilateral cleft lip. Seven patients had a history of left-sided cleft lip, and 2 patients had right-sided cleft lip. Open-approach let-down rhinoplasty with costal cartilage grafts and full-thickness skin grafts was performed in 8 patients, whereas closed-approach let-down rhinoplasty with costal cartilage grafts was performed in 2 patients. Columellar struts and affected-side onlay costal cartilage grafts were used in all patients. All patients reported being satisfied with the let-down rhinoplasty outcome, and none complained of functional problems. However, nostril symmetry was not observed in some patients, particularly in patients who underwent closed-approach rhinoplasty. Combining open approach, full-thickness skin graft, costal cartilage graft, and let-down rhinoplasty shows promising and satisfactory outcomes in patients with CLN. However, further studies are required to confirm this observation.

Aesthetic rhinoplasty: a paradigm shift towards cosmesis in Indian population

Background: The tremendous growth of cosmetic surgery among Asians is largely due to strength of indigenous economies accompanying globalization. This increase in number can also be attributed to usage of social media as well as increased desire to look perfect. The current study is an attempt to measures aesthetic outcome and identify possible interactions between other possible outcome determinants. Methods: The present study was a 1.5 years prospective interventional study conducted at SMS Medical College, India from January 2021 to July 2022. A total of 51 samples were included in our study. The rhinoplasty outcome evaluation (ROE) questionnaire was used to assess patient satisfaction which was presented and completed by all patients before and after 6 months of surgery and data was analysed. Results: In the present study mean age of study participants was 25.7 years and most subjects (64.7%) were male and (35.3%) were female. Mean total ROE at pre-op and post-op 6 months was 35.05±13.4 and 57.4±27.9 respectively and mean Total ROE difference between pre-op and post-op 6 month was -22.4±36.1. This difference was found to be statistically significant (p value 0.0001). Conclusions: Aesthetic rhinoplasty in India is emerging as a lifestyle choice because of increased users of social media as well as awareness about procedures available for enhancing facial features. Our study gives a glimpse towards the shift of rhinoplasty in India and explains the possible reasons behind this shift.

Evaluation of quality of life after septorhinoplasty using Rhinoplasty Outcome Evaluation questionnaire

BackgroundTo assess satisfaction level of patients undergoing septorhinoplasty pre- and post-operatively using Rhinoplasty Outcome Evaluation (ROE) questionnaire.MethodsThe present prospective study, after approval by Institutional Ethics Committee, was conducted in the Department of ENT, SMGS Hospital, from March 2021 to November 2022 on 83 patients who underwent septorhinoplasty. Demographic and clinical characteristics (age, gender, education, technique of surgery) of all participants were recorded. All patients were asked to answer the Rhinoplasty Outcome Evaluation (ROE) questionnaire 1 day prior to surgery. Postoperative ROE questionnaire was asked at the 6th month in ENT OPD by the same researcher.ResultsIn our study, the mean preoperative total ROE score was 32.17 ± 5.38, and the mean postoperative total ROE score was 87.11 ± 5.39, the difference being statistically significant (p = 0.0039). Higher post-operative satisfaction score (89.7 ± 5.64) was seen in patients aged more than 35 years, as compared to younger patients (78.4 ± 5.8). In our study, upon gender-wise comparison, there was more statistically significant satisfaction in male patients than female patients postoperatively (p = 0.0022). Better postoperative ROE score was seen in lower literacy group (88.9 ± 6.73) than higher literacy group (83.3 ± 5.63). However, both open and closed techniques showed statistically insignificant difference in postoperative ROE score (p = 0.388).ConclusionBased on the Rhinoplasty Outcome Evaluation (ROE) questionnaire, our study showed that septorhinoplasty significantly improved quality of life in majority of our study subjects in terms of both aesthetic as well as functional parameters.

Exploring the Resurgence of the Preservation Rhinoplasty: A Systematic Literature Review.

The underlying principles of preservation rhinoplasty (PR) center around maintaining the soft tissue envelope, dorsum, and alar cartilage through surgical manipulations and tip suture techniques. In particular, the let-down (LD) and push-down (PD) techniques have been described, although reports of indications and outcomes in the literature are sparse. A systematic review of the literature was performed using search terms "preservation" OR "let down" OR "push down" AND "rhinoplasty" on PubMed, Cochrane, SCOPUS, and EMBASE databases. Patient demographic information, operative details, and surgical outcomes were recorded. Sub-cohorts for patients who underwent LD and PD techniques were analyzed utilizing Fischer's exact test for categorical variables and Student's t test for continuous variables. Overall, there were 5967 PR patients in 30 studies in the final analysis, with 307 patients in the PD cohort and 529 patients in the LD cohort. The Rhinoplasty Outcome Evaluation Questionnaire showed a significant increase of patient satisfaction after PR compared to before PR (62.13 vs 91.14; p < 0.001). There was a significantly lower rate of residual dorsal hump or recurrence of 1.3% (n = 4) in the PD when compared to 4.6% (n = 23) in LD cohorts (p = 0.02). The revision rate of PD (0%, n = 0) was also significantly lower than that of LD (5.0%, n = 25) (p < 0.001). Based on these published articles, it seems that preservation rhinoplasty is safe and efficacious procedure with improved dorsal aesthetic lines, reduced dorsal contour irregularities, and claimed excellent patient satisfaction. In particular, the PD technique has fewer reported complications and revisions than LD approach, although PD is often indicated in patients with smaller dorsal humps. 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 .

Preservation Rhinoplasty: A New Approach to Mestizo Noses.

The Rhinoplasty Outcome Evaluation (ROE), a Likert-type questionnaire validated in Spanish, was used to assess the level of satisfaction of 14 mestizo patients who underwent preservation rhinoplasty from March to July 2021 at 1 year after their surgery at the Higuereta Clinic in Lima, Peru. The study included 14 patients, three men and 11 women, who underwent preservation rhinoplasty. A presurgical ROE questionnaire was applied, presenting a minimum value of 6, a maximum value of 21, and a mean of 12. When applied 1 year after surgery, the same ROE questionnaire presented a minimum value of 28, a maximum value of 30, and a mean of 30. The variation had a minimum value of 9 and a maximum value of 23, with a mean of 17 (P < 0.001). Preservation rhinoplasty can be successfully implemented in mestizo noses with good aesthetic results.

Rhinoplasty Technique for Improving Nasal Base Aesthetics: Lateral Columellar Grafting.

One of the most important factors in nasal base aesthetics is symmetry. In the age of social media, the expectations of rhinoplasty patients and the rate of requests for a more symmetrical nose have increased. In this article, a lateral columellar grafting technique that can be applied to augment the more defective side of the columella and obtain a more symmetrical nasal base is presented. A total of 86 patients (women, 79; men, 7) were included in this study. The surfaces of the right and left lateral margins of the columella were evaluated from the basal view at the final stage of surgery, and a lateral columellar graft was placed on the more defective side. All patients who were included in the study were assessed with the Rhinoplasty Outcome Evaluation questionnaire before and 1 year after surgery. The median age of the patients was 28.3 years (range, 18-56 years). Eighty-two patients were primary rhinoplasty patients, and 4 patients were secondary rhinoplasty patients. The median Rhinoplasty Outcome Evaluation score was 68.3 points before surgery and 92.3 points 1 year after surgery, showing a significant increase (P = 0.003). Patient satisfaction was found to be excellent in 93% of the included patients. Using the lateral columellar grafting technique, greater symmetry of the columella and nostrils can be obtained by augmenting the more defective side of the lateral columellar surface.

Normal values of the Turkish version of the Rhinoplasty Outcome Evaluation Questionnaire (ROE-T) for the Turkish population

Objectives: In this study, it was aimed to determine the normal values of the Turkish version of the Rhinoplasty Outcome Evaluation Questionnaire (ROE-T) for the Turkish population. Patients and Methods: In this cross-sectional clinical study, 200 patients (92 males, 108 females; mean age: 28.1±5.4 years; range, 18 to 52 years) who were candidates for rhinoplasty were included in the rhinoplasty group, and 200 individuals (85 males, 115 females; mean age: 26.7±6.2 years; range, 18 to 50 years) who did not need rhinoplasty were included in the control group. The ROE-T questionnaire was filled by all participants. Sensitivity, specificity, and cut-off value of the questionnaire were calculated. Results: The mean ROE-T score was 4.90±2.28 in the rhinoplasty group, while it was 15.28±2.16 in the control group. The cut-off value of the questionnaire was 11, with 96.0% sensitivity and 98.6% specificity. Conclusion: We believe that the ROE-T is an effective and easy-to-use questionnaire in the evaluation of rhinoplasty-related patient satisfaction in the Turkish population.

Patient Satisfaction among Different Age Groups Who Underwent Aesthetic and Functional Rhinoplasty in Sulaymaniyah

Background: Cosmetic surgery is performed to improve an individual’s satisfaction with their appearance and to improve their psychological health by improving self-confidence. Our study aimed to evaluate patient satisfaction regarding nose appearance and function. Objective: To evaluate the satisfaction of patients who underwent rhinoplasty by using the Rhinoplasty outcomes evaluation (ROE) questionnaire and to determine the impact of patient age on the outcomes. Patients and Methods: A prospective study of 90 patients who underwent open rhinoplasty procedures, including other nasal procedures like septoplasty or turbinoplasty, in both private and public Sulaimani Surgical Teaching Hospitals (department of oral maxillofacial surgery) from October 2020 to March 2022. The Rhinoplasty Outcomes Evaluation (ROE) questionnaire was used for esthetic and functional assessment. Results before and after surgery were compared. Results: In this study, ninety patients participated by completing the questionnaires and the follow-up period six months postoperatively. The main reasons for rhinoplasty in our patients were: esthetic 50% (n=45), functional 8.9 % (n=8), and a combination of both esthetic and functional in 41.1% (n=37) of patients. There was a significant overall increase in patient satisfaction with functional and esthetic outcomes post-surgery (p &lt; 0.01), and there was no significant difference among different age groups postoperatively (p &gt; 0.01) based on ROE. Conclusion: There was a significant overall increase in patients’ satisfaction with functional and aesthetic outcomes post-surgery. There was no significant difference in satisfaction among different age groups. Keywords:Rhinoplasty, Esthetic, Patient satisfaction, Questionnaire, Functional assessment

Patient Satisfaction among Different Age Groups Who Underwent Aesthetic and Functional Rhinoplasty in Sulaymaniyah

Background: Cosmetic surgery is performed to improve an individual’s satisfaction with their appearance and to improve their psychological health by improving self-confidence. Our study aimed to evaluate patient satisfaction regarding nose appearance and function.&#x0D; Objective: To evaluate the satisfaction of patients who underwent rhinoplasty by using the Rhinoplasty outcomes evaluation (ROE) questionnaire and to determine the impact of patient age on the outcomes.&#x0D; Patients and Methods: A prospective study of 90 patients who underwent open rhinoplasty procedures, including other nasal procedures like septoplasty or turbinoplasty, in both private and public Sulaimani Surgical Teaching Hospitals (department of oral maxillofacial surgery) from October 2020 to March 2022. The Rhinoplasty Outcomes Evaluation (ROE) questionnaire was used for esthetic and functional assessment. Results before and after surgery were compared.&#x0D; Results: In this study, ninety patients participated by completing the questionnaires and the follow-up period six months postoperatively. The main reasons for rhinoplasty in our patients were: esthetic 50% (n=45), functional 8.9 % (n=8), and a combination of both esthetic and functional in 41.1% (n=37) of patients. There was a significant overall increase in patient satisfaction with functional and esthetic outcomes post-surgery (p &lt; 0.01), and there was no significant difference among different age groups postoperatively (p &gt; 0.01) based on ROE.&#x0D; Conclusion: There was a significant overall increase in patients’ satisfaction with functional and aesthetic outcomes post-surgery. There was no significant difference in satisfaction among different age groups.

Development and Validation of the Rhinoplasty Outcomes Evaluation (ROE) Questionnaire: An Analytical Study.

BACKGROUND:Rhinoplasty Outcome Evaluation (ROE) is an easy-to-use questionnaire that allows comprehensive assessment of rhinoplasty-related patient satisfaction. However, the normal values for this questionnaire are not known. Therefore, we aim to validate the ROE questionnaire adapted to Iranian culture.METHOD:In this cross-sectional descriptive study, the statistical population consisted of applicants for cosmetic surgery referred to Shahid Rajaee Hospital, Shiraz, Iran, in the autumn and winter of 2017. Two hundred individuals participated in this research by a convenience sampling method. The questionnaire (ROE) was translated to Persian and backward translated to English by independent medical extern Persian speakers with complete English proficiency. The data were analyzed using SPSS software version 23 using exploratory factor analysis. RESULTS:The findings showed that the Cronbach’s Alpha of composite reliability (CR) and average variance extracted (AVE); overall, values above 0.4 were favorable in this measure. In addition, the AVE ranged from 0.50 to 0.59, which confirmed convergent validity. The AVEs of each factor was higher than the squared correlations and confirmed discriminant validity within the constructs. In the presence of significant factor loadings and composite reliability greater than 0.70, convergence validity was confirmed. Furthermore, the higher AVEs for each factor were compared to the squared correlations to confirm discriminant validity.CONCLUSION:The Iranian version of ROE is a valid instrument to assess results in rhinoplasty patients.

Comparison of crushed cartilage used and not used as camouflage grafts in patients who had undergone septorhinoplasty

ObjectiveSeptorhinoplasty is the most frequently performed aesthetic operation. Many techniques are used in septorhinoplasty, and these techniques can affect patient satisfaction, which is one of the most important parameters showing success in surgery. In this study, we aimed to compare the postoperative satisfaction of patients with and without crushed cartilage onlay grafts. MethodsPatients who underwent septorhinoplasty between 2017 and 2019 were included in the study. A rhinoplasty outcomes evaluation (ROE) questionnaire and a visual analog scale (VAS) were completed before and after surgery. Pre- and postoperative values were compared. The patients were classified into two groups as patients with or without crushed cartilage grafts, and the results were compared. ResultsA total of patients were included in our study, 54 of which were female, and 39 were male. Results showed that post-operative ROE and VAS scores were statistically significantly improved (p < 0.05). In the group with crushed cartilage, the 12th month ROE and VAS scores were lower than the group without crushed cartilage (p < 0.05). ConclusionIn the group with crushed cartilage, the satisfaction levels in the 12th month were lower than those of the patients without crushed cartilage.

Quality of Life (QoL) and Outcome After Preservation Rhinoplasty (PR) Using the Rhinoplasty Outcome Evaluation (ROE) Questionnaire-A Prospective Observational Single-Centre Study.

Rhinoplasty is a challenging procedure, and the ultimate goal is not only to restore the function and youthful appearance, but also to improve the quality of life (QoL). Little is known about the QoL after preservation rhinoplasty (PR). The aim of this study was to assess patient satisfaction after PR by using a validated questionnaire. Patients undergoing primary PR were included in this prospective cohort single-centre (private) study. Overall, 58 patients (41 female and 17 male patients, mean age 32 ± 9.7 years) were operated on between 2017 and 2021. Patient assessment regarding their outcome was evaluated before surgery and at final follow-up using a validated questionnaire (Rhinoplasty Outcomes Evaluation Questionnaire = ROE). Subgroup analyses were performed between the ROE questions and radiological analysis by using the cone-beam computed tomography (CT) before surgery and at final follow-up. After a mean follow-up of 19.7 ± 7.9 months (range = 1-50 months), a high overall patient satisfaction was observed (37.9 ± 9.2 vs. 81.25 ± 14.17, p &lt; 0.0001). Subgroup analysis showed the highest improvement in nose appearance, breathing, and self-confidence after surgery. The improvement of subjective breathing (1.471 ± 0.90 vs. 3.1 ± 0.88; p&lt;0.0001) goes in line with an overall improved internal nasal valve (INV) angle (19.88° ± 3.3° vs. 22.04° ± 4.1°, p = 0.0231). Our study showed a high patient satisfaction after PR as evaluated by the ROE, which goes in line with aesthetics and function. 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 .

Hybrid Preservation Rhinoplasty: Combining Mix-Down and Semi Let-Push Down Techniques.

Rhinoplasty is 1 of the most applied procedures among aesthetic and plastic surgery areas. Dorsal hump deformity is a common deformity among Caucasians based on the natural anatomy of the nose. Dorsal preservation techniques arose as a necessity for overcoming the negative outcomes of traditional hump reduction surgery in patients with hump deformity. Beside the strong advantages of dorsal preservation techniques such as push-down and let-down techniques in the fixation of dorsal hump deformity, innovations on these procedures would bring better outcomes in terms of aesthetic and functional manners. In present research, the author defines a new technique, which combines new procedures as mix-down and semi let-down and semi push-down techniques. This study was designed as a retrospective. According to the inclusion and exclusion criteria, 36 patients (26 females and 10 males) were included in the study. The author applied to patients hybrid preservation rhinoplasty approach, which is a combination of mix-down and semi let-down and semi push-down techniques. All patients completed the Rhinoplasty Outcome Evaluation (ROE) questionnaire before surgery and at their 1-year follow-up appointment. The follow-up period ranged between 13 and 28 months (median of 19.8months). The initial median ROE score was 55.5, and it increased to 91.00 points at 12 months after surgery ( P < 0.001). According to the ROE scale, patients' satisfaction was found as excellent in 91.6% of patients. Present study showed satisfactory outcomes of hybrid dorsal preservation technique, which is a combination of mix-down and semi-let down and semi-push down approaches. This new approach will be suitable for selected patients and easy to perform by the surgeons. Moreover, patients who have concomitant hump and deviation deformities will benefit from hybrid dorsal preservation technique.Level of Evidence: 3.

The Effect of the Vertical Alar Resection (VAR) Technique on Tip Stability; Long-Term Results.

Main properties of nasal tip are the nasal tip projection (NTP), the nasal tip rotation (NTR), and the definition. Its surgery is difficult due to anatomic variations, pathologies, and various surgery possibilities. The ideal technique must also provide good results in long-term. The aim of the study was to analyze long-term results of vertical alar resection (VAR) technique in rhinoplasty. Forty-eight patients who underwent rhinoplasty operations that VAR method was used by senior author between 2001 and 2017 were included into the study (42 women and six men). The mean age of patients was 35.5 years (range 18-56 years). Mean post-operative follow-up period was 86.8 months (range 25-225 months). We analyzed pre=operative, early, and late post-operative photographs of patients. NTP and NTR changes in years were objectively evaluated. Patients also completed Rhinoplasty Outcome Evaluation questionnaire in their last control visit. Mean NTP (through Goode Method) was changed from 0.60 in early to 0.59 in late post-operative control, mean nasofacial angle from 29.4 in early to 28.7 in late post-operative control. Mean nasolabial angle (NLA) changed from 97.3 to 94.5 and Tip rotation angle (TRA) from 35.2 to 35.4 between early and late post-operative control. Differences between early and late post-operative measures of NTP and NLA were significant (p<0.001 for all), but TRA did not changed significantly (p>0.001). VAR is a useful method for modifications of lateral crura and nasal tip. With VAR, we can control NTP and NTR, length of lateral crus and nose; get satisfying and long lasting results.