Rhinoplasty Outcome Evaluation Questionnaire Research Articles

Push-Down Technique Without Osteotomy: A New Approach.

Dorsal hump reduction is one of the most frequently performed rhinoplasty operations among white populations. The best method for preserving a natural nasal dorsum and avoiding revision surgery is to perform the push-down technique. The concept of the push-down technique is not new and has been improved over time. In the present study, the author introduces a new approach for the push-down technique in which there is no need for osteotomy. According to the inclusion and exclusion criteria, sixty-two patients were included in the present study. All patients who were included in the study were assessed with the Rhinoplasty Outcome Evaluation (ROE) questionnaire at their 1-year follow-up appointment. In the present technique, the superior dorsal cartilage was pushed down to the reverse side of the septal deviation, and the nasal dorsum was rasped with a micromotor rasping machine instead of undergoing osteotomy. The initial median ROE score was 68.5 points, and the postoperative median score was 90.5 points. A final score greater than 85 was considered excellent and an indication of high patient satisfaction. Among the sixty-two patients, 56 had a score greater than 85 points (90.32%) (p = 0.001). There were no complications, and there was no need for revision surgery. This push-down technique can be considered an easy and suitable approach for selected patient populations. Additionally, the recovery time is shortened with the push-down technique without osteotomy. 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.

Improvement of Alar Concavity With Scroll Ligament Preservation: Sandwich Technique.

Excessive concavity of the lower lateral crura can cause significant aesthetic problems for the nasal tip and can be associated with significant functional problems, such as insufficiencies in the external nasal valve. The aim of this study was to develop a novel technique for the improvement of several alar concavities that preserve the scroll area. In this retrospective study, 51 primary rhinoplasty patients with unoperated alar concavity deformities were assessed. Alar concavities were repaired with alar strut grafts and a superior transposition flap or superior-based sliding flap, which were designed with the "sandwich" technique. Additionally, the scroll ligament was completely preserved in the 2 variants of the technique. All patients who were included in the study were assessed with the Rhinoplasty Outcome Evaluation (ROE) questionnaire before surgery and at their 1-year follow-up appointment. The median age of patients was 29.2 years (range, 19-49 years). The ROE scores ranged between 90 and 100 points after 1 year. The median score was 91.2 points, and this was significantly increased at the 1-year follow-up appointment (P = 0.002). Patient satisfaction was found to be excellent in 92% of the included patients. Patients were also evaluated in terms of functionality. The patients' patency scores increased to 9.4 from 6.1 (out of 10) after a 12-month follow-up (P = 0.003). This "sandwich" technique involves a combination of superior transposition flaps, superior-based sliding flaps, and alar strut grafts. Thus, patients who receive this treatment may also benefit from new flap techniques and vertical and longitudinal scroll ligament preservation. This new technique presents a novel and easy method for the reconstruction of severe alar concavities.

Rhinoplasty in secondary nasal deformities: Subjective and objective outcome evaluation

Introduction:Secondary nasal deformities are associated with trauma and secondary cleft nose (after primary cleft nose surgery). Nasal deformities affect esthetic, function, and psychological status of the patient. The goal of the secondary rhinoplasty is to correct both form and function, so that this positively impacts on their facial appearance.Aims:The study aimed to evaluate the patient satisfaction (subjective outcome) by rhinoplasty outcome evaluation questionnaire (ROEQ) preoperatively and postoperatively and esthetic outcome (objective outcome) by surgical team in patients with secondary nasal deformities.Materials and Methods:Secondary rhinoplasty was done in 13 patients of traumatic and unilateral secondary cleft nose through the external approach. Objective outcome was assessed by surgical team with clinical measurement, radiograph (lateral cephalometric), and photographic documentation pre- and postoperatively. Clinical measurements include nasolabial and nasofrontal angle. The patients completed the ROEQ for the subjective outcome evaluation.Results:There was significant improvement of subjective outcome (83.30%) based on the ROEQ and objective outcome based on the clinical measurement.Conclusion:Our study suggests that secondary rhinoplasty in trauma and cleft patients leads to both subjective and objective improvement of the facial appearance.

Psychological Analysis of Non-surgical Rhinoplasty.

The aim of this study is to analyze the psychological outcomes for patients undergoing non-surgical correction of nasal defects using injections of cross-linked hyaluronic acid. We assessed changes in the subjective perception of nasal appearance after non-surgical rhinoplasty using the Rhinoplasty Outcomes Evaluation (ROE) questionnaire, which is validated and widely used in the literature. One hundred adult subjects without prior history of surgical or non-surgical rhinoplasty underwent non-surgical recontouring using the hyaluronic acid filler from December 2016 to December 2018. The points of inoculation have been standardized by the authors and are divided according to the aesthetic subunits of the nose. A final 74 patients (65 females and 9 males) completed a one-year follow-up and were included in the present study. The ROE questionnaire consists of six questions and assesses the way patients perceive the appearance of their nose and the way they think the people around them view the appearance of their nose. The results of each question were analyzed for each patient, comparing the preoperative results over a 12-month time-frame. Candidates for rhinoplasty, either medical or surgical, are among the most difficult to treat and, interestingly, there is substantial literature showing that among these patients, there is a higher rate of psychiatric disorders. Many of these patients seek aesthetic surgery and are often dissatisfied with the outcome of their surgery. The authors suggest that the use of ROE is not only a valid method of assessing patient satisfaction, but it could also be used as a tool to highlight some of the psychological characteristics of patients long before performing any treatment and could help identify potentially problematic patients.Level of Evidence IV 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.

Cosmetic and Functional Outcomes of Septorhinoplasty.

prospective cohort study. patients with complaints of nasal obstruction and external deformity who are undergoing Septorhinoplasty after evaluation. patients undergoing Septorhinoplasty at Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla during a period of 1½ years, starting from 01/01/2017. non-random, consecutive sampling. The mean age in this study is 26.10years. The most common age group of patients who were included in the study was 11-20years. We had 11 females and 8 males. Female to male ratio was 1.375. The mean duration of symptom was 6.33years. Most of the patients in our study were students. The mean pre-op ROE score was 29.79 ± 15.28 and post-op score was 87.32 ± 8.75. There was significant improvement in ROE scores following Septorhinoplasty (p < 0.0001). The mean pre-op PNIF score was 76.58 ± 41.37 and post-op score was 125 ± 50.22. There was significant improvement in PNIF scores following surgery (p < 0.0001). There is significant improvement in cosmetic and functional aspects in patients undergoing Septorhinoplasty. There is significant improvement in external appearance and nasal obstruction following Septorhinoplasty. The patient satisfaction following Septorhinoplasty can be measured with ease with the help of Rhinoplasty outcome evaluation questionnaire and Peak nasal inspiratory flow meter.

Rainbow graft for tip reconstruction in revision rhinoplasty

Patients undergoing revision rhinoplasty can show complex tip deformities such as asymmetry, dome angulation with cartilage interruption, alar pinch and retraction, and underprojection. When these defects are present at the same time, often multiple cartilage grafts are needed to restore a pleasing tip and functional external nasal valve. This study reports our experience with the rainbow graft, a previously described technique that can repair with a single cartilage graft the above-mentioned defects. We performed a retrospective review of 21 patients who had undergone revision rhinoplasty between 2006 and 2017 employing the rainbow graft technique to correct complex tip deformities. The presence of tip deformities such as asymmetry, dome angulation with cartilage interruption, alar pinch, alar retraction, and under/overprojection was recorded preoperatively and postoperatively. Complete photographic documentation was done, and Rhinoplasty Outcome Evaluation (ROE) questionnaire was administered to the patients. Five patients were male and 16 were females. Mean age of patients was 40±7.6 years. Follow-up ranged from 1 to 12 years, mean 5 ± 3 years. Eight patients had undergone one rhinoplasty, 10 patients had undergone two, and three patients had undergone three. Before surgery, all patients showed asymmetry, 20 dome angulation, 19 alar pinch, and 18 retraction. Eight showed tip overprojection, six underprojection, and seven no alteration of tip projection. The mean ROE score was 20.23±7.37. After surgery, two patients showed persistent asymmetry, none had dome angulation, one alar pinch, and two alar retraction. Projection was corrected in every patient. We observed no case of graft infection, malposition, or resorption, and corrections achieved remained stable during follow-up. Mean postoperative ROE score was 80.75±6.24. Its improvement was statistically significant (p<0.001). The rainbow graft is a safe and effective technique in revision rhinoplasty indicated for the total restoration of nasal tip appearance in the presence of complex secondary deformities.

Satisfaction in Patients After Rhinoplasty Using the Rhinoplasty Outcome Evaluation Questionnaire.

IntroductionRhinoplasty is a challenging procedure. The goal of the surgery is not only to restore the function and youthful appearance of the nose but also to improve quality of life. With the passage of time, the trend has been changing rapidly from more invasive to less invasive procedures. Although the technical aspects of rhinoplasty are important, patient satisfaction is the factor that dictates the success of the procedure.Materials and methodsA total of 118 rhinoplasties were performed in our department between 2016 and 2018. The Rhinoplasty Outcome Evaluation (ROE) questionnaire was used to study the patients' satisfaction level. Ninety out of 118 patients took part in this study. Rhinoplasty was done using an open technique in all cases. The ROE questionnaire was filled preoperation and six months postoperation. Data analysis was done using SSPS statistic version 20 (IBM Corp., Armonk, NY, US).ResultsThe main reasons for rhinoplasty in our patients were: aesthetic 23.3% (n=21), functional 25.5% (n=23), and a combination of both in 51% (n=46) patients. The mean ROE score of all patients preoperation was 30.5 (males: 31.3, females 29.8) and the mean score postoperation was 79.5 (males 78.2, females 80.9) at six months with no statistical differences (CI 17.11 - 12.59, P=0.762). However, both genders showed a statistically significant improvement between the preoperative and postoperative scores (mean difference = 49.3, CI 63.25 - 35.34, P<0.01), indicating an overall good satisfaction level after surgery. The satisfaction level of patients was inversely proportional to their level of understanding and knowledge of the surgical procedure. This difference was statistically significant ( CI 7.36-10.42, P<0.01). Minor corrections or modifications were done in eight patients under local anesthesia, with no significant difference in ROE scores as compared to those who had single surgery (CI 0.7 - 1.6, P=0.92). There was no statistically significant difference in the before and after surgery ROE scores among patients operated by different surgeons as well (P=0.82).ConclusionOur study shows that rhinoplasty, despite being a complex procedure, has proven benefits in terms of functional as well as aesthetic outcomes. The ROE questionnaire proves to be a valid tool for estimating patient satisfaction in our population. There is a need for further training and education of surgeons in Pakistan to improve the functional and aesthetic disabilities of nasal deformities.

Vertical Alar Folding (VAF): A Useful Technique for Correction of Long and Concave Lateral Crura in Rhinoplasty.

The tripod theory explains the dynamics of the nasal tip, where surgery is difficult because of anatomic variations and pathologies and the various surgical possibilities. Abnormalities or weaknesses of the lateral crura can result in concavity in ala or alar collapse and cause aesthetic and functional impairments of the nose. Several tip plasty techniques and lateral crura modifications are used in rhinoplasty. To describe the vertical alar folding (VAF) technique for making modifications in the lateral crura (LC) and rotation of the tip. Included in the study were 83 patients (59 women, 24 men) undergoing rhinoplasty using VAF with the senior author as surgeon between 2013 and 2018. The mean age was 26.3years (range 18-47). Mean postoperative follow-up period was 26.7months (range 12-64). Patients who completed the 1-year postoperative period completed the rhinoplasty outcome evaluation (ROE) questionnaire. Outcome measures were performed at examinations, and preoperative and postoperative photographs of the patients were analyzed. In the span of 5years, no revision surgery was required for technique-specific reasons. In patients who had a droopy or asymmetric tip or long and concave lateral crura, we saw remarkable functional and aesthetic improvements with VAF. According to the ROE questionnaire, 90.3% (75 out of 83) of the patients were content with the aesthetic and functional results. VAF is a useful and effective method for modifying the LC and tip of the nose. VAF allowed for controlling the rotation and projection of the tip, changing the length of the lateral crus and nose with durability and smooth, symmetric contours, and correcting concavity of a lateral crus for better functioning and aesthetics. 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 .

Three Dimensional Rhinoplasty and Nasal Airway Improvement in Cleft-Nose Deformity.

Septorhinoplasty is particularly challenging among revision surgeries for cleft sequelae. The challenge of cleft septorhinoplasty is mainly due to the complex anatomy of nose, deformity of each of its components and the difficulty and lack of clarity in surgical management. From 2014 to 2017, 26 patients with cleft lip nose deformity were operated by the same cleft team. The study was conducted to assess the improvement in nasal airway and appearance following secondary rhinoplasty with extracorporeal septoplasty. Post operatively each patient was evaluated using the standard modified rhinoplasty outcome evaluation questionnaire, a validated instrument that aids in stratifying patients according to their subjective response. All patients reported great relief of nasal obstruction and improved breathing. More than 80% of our patients were satisfied with improved aesthetics and reported better self-confidence. Secondary cleft rhinoplasty with extracorporeal septoplasty surgery significantly improves the cosmesis and nasal airway opening, subsequently giving them improved self-confidence.

The Association Between Facial Proportions and Patient Satisfaction After Rhinoplasty: A Prospective Study.

Rhinoplasty is one of the most common aesthetic surgeries. The aim of the study was to evaluate facial proportions and patient satisfaction with the appearance of their nose after rhinoplasty compared to preoperatively. This cross-sectional study was conducted at Islamic Azad University, Mashhad Branch. Eighty-two candidates with indications for primary cosmetic rhinoplasty were selected. Facial proportions and patient satisfaction with their nasal appearance were evaluated before and 6 months after rhinoplasty. Patient satisfaction was assessed using the Rhinoplasty Outcome Evaluation questionnaire. Eighty-two patients referred for cosmetic rhinoplasty (13.4% men and 86.6% women) with a mean age of 28.5 (6.4) years underwent open rhinoplasty and were evaluated. Facial proportions, including nasofrontal, nasolabial, and nasomental ratios increased significantly, while the nasofacial ratio, nasal tip projection, columellar show, alar base, and nasal length reduced significantly after rhinoplasty (P < .05). Furthermore, patient satisfaction with the appearance of their nose increased significantly after surgery (P < .001). All of the facial proportions changed significantly following rhinoplasty. Although patient satisfaction with nose appearance increases significantly after the operation, there is no significant association between patient satisfaction and facial proportions. As beauty is a subjective, relative and qualitative issue, facial proportions may not be a proper tool to determine facial beauty and predict the satisfaction rate following rhinoplasty.

Dorsal Roof Technique for Dorsum Preservation in Rhinoplasty.

Management of the nasal dorsum is an important part of rhinoplasty. Hump removal results in the destruction of the internal valve and keystone area, which are reconstructed with either spreader flaps or grafts for aesthetic and functional reasons. The goal of this work was to present the dorsal roof technique for both dorsum reduction and narrowing during rhinoplasty. Fifty-two patients (35 females, 17 males) underwent septorhinoplasty surgery with the dorsal roof technique. During the follow-up period, all patients were photographed in the standard views. Photos were examined by two independent plastic surgeons. The pyramidal angles of the patients were measured with a protractor preoperatively and 1 year postoperatively. A rhinoplasty outcomes evaluation questionnaire was administered to all patients at the 1-year follow-up visit. Functional improvement was assessed utilizing self-evaluated nasal patency. The chi-square test was employed for statistical analyses. Data were evaluated retrospectively. Of the 52 patients, 44 completed the 1-year follow-up period and rhinoplasty outcomes evaluation questionnaire. During the follow-up period, no irregularity or residual hump was detected. Significant narrowing was achieved (P < 0.001). High patient satisfaction was achieved, and no functional or aesthetic complications were encountered. Whenever possible, the dorsal roof technique is preferred to resection or camouflage the dorsum. This technique allows treatment of the wide dorsum, wide nasal base, and dorsal hump without resection, thus maintaining the integrity of the dorsal bone-cartilage complex.

The Turkish Version of the Rhinoplasty Outcomes Evaluation Questionnaire: Validation and Clinical Application

Background:An assessment of rhinoplasty from the patient’s perspective, in terms of satisfaction and quality of life, is quite important because these are the predominant factors indicating the success of rhinoplasty.Aims:To translate the Rhinoplasty Outcomes Evaluation into Turkish and then validate the new version for use in Turkish patients.Study Design:Validation study.Methods:We enrolled 30 participants who were able to read and write Turkish and underwent primary rhinoplasty. The control group consisted of 58 healthy volunteers with no need for aesthetic or functional nasal surgery. The reliability of the Rhinoplasty Outcomes Evaluation-T was analyzed according to its internal consistency and test-retest reproducibility. Discriminant validity was calculated by comparing the Rhinoplasty Outcomes Evaluation-T scores between the patient and control groups. Responsiveness and sensitivity to changes in rhinoplasty outcomes were analyzed by comparing the patients’ pre- and postoperative Rhinoplasty Outcomes Evaluation-T scores.Results:The scores for questions 1-6 of the Rhinoplasty Outcomes Evaluation-T, as well as the total scores, were significantly lower in the patient group than in the control group (all p<0.05). In the patient group, the scores for questions 1-6 of the Rhinoplasty Outcomes Evaluation-T, as well as the total scores, were higher postoperatively than preoperatively (all p<0.05). The scores for each Rhinoplasty Outcomes Evaluation-T question, as well as the total scores, did not differ significantly with respect to test-retest reproducibility (all p>0.05). The internal consistency of the Rhinoplasty Outcomes Evaluation-T was high, as evidenced by Cronbach’s α values of 0.887 preoperatively and 0.798 postoperatively.Conclusion:The Rhinoplasty Outcomes Evaluation-T constitutes a validated instrument with which to measure rhinoplasty outcomes among Turkish patients.

The Turkish Version of the Rhinoplasty Outcomes Evaluation Questionnaire: Validation and Clinical Application

The Turkish Version of the Rhinoplasty Outcomes Evaluation Questionnaire: Validation and Clinical Application

The Use of Bone Dust to Correct the Open Roof Deformity in Rhinoplasty

Hump removal frequently results in an open roof during rhinoplasty, which is conventionally closed with lateral osteotomies. However, if the patient has a narrow bony vault, lateral osteotomies are problematic. In this article, the author presents a new and practical approach to fix the open roof deformity. A total of 240 patients (female, n = 187; male, n = 53) were enrolled and operated on with the presented technique. This approach has four steps, as follows: complete submembranous dissection, preparation of spreader flaps, harvesting of bone dust from the bony hump, and placement of the bone dust. The patient's nasal dorsum was evaluated by ultrasonography. During the follow-up period, all patients were photographed postoperatively from standard views using a digital camera. Photographs were inspected by two independent plastic surgeons. A palpation test for the nasal dorsum was conducted by a senior surgeon to identify any irregularities. A rhinoplasty outcomes evaluation questionnaire was administered to all patients at a 1-year follow-up visit. Functional improvement was assessed with self-evaluation of nasal patency. The chi-square test was used for statistical analysis. Of the 240 patients, 182 completed the 1-year follow-up period and rhinoplasty outcomes evaluation questionnaire. Thirty-seven patients were evaluated by ultrasonography at 1 year postoperatively. During the follow-up period, no resorption or displacement was detected. High patient satisfaction was achieved, and no complications were encountered. The presented four-step surgical concept was useful for rhinoplasty surgeons to successfully manage open roof deformity in selected patients.

Development and Validation of a Brief Four-Component Questionnaire to Identify Patient's Motivation to Undergo Functional Rhinoplasty

Outcome of functional rhinoplasty depends on different domains such as functional and aesthetic improvement. The aim of this study was to develop a brief and comprehensible questionnaire to identify patient motivation to undergo rhinoplasty and to measure the outcome of an intervention within a short time during outpatient consultation. Patients undergoing rhinoplasty were asked to complete the Rhinoplasty Outcome Evaluation (ROE) questionnaire, the Nasal Obstruction Symptom Evaluation (NOSE) scale, and the Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty (OAR) preoperatively, as well as one, three, and twelve months postoperatively. Patient satisfaction after surgery was assessed at postoperative consultations using a five-point Likert scale. Principle component analysis was performed to reveal the main domains, which were detected by the different questionnaires. Items with the strongest loading on a factor were identified by correlation matrix. Influence of the nasal appearance on the quality of life, troubles with nasal breathing, subjective perception of nasal appearance, and the wish for modification or alteration were found to be the four important domains of the questionnaires. The questions with the strongest loading on these domains were compiled and the four-component questionnaire (4CQ) was developed. The 4CQ is a very effective instrument to obtain a comprehensive impression of the varied determinants representing the major motifs to undergo functional rhinoplasty within a short time. The preoperative assessment of the 4CQ allows an estimation concerning the expected outcome.

Evaluation of postoperative patient satisfaction after covering the nasal dorsum with upper lateral cartilage: “upper lateral closing”

IntroductionFollowing nasal hump removal during septorhinoplasty, the middle vault should be reconstructed to avoid functional and esthetic problems. Middle vault reconstruction, however, may result in widening of the middle vault and may need a camouflage graft to cover dorsal irregularities. ObjectiveTo present the results of reconstructing the middle vault with a technique that covers the nasal dorsum with upper lateral cartilage, from the viewpoint of patient satisfaction. MethodsRetrospective study of patients who underwent septorhinoplasty that included nasal dorsum closure with upper lateral cartilage from December 1, 2014 to January 31, 2016. Those with postoperative follow-up of less than 3 months were excluded. The final study group included 39 patients. The same surgeon performed all septorhinoplasties. The dorsum was closed using an “upper lateral closing” technique that approximated upper lateral cartilages to each other over the septum. Postoperative patient satisfaction was determined using a visual analog scale and the rhinoplasty outcomes evaluation questionnaire. The questionnaire evaluates patient esthetic and functional satisfaction with the operated nose. High scores indicate improved esthetic results. ResultsNo dorsal irregularities were seen at postoperative follow-up evaluation of the patients. For esthetic nasal appearance, the median visual analogue scale scores was 86%, and the mean for the questionnaire was 77.03%. ConclusionThe natural dome-shaped anatomy of the nasal dorsum was achieved by approximating the upper lateral cartilages to each other. Closing the dorsum with this technique also covers any dorsal irregularities and results in a smooth dorsum. Patients expressed satisfaction with the esthetic and functional aspects of the smooth, attractive nasal dorsum.

An Alternative Rhinoplasty Technique: Rotational Spreader Flap ("Rabbit Flap").

In modern rhinoplasty, septal cartilage is the most commonly used graft material. It is a big challenge if septal cartilage is insufficient. We present an alternative technique named the "rabbit flap," created from the cephalic portion of the lower lateral cartilage to show its effectiveness on nasolabial angle, nasal axis deviation, and nasal dorsal line. An alternative flap, called a "rabbit flap," is constituted from the cephalic portion of the lower lateral cartilage (LLC). The key for this flap's success is in not cutting the connection between the lateral and medial crus of the alar cartilage. The flap is rotated and placed between the upper lateral cartilage and the septum to ensure a spreader graft effect; it can also be moved forward and backward to adjust the nasal tip rotation. Patients whose minimum width of LLC was 12mm were included in this study. We subjectively evaluated the results of this technique for 24 patients who completed the rhinoplasty outcomes evaluation (ROE) questionnaire and objectively by measuring the nasal axis and nasolabial angles in the preoperative and postoperative first-year periods. There were significant improvements in ROE, nasal axis deviation, and nasolabial angle scores when preoperative and postoperative first-year controls were compared (p<0.001). We also observed no complications. With this technique, we can correct both a nasal tip rotation and a mild nasal axis deviation. Moreover, we can achieve a proper nasal dorsal line and prevent an inverted V deformity. By expanding the internal nasal valve, a functionally effective surgery can be performed. However, the LLC must be strong enough to avoid alar collapse. In light of our results, we believe that the technique we call the "rabbit flap" can be used as an alternative rhinoplasty technique. 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 .

Factors that contribute to disagreement in satisfaction between surgeons and patients after corrective septorhinoplasty.

Corrective septorhinoplasty is one of the most common facial plastic surgeries. However, surgeons and patients sometimes disagree about postoperative-outcome satisfaction after corrective septorhinoplasty. We investigated the factors that influenced the disagreement in satisfaction between surgeons and patients after corrective septorhinoplasty. Surgeon satisfaction was assessed by other plastic surgeons by comparing patient photographs taken at the preoperative and 12-month postoperative periods. Patient satisfaction was assessed by the Rhinoplasty Outcome Evaluation Questionnaire (ROEQ) before surgery and 12 months after surgery. The dissatisfied group was defined as showing a negative change or no change in the ROEQ quartile between baseline and 12 months after surgery. A total of 70 patients were included. No significant differences were observed between the satisfied and dissatisfied groups in sex, marital status, depression history, and major anesthetic problems. However, the dissatisfied group was significantly younger, more likely to be employed, and better educated than the satisfied group. In addition, a multivariate logistic regression analysis indicated that being highly educated was a predictor of disagreement in satisfaction between surgeons and patients. Our findings indicated that highly educated patients who underwent corrective septorhinoplasty required more detailed preoperative guidance, including more complete information on the limitations of the surgery.

Assessment of Aesthetic Results of 100 Patients Who Underwent Rhinoplasty-Rhinoplasty Outcome Evaluation.

Background:To assess the long-term aesthetic results of rhinoplasty and predict the final outcome.Methods:The sample was composed of 100 patients (34 men and 66 women) between 23 and 57 years old (mean, 34.8) operated on exclusively for aesthetic reasons. The time elapsed from the operation ranged from 3 to 13 years with a mean of 6.8 years. The study used Rhinoplasty Outcome Evaluation questionnaire, a simple, reliable, validated, and widely used inventory.Results:The vast majority of patients (93%) were satisfied postoperatively with scores > 50% (67 patients had scores > 80%). Only 7 patients had scores less than 50%. The mean score was 82.4 ± 1.7% with a median of 87%. In addition, it seems that the results of the operation remain high through time with a small decline along age groups and years elapsed. Women were found more satisfied than men (P = 0.03).Conclusions:The study concludes that the results of aesthetic rhinoplasty, if performed by skilled and experienced surgeons, are very satisfying and stable throughout time.

Prospective Patient-Related Outcome Evaluation of Secondary Cleft Rhinoplasty Using a Validated Questionnaire.

To evaluate patient satisfaction and quality of life following secondary cleft rhinoplasty. Prospective consecutive patient, single unit, single surgeon study. Spires Cleft Centre, Salisbury, Wilshire, United Kingdom, and private practice. 56 (27 secondary cleft rhinoplasty) patients completed evaluation forms preoperatively and 3 to 6 months postoperatively. Subjective assessment was performed using a validated Rhinoplasty Outcomes Evaluation (ROE) questionnaire. This instrument comprises six questions that capture three quality-of-life domains: physical, mental/emotional, and social. Rhinoplasty outcomes evaluation scores were calculated (range = 0 to 100) to indication satisfaction with rhinoplasty outcomes. Average age was 28 years (range = 18 to 59 years). There was a significant subjective improvement in the total ROE evaluation scores from 28 ± 10 to 80 ± 11 (P < .01) in secondary cleft rhinoplasty. Similar results were achieved in noncleft rhinoplasty 34 ± 9 to 84 ± 9 (P < .01). Specific scores for nasal aesthetic appearance improved from 0.3 ± 0.2 to 3.2 ± 0.3 (P < .01) in secondary cleft rhinoplasty. No significant change was seen in breathing capacity in secondary cleft rhinoplasty (from 2.7 ± 0.3 to 3.2 ± 0.2; P = .29). All patients said they would undergo the procedure again. Our results demonstrate high patient satisfaction after cleft rhinoplasty with particular regard to cosmetic appearance. These results are similar to those for noncleft rhinoplasty. We would recommend the use of this simple and quick validated outcome tool with all rhinoplasty patients.