Evidence-based medicine: Rhinoplasty

Overview

This is a teaching article written for the American Board of Plastic Surgery Maintenance of Certification programme rather than a study of patients. It walks a surgeon through consultation, planning and aftercare, and pulls current published data into each step. No patient series, sample size or outcome rates are reported in the abstract.

Sections of note

• Stated learning goals cover the aesthetic, functional and emotional assessment of a person presenting for rhinoplasty.
• Covers the range of surgical options for meeting the goals agreed at consultation.
• Covers nonsurgical options for nasal deformity and states their limitations.
• Covers the benefits and risks of antibiotics given around the time of surgery.
• Covers common expected events after surgery and how to build a care plan from best available evidence.
• Written to accompany practice-based assessment, so it summarises existing literature rather than generating new data.

What it means for a patient

• The consultation is meant to assess three things together: appearance, breathing, and the patient's emotional expectations.
• Not every nasal concern needs an operation. Nonsurgical treatments exist but have limits the article sets out.
• Antibiotics around rhinoplasty are treated as an open question, weighed by benefit against risk rather than given automatically.
• This is a review of other people's evidence with no numbers of its own, so it cannot say how often any specific outcome occurs.

Why this paper matters

Board certification reviews shape what a generation of plastic surgeons treats as standard practice, so the content here reflects the mainstream position in 2014. It signals that emotional evaluation sits alongside anatomy in the standard workup. What it cannot settle is the quality of the underlying evidence, much of which in rhinoplasty comes from single-surgeon case series.

Terms

• Evidence-based medicine: making clinical decisions from published research rather than habit alone.
• Maintenance of Certification: periodic assessment surgeons complete to keep board certification.
• Perioperative: the period immediately before, during and after an operation.
• Nasal deformity: any shape or structural problem of the nose, present from birth or acquired later.
• Postoperative sequelae: expected after-effects of surgery, distinct from complications.