Patient Satisfaction After Rhinoplasty: A Social Media Analysis

Overview

Rhinoplasty has a lower satisfaction rate than other cosmetic procedures. Previous attempts to understand why relied on surgeon-run surveys, expert ratings and measurements. The authors instead read every primary rhinoplasty review on RealSelf, a consumer website where patients post about cosmetic surgery, and recorded gender, whether the patient was satisfied, and the stated reason.

Sections of note

• 2,326 reviews of primary rhinoplasty, 2,032 from women and 294 from men.
• Overall satisfaction rate 83.6 percent.
• Women were satisfied significantly more often than men, 87.6 percent against 56.1 percent, p less than 0.001.
• Men's most common complaints were a remaining bump on the bridge, a tip not rotated up enough, and a nose that was too small.
• Women's most common complaints were a remaining bump on the bridge, an under-rotated tip, and a bulbous tip.
• Dissatisfied women were significantly more likely than dissatisfied men to name the specific physical or functional reason. Data were compared using chi-squared analysis.

What it means for a patient

• A residual bump on the bridge and a tip left pointing too far down were the two leading complaints in both sexes.
• Men reported dissatisfaction much more often, and were vaguer about why, which the authors flag as relevant to consultation.
• The concern that the nose was made too small appeared only among men, which bears on how much reduction is appropriate.
• Reviews are self-selected and unverified, with no confirmation of what surgery was performed, no follow-up interval and no way to check the account. This is opinion data, not clinical outcome data.

Why this paper matters

It reads what patients say when no surgeon is asking, which surgeon-run surveys cannot capture. The gap between male and female satisfaction is large enough to affect how men are counselled before surgery. Whether the difference reflects surgical results, expectations, or who chooses to post a review is unresolved.

Terms

• Primary rhinoplasty: a first operation on a nose not previously operated on.
• Dorsal hump: a bump on the bridge of the nose.
• Under-rotated tip: a nasal tip left pointing further down than intended.
• Bulbous tip: a rounded, wide nasal tip lacking definition.
• Chi-squared analysis: a statistical test comparing proportions between groups.