Assessing Demographic Differences in Patient-Perceived Improvement in Facial Appearance and Quality of Life Following Rhinoplasty

Schwitzer JA, Albino FP, Mathis RK, Scott AM, Gamble L, Baker SB.

PubMed 26063837 Publisher (DOI)Free full text (PMC)

What this paper says

Among 59 rhinoplasty patients completing the FACE-Q questionnaire, women, Caucasian patients, patients under 35 and patients earning 100,000 dollars or more reported larger gains in appearance satisfaction and quality of life.

Overview

Rhinoplasty patients are a more varied group than they once were, and the authors asked whether who a patient is predicts how much benefit they report. Patients completed four FACE-Q scales before and after surgery, and the change in scores was compared across sex, ethnicity, age and income.

Sections of note

59 patients completed the FACE-Q scales.
Scales used were satisfaction with facial appearance, satisfaction with nose, social function and psychological wellbeing. Higher scores mean greater satisfaction or better quality of life.
Women improved significantly in both appearance satisfaction and quality of life. Men improved significantly only in appearance satisfaction.
Caucasian patients improved significantly in both. Non-Caucasian patients did not show significant improvement.
Patients under 35 were more likely than those over 35 to gain in both appearance satisfaction and quality of life.
Patients with income of 100,000 dollars or more were more likely to gain significantly in both than patients earning less.

What it means for a patient

Reported benefit from rhinoplasty was not uniform across different groups of patients in this sample.
The study measures what patients said on a questionnaire, not surgical quality, so it does not show that the operations differed.
Groups showing no significant change may be small within a 59-patient sample, which makes a real effect harder to detect.
Single centre, no comparison group, no stated follow-up interval, and the abstract gives no group sizes or effect sizes.

Why this paper matters

Consultation involves setting expectations, and evidence on which patients report the least benefit is directly relevant to that conversation. The finding that non-Caucasian patients showed no significant gain raises a question about whether standard aesthetic goals and questionnaires fit all patients equally. With 59 patients the finding is a signal to investigate, not a conclusion.

Terms

Demographic: a characteristic such as age, sex, ethnicity or income used to describe a population.
FACE-Q: a validated questionnaire measuring appearance satisfaction and quality of life after facial procedures.
Patient-reported outcome: a result measured by asking the patient rather than by examination.
Statistically significant: unlikely to be explained by chance alone.
Predictor: a variable associated with a difference in outcome.
Quality of life: a measure of how a condition or treatment affects daily functioning and wellbeing.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

Abstract

Background: As rhinoplasty patient demographics evolve, surgeons must consider the impact of demographics on patient satisfaction.

Objectives: The objective of this study was to identify independent demographic predictors of differences in satisfaction with appearance and quality of life following rhinoplasty utilizing the FACE-Q patient-reported outcome instrument.

Methods: Patients presenting for rhinoplasty completed the following FACE-Q scales: Satisfaction with Facial Appearance, Satisfaction with Nose, Social Function, and Psychological Well-being. Higher FACE-Q scores indicate greater satisfaction with appearance or superior quality of life. Pre- and post-treatment scores were compared in the context of patient demographics.

Results: The scales were completed by 59 patients. Women demonstrated statistically significant improvements in Satisfaction with Facial Appearance and quality of life while men only experienced significant improvement in Satisfaction with Facial appearance. Caucasians demonstrated statistically significant improvement in Satisfaction with Facial Appearance and quality of life while non-Caucasians did not. Patients younger than 35 years old were more likely to experience enhanced Satisfaction with Facial Appearance and quality of life compared with patients older than 35 years old. Patients with income ≥$100,000 were more likely to experience significant increases in Satisfaction with Facial Appearance and quality of life than patients with incomes <$100,000.

Conclusions: In an objective study using a validated patient-reported outcome instrument, the authors were able to quantify differences in the clinically meaningful change in perception of appearance and quality of life that rhinoplasty patients gain based on demographic variables. The authors also demonstrated that these variables are potential predictors of differences in satisfaction.

Abstract as indexed by PubMed; the article is open access (PubMed Central).