Rhinoplasty Results Are Influenced by Non-nasal Features

Overview

Rhinoplasty results are judged from photographs at meetings, in journals, and online. The authors tested whether features other than the nose bias that judgment. They built composite photographs by transferring one patient's eyes, eyebrows and lips onto another patient's face, then had the images rated.

Sections of note

• Pairs of photographs of aesthetic rhinoplasty patients were matched by sex, age, and skin tone.
• Eyes and eyebrows and lips were transferred from a donor patient's photograph onto the original patient's photograph to create composites.
• 16 sets of photographs were rated: 8 originals and 8 composites.
• Plastic surgeons rated the rhinoplasty result objectively; non-plastic surgeons rated overall attractiveness.
• Postoperative photographs judged more attractive were associated with higher ratings of rhinoplasty improvement.
• The authors conclude the objective nasal result may be influenced by non-nasal aesthetic factors, and recommend greater emphasis on neutralizing those factors in before and after photographs.
• The abstract gives no rater counts, effect sizes, or statistical values.

What it means for a patient

• Before and after photographs can look more convincing because of the eyes and lips rather than the nose.
• Trained surgeons were affected by this too, not only lay viewers.
• When comparing surgeons' galleries, features outside the nose influence the impression a result makes.
• Limits: 16 photograph sets, no reported number of raters, and no statistical detail in the abstract.

Why this paper matters

Rhinoplasty outcomes are largely assessed by looking at pictures, and this shows that assessment is not isolated to the nose. It argues for standardizing photographs before publication or comparison. The abstract does not quantify how large the bias is.

Terms

• Composite photograph: An image built by combining features from two different faces.
• Objective rating: A judgment made against defined criteria rather than overall impression.
• Subjective aesthetics: Judgments of attractiveness that vary between observers.
• Non-nasal features: Parts of the face other than the nose, here the eyes, eyebrows, and lips.
• Skin tone matching: Pairing photographs of similar complexion so it does not confound comparison.