Influence of the Subjective Body Image on the Outcome of Functional Rhinoplasty

Overview

Functional rhinoplasty aims at breathing, yet appearance often has to be changed to achieve it. This study asked whether how a patient perceives their nose's appearance influences the outcome, using a validated appearance questionnaire before surgery and at three points afterward.

Sections of note

• 87 patients undergoing functional rhinoplasty: 42 male, 45 female, median age 25 years.
• Patients completed the German version of the Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty preoperatively and at 1, 3 and 12 months.
• Satisfaction was measured on a five-point Likert scale at 1, 3 and 12 months.
• At the preoperative consultation, women had lower visual analogue scale scores than men, 2.71 SD 1.96 versus 4.03 SD 2.02, p 0.006, and higher D-OAR scores, 16.07 SD 5.62 versus 13.34 SD 5.00, p 0.020.
• After surgery, visual analogue scores rose and D-OAR scores fell regardless of gender.
• Satisfaction correlated significantly with the D-OAR score at every assessment point.
• No significant correlation was found between postoperative satisfaction and the initial preoperative D-OAR score. Level of evidence IV.

What it means for a patient

• How you feel about your nose's appearance tracks with satisfaction at any given moment, but how you felt before surgery did not predict how satisfied you would be afterward.
• Women in this group rated their noses less favorably than men before surgery, and both improved after.
• Appearance mattered to satisfaction even though the operation was undertaken for breathing.
• Limits: 87 patients, one center, level IV evidence, and 12 months of follow-up.

Why this paper matters

Functional and cosmetic goals are often treated as separable, and this shows appearance perception influences satisfaction even in breathing-led surgery. The negative predictive finding is equally useful: a poor preoperative self-rating is not a reason to expect dissatisfaction. Whether these correlations hold in larger and different populations is untested.

Terms

• Functional rhinoplasty: Nasal surgery aimed at breathing rather than appearance.
• Body image: How a person perceives and feels about their own body.
• Utrecht Questionnaire (D-OAR): A validated instrument scoring outcome in aesthetic rhinoplasty; lower is better.
• Visual analogue scale: A line on which a patient marks a rating.
• Correlation: A statistical relationship in which two measures move together.