JAMA FPS JAMA Facial Plastic Surgery · 2019

Assessment of the Influence of "Other-Race Effect" on Visual Attention and Perception of Attractiveness Before and After Rhinoplasty

Darrach H, Ishii LE, Liao D, Nellis JC, Bater K, Cobo R, Byrne PJ, Boahene KDO, Papel ID, Kontis TC, Ishii M.

PubMed 30629094 Publisher (DOI)Free full text (PMC)

What this paper says

Using eye tracking with 134 observers and ratings from another 134, white graders saw an attractiveness gain after rhinoplasty in both white and Latin American patients, while Latin American graders saw a gain only in their own race.

Overview

People recognize faces of their own race more accurately, an effect known to shape social interaction. This study tested whether it also shapes how rhinoplasty results are perceived, combining eye-tracking of where observers look with separate ratings of racial identification and attractiveness.

Sections of note

Part one: 134 participants viewed 32 paired facial images of white and Latin American patients, before or after rhinoplasty, on an eye-tracking system recording scan paths.
Part two: a separate 134 participants graded the same images for degree of racial identification and perceived attractiveness.
Eye-tracking participants: 68 (51%) women, mean age 26.4 years SD 7.7. Graders: 64 (48%) women, mean age 25.0 years SD 6.9.
Rhinoplasty did not affect racial identity scores among same-race or other-race evaluators.
Visual fixation times were significantly longer for white faces among white, Asian and African American observers, but not among Latin American observers, P .51.
White graders reported significant postoperative attractiveness gains for white patients, 8.07 points, and Latin American patients, 3.69 points.
Latin American graders saw a significant gain only in Latin American patients, 10.50 points. Neither attractiveness nor rhinoplasty status influenced fixation times.

What it means for a patient

Rhinoplasty did not change how strongly observers identified a patient's race, in either direction.
How much the result registers as an improvement depended on the observer's own background.
The authors recommend counseling patients that perceived benefit may vary by the observer group.
Limits: young observers recruited for a study, still images, and only two patient racial groups examined.

Why this paper matters

A stated concern in ethnic rhinoplasty is loss of racial identity, and this measured it directly and found none. It also shows that the social payoff of surgery is not uniform across observers. The study measures perception of strangers in a laboratory, not real social outcomes.

Terms

Other-race effect: The tendency to recognize faces of one's own race more accurately.
Eye tracking: Technology recording where and how long a person looks at an image.
Visual fixation time: How long the gaze rests on a particular area.
Racial identification score: A rating of how strongly a face reads as belonging to a given group.
Casual observer: A member of the public with no professional connection to the field.

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

Abstract

Importance: The "other-race effect" describes the phenomenon in which individuals demonstrate greatest recognition ability among faces of their own race. Thus, in our multicultural world, it follows that race influences social interactions. However, the association of race with perception of plastic surgery outcomes has not been studied.

Objective: To objectively measure how the other-race effect influences perception of white and Latin American patients undergoing rhinoplasty by using eye-tracking technology and survey methodology.

Design, Setting, And Participants: In the first part of the study, 134 participants viewed 32 paired facial images of white and Latin American patients, either prerhinoplasty or postrhinoplasty, on an eye-tracking system that recorded observer scan paths. In the second part of this study, the same patient images were individually graded by a separate group of 134 participants for degree of racial identification and perceived attractiveness.

Main Outcomes And Measures: The primary outcome was to measure the influence of patient and observer race on perception of rhinoplasty outcomes. For the eye-tracking part, planned hypothesis testing was conducted using an analysis of variance to compare patient race, rhinoplasty status, and attractiveness with respect to visual fixation time.

Results: Of the 134 eye-tracking participants, 68 (51%) were women and the mean (SD) age was 26.4 (7.7) years; of the 134 graders, 64 (48%) were women and the mean (SD) age was 25.0 (6.9) years. Rhinoplasty did not affect racial identity scores among either same-race or other-race evaluators. Visual fixation times for white faces were significantly increased compared with Latin American faces among all casual observer groups (white observers mean change, -20.14 milliseconds; 95% CI, -29.65 to -10.62 milliseconds; P < .001; Asian observers mean change, -39.04 milliseconds; 95% CI, -48.95 to -29.15 milliseconds; P < .001; and African American observers mean change, -20.73 milliseconds; 95% CI, -37.78 to -3.69 milliseconds; P < .02), with the exception of Latin American observers (mean change, -7.8 milliseconds; 95% CI, -29.15 to 14.39 milliseconds; P < .51). With respect to attractiveness, white graders reported a significant postrhinoplasty increase across both races (white patients mean change, 8.07 points; 95% CI, 5.01-11.12 points; P < .001; and Latin American patients mean change, 3.69 points; 95% CI, 0.87-6.49 points; P = .01), whereas Latin American graders only observed a significant attractiveness increase in their own race (Latin American patients mean change, 10.50 points; 95% CI, 1.70-19.32 points; P = .02). Neither perceived attractiveness nor rhinoplasty status influenced fixation times.

Conclusions And Relevance: Both patient and observer race influence visual attention and perception of attractiveness before and after rhinoplasty. These findings underscore the importance of counseling patients that the influence of rhinoplasty, as perceived by the casual observer, may vary by race or ethnicity of the observer group.

Level Of Evidence: NA.

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