Invited Discussion on "Awareness of Facial Asymmetry and Its Impact on Postoperative Satisfaction of Rhinoplasty Patient"

Lisiecki JL, Gilman RH.

What this paper says

An invited commentary on a study of facial asymmetry and rhinoplasty satisfaction, noting that the study did not define the asymmetry it measured or check whether the surgical results were symmetric.

Overview

This is a discussion piece written to accompany another paper, not original research. The commentators address a study that used validated patient reported outcome questionnaires to test whether facial asymmetry affects satisfaction after rhinoplasty. They comment on its methods and add suggestions on counselling patients.

Sections of note

Invited discussion; the journal assigns level of evidence V, the lowest tier.
No patients, measurements, outcomes or follow up of its own are reported.
The commentators note the original study translated a recognized clinical factor into data using validated patient reported outcome tools.
They state the study could be improved by better defining the asymmetry the study patients had.
They state it could also be improved by investigating the symmetry of the surgical result itself.
They offer suggestions on how to counsel patients about facial asymmetry and its effect on a rhinoplasty result.

What it means for a patient

This piece contains no findings a patient can act on; it evaluates another study.
The criticism is relevant: the original study did not check whether the noses were actually made straight.
A face that is asymmetric can leave a straightened nose still looking off centre, which is the point both papers address.

Why this paper matters

Commentaries mark where the field disagrees about method. Here the disagreement is about how facial asymmetry should be defined and measured before it is linked to satisfaction. Until asymmetry is measured consistently, the relationship reported in the original study stays uncertain.

Terms

Invited discussion: a commentary a journal commissions to accompany a published article.
Facial asymmetry: the two sides of the face differing in shape or position.
Patient reported outcome tool: a questionnaire completed by the patient rather than the surgeon.
Level of evidence V: expert opinion, the weakest category of clinical evidence.

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

From the abstract

“In this invited discussion, we applaud the authors of "Awareness of Facial Asymmetry and Its Impact on Postoperative Satisfaction of Rhinoplasty Patient" for their efforts to reinforce the importance of recognizing facial asymmetry preoperatively in the rhinoplasty patient. They can be applauded for translating this…”

Excerpt; the full abstract is on PubMed.