Crowdsourced Assessment of Aesthetic Outcomes of Dorsal Preservation Rhinoplasty

Overview

Aesthetic judgment is subjective, so the UCLA authors used crowdsourcing: anonymous online workers rated before-and-after photographs on overall nasal appearance, profile, symmetry of the dorsal aesthetic lines and dorsal contour, and stated how confident they were that the person had had surgery. Improvement was scored as the pre-to-post change and compared between cohorts.

Sections of note

• Structural cohort 34 patients; preservation cohort 30.
• Improvement scores: preservation 0.300 (95% CI 0.047); structural 0.377 (95% CI 0.055).
• Detecting surgery: correlation coefficient 0.74 in the structural cohort (raters could tell) versus -0.0554 in the preservation cohort (raters could not).
• The authors also present crowdsourcing itself as an efficient, reliable rating method.

What it means for a patient

• Both approaches improved appearance to untrained eyes.
• The preservation noses looked "unoperated" to raters, which is the main aesthetic claim of the technique, supported here.
• The structural cohort's slightly higher improvement score and the preservation cohort's naturalness are different measures; the study does not say one is better overall.

Why this paper matters

It is the first crowdsourced comparison of the two techniques and offers a scalable outcome tool. Limits: retrospective, 64 patients, photographs only, lay raters, follow-up interval not stated.

Terms

• Crowdsourcing: collecting ratings from many anonymous online workers.
• Dorsal preservation: lowering the intact bridge instead of removing the hump.
• Structural rhinoplasty: removing the hump and rebuilding the middle vault with grafts.
• Dorsal aesthetic lines: the highlight lines from brow to tip on the front view.
• Correlation coefficient: a -1 to 1 measure of how well one variable tracks another.