APS Aesthetic Plastic Surgery · 2026

Visual Attention in Rhinoplasty: Eye-Tracking Comparison of Patients and Physicians on Profile Images

Ugurlu BN, Aktar Ugurlu G, Simsek E.

PubMed 41413747 Publisher (DOI)Free full text (PMC)

What this paper says

Eye-tracking of 26 patients and 13 surgeons viewing 21 profile photographs showed patients stared longest at the nasal tip (25.2 versus 15.6 seconds) while surgeons looked longest at the radix (38.9 versus 24.9 seconds).

Overview

Where people look shapes what they judge. The Turkish authors recorded eye movements of rhinoplasty patients and experienced otolaryngologists viewing standardised lateral profiles, measuring first fixation, total viewing time, fixation count and revisits across ten facial regions.

Sections of note

26 patients, 13 surgeons, 21 profile images.
Both groups looked most at the nose overall.
Patients: tip viewing time 25.18 versus 15.64 seconds (P = .011); fixations 97.62 versus 63.92 (P = .021).
Surgeons: radix viewing time 38.89 versus 24.91 seconds (P = .025); fixations 144.38 versus 108.04 (P = .043).
No differences in other facial regions. Level of Evidence III.

What it means for a patient

You and your surgeon may literally be looking at different parts of the nose: you at the tip, the surgeon at the root and bridge.
Saying explicitly what bothers you, rather than assuming the surgeon sees it, matters.
Surgeons focus on the radix because it sets the whole profile; patients focus on the tip because it is what they notice in the mirror.

Why this paper matters

It gives objective evidence for a mismatch in attention that underlies many consultation misunderstandings. Limits: small groups, profile view only, single centre.

Terms

Eye-tracking: technology that records where a person's gaze falls.
Fixation: a pause of the gaze on one spot.
Radix: the root of the nose between the eyes.
Nasal tip: the lowest, most forward point of the nose.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

Abstract

Background: Visual attention influences aesthetic perception and may affect expectations and satisfaction in rhinoplasty.

Objectives: To compare how patients and rhinoplasty surgeons visually assess facial profiles using eye-tracking technology.

Methods: This cross-sectional observational study included 26 patients and 13 experienced otolaryngologists. All participants viewed 21 standardized lateral facial profile photographs. Visual attention across ten facial regions was recorded using eye-tracking technology, focusing on first fixation area, total viewing time, fixation count, and revisits.

Results: Both groups focused most on the nasal region. Patients demonstrated significantly higher visual engagement with the nasal tip, including longer viewing time (25.18 ± 10.23 s vs 15.64 ± 11.19 s; P = .011) and more fixations (97.62 ± 40.64 vs 63.92 ± 42.24; P = .021). Physicians, by contrast, focused more on the radix, with longer viewing time (38.89 ± 17.49 s vs 24.91 ± 17.64 s; P = .025) and more fixations (144.38 ± 47.59 vs 108.04 ± 52.72; P = .043). No statistically significant differences were observed in other facial regions.

Conclusion: Patients and surgeons focus on different nasal regions, and eye-tracking may help align their aesthetic expectations.

Level Of Evidence Iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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