Layperson Perceptions of Surgical Versus Non-Surgical Rhinoplasty Outcomes
Jonlin Chen, BS, Mya Abousy, BA, Hillary Jenny, MD, MPH, Jordan Steinberg, MD, PhD, Richard Redett, MD, Robin Yang, DDS, MD.
Johns Hopkins School of Medicine, Baltimore, MD, USA.
Background: As pressure to decrease patient recovery time following aesthetic procedures has increased, nonsurgical techniques have emerged to augment or rival conventional surgical techniques. “Liquid rhinoplasty” refers to using soft-tissue filler injections to reshape the nose for improved facial appearance and function. Despite growing popularity of non-surgical rhinoplasties, little is known on how the public perceives invasive versus non-invasive treatment outcomes. The aim of this study was to determine differences in observer ratings of post-procedural attractiveness, personality traits, and success for non-surgical and surgical rhinoplasty approaches.
Methods: A Qualtrics survey was distributed via Amazon’s Mechanical Turk to casual observers in February 2020. The survey presented a series of randomized sets of before and after publicly available images of four surgical rhinoplasty cases, four non-surgical rhinoplasty cases, and three age- and gender-matched control patients who did not receive nasal procedures. Participants rated changes in attractiveness, personality traits (kindness, self-esteem, femininity), financial wealthiness, and professional and social success between the before and after images. Participants were also informed about each treatment and asked which treatment they would prefer. Multivariate regression determined differences in perceived outcomes between surgical and nonsurgical cases.
Results: A total of 569 survey participants (mean age 40 years, 60.3% female) successfully completed the study. Respondents preferred surgical over non-surgical rhinoplasty when presented with procedural pros and cons (55% surgical versus 45% nonsurgical). After accounting for respondent age and gender, respondents rated significantly higher improvements in attractiveness (coefficient -12.52; 95%CI, -13.5 to -11.51), approachability (coefficient -7.62; 95%CI, -8.52 to -6.74), femininity (coefficient -10.31; 95%CI, -11.33 to -9.29), financial wealthiness (coefficient -3.33; 95%CI, -4.05 to -2.61), kindness (coefficient -5.37; 95%CI, -6.18 to -4.57), professional success (coefficient -4.98; 95%CI, -5.75 to -4.22), social success (coefficient -7.78; 95%CI, -8.64 to -6.91), and self-esteem (coefficient -11.20; 95%CI, -12.18 to -10.22) following surgical compared to non-surgical rhinoplasty.
Conclusion: As determined by casual observers, surgical rhinoplasty was associated with more positive changes in attractiveness, personality traits, and social success than non-surgical rhinoplasty. These findings may inform patient-physician discussions regarding rhinoplasty techniques by helping set realistic patient expectations of perceived aesthetic outcomes.
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