Cosmetics and function: Quality-of-Life changes after rhinoplasty surgery

Objectives/Hypothesis: To measure patient quality of life after rhinoplasty in regard to nose appearance and function with use of the modern structural and functional surgical approach. Study Design: Retrospective chart review at a tertiary referral center. Methods: We performed a retrospective chart review with prospective follow-up. All patients with rhinoplasty in the past 5 years by the senior author were identified. Patients who simultaneously underwent additional nasal surgery were excluded. McNemar test was used to compare preoperative and postoperative clinical evaluations. Paired t tests were used to evaluate questionnaire scores preoperatively and postoperatively from the nasal obstruction symptom evaluation and rhinoplasty outcome evaluation. Two-group t tests were used for comparative analysis after dividing patients into two groups on the basis of dorsal reduction, osteotomies, open versus closed approach, and revisions. Results: Among 370 patients invited, 126 participated and 113 provided completed questionnaires. Analysis of preoperative and postoperative nasal-obstruction symptom evaluation scores showed a median difference of -40 (quartiles, -25 and -60), indicating improvement (P <.01). Preoperative and postoperative rhinoplasty outcome evaluation scores showed a median difference of 29.2 (quartiles, 12 and 50), also indicating improvement (P <.01). Difference in improvement in scores was not significant when groups were divided on the basis of dorsal reduction, osteotomies, and open versus closed approach or whether rhinoplasty was primary versus revision. Conclusions: Modern rhinoplasty techniques that depend on a strong structural framework of grafts compared with the traditional reduction rhinoplasty techniques significantly improve patient quality of life in regard to nose function and appearance.