# Preoperative awareness of nasal and facial aesthetic deformities among rhinoplasty candidates

## TL;DR

This study found that rhinoplasty patients and surgeons often disagree on nasal and facial deformities, and preoperative counseling does not significantly change patient expectations.

## Contribution

The study highlights the need for improved educational strategies in rhinoplasty planning due to limited patient awareness of facial deformities.

## Key findings

- Patients and surgeons showed significant discrepancies in evaluating nasal deviation and extranasal regions.
- Preoperative counseling did not significantly alter patients' self-perception or aesthetic expectations.
- Patients frequently reported nasal hump and deviation as concerns, while surgeons identified additional issues like tip ptosis.

## Abstract

This study primarily aimed to evaluate the preoperative awareness of nasal and facial anatomical deformities among patients scheduled for primary rhinoplasty. The secondary objective was to assess changes in patients’ self-perception and aesthetic expectations regarding surgical outcomes following preoperative consultation with the surgeon.

In this prospective cross-sectional study, 56 adult patients seeking primary aesthetic rhinoplasty at a tertiary care center were included. Each participant completed a 10-item anatomical evaluation form. An experienced rhinoplasty surgeon independently evaluated the same parameters. Additionally, participants completed a two-item visual analogue scale (VAS) questionnaire both before and after the preoperative consultation.

Patients most frequently reported a nasal hump (91%), nasal deviation (89%), and a drooping nasal tip (77%) as their primary concerns. The surgeon most commonly identified a nasal hump (98%), tip ptosis (61%), and nasal deviation (59%). A significant discrepancy was observed between patient and surgeon evaluations of nasal deviation (p < 0.01), as well as in the recognition of extranasal aesthetic regions, particularly the cheek–midface (p = 0.04) and forehead–glabella (p < 0.01) areas. VAS scores for nasal appearance and expected surgical outcomes showed no significant change after the consultation (p = 0.184, p = 0.243).

Although there was general agreement between patients and the surgeon regarding nasal deformities, patient awareness of adjacent facial regions remained limited. Furthermore, preoperative counseling alone was insufficient to alter patients’ self-perception or aesthetic expectations, highlighting the need for enhanced educational strategies in rhinoplasty planning.