Aesthetic outcome after nasal reconstruction: patient versus panel perception

• Published in: Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2008-12, Vol.61 (12), p.1459-1464
• Main Authors: Moolenburgh, Sanne E, Mureau, Marc A.M, Hofer, Stefan O.P
• Format: Article
• Language: English
• Subjects: Adult; Aesthetic outcome; Aged; Aged, 80 and over; Biological and medical sciences; Dermatology; Esthetics; Female; Follow-Up Studies; Humans; Male; Medical sciences; Middle Aged; Nasal reconstruction; Nose Deformities, Acquired - pathology; Nose Deformities, Acquired - surgery; Nose Neoplasms - surgery; Panel perception; Patient perception; Patient Satisfaction; Plastic Surgery; Reproducibility of Results; Rhinoplasty - methods; Rhinoplasty - psychology; Skin cancer; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Tumors of the skin and soft tissue. Premalignant lesions
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2007.09.018

Summary Background Nasal reconstruction after extensive ablative therapy poses a reconstructive challenge. The aim of this study was to assess subjective aesthetic outcome after nasal reconstruction scored by patients and a panel. In addition, inter-rater variability as well as important parameters of good aesthetic outcome were analysed. Methods A total of 39 consecutive patients treated between November 2001 and May 2005 for (sub) total nasal defects were included. All patients were photographed in a standardised setting. Subjective aesthetic outcome (eight different nasal characteristics on a five-point Likert scale) was assessed by reconstructed patients individually as well as an independent professional panel consisting of five plastic surgeons. Results Thirty-three patients (87%) participated in the follow-up study. Questionnaire results demonstrated statistically significant lower panel satisfaction scores (3.5 ± 0.9) with total nasal appearance than patients (4.2 ± 1.3; P = 0.03). There was a high agreement among panel members as judged by a low inter-rater variability. No relationship between severity of nasal defects and aesthetic outcome was found by patients or professionals. Conclusion Patient subjective aesthetic outcome was significantly higher than that of a professional panel. Severity of nasal deformity was not an indicator for patient satisfaction.