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Benefits of a Short, Practical Questionnaire to Measure Subjective Perception of Nasal Appearance after Aesthetic Rhinoplasty

Lohuis, Peter J. F. M. M.D., Ph.D.; Hakim, Sara M.D.; Duivesteijn, Wouter M.Sc., Ph.D.; Knobbe, Arno Ph.D.; Tasman, Abel-Jan M.D.

Plastic and Reconstructive Surgery: December 2013 - Volume 132 - Issue 6 - p 913e–923e
doi: 10.1097/01.prs.0000434403.83692.95
Cosmetic: Outcomes Article

Background: The authors tested a short, practically designed questionnaire to assess changes in subjective perception of nasal appearance in patients before and after aesthetic rhinoplasty.

Methods: A prospective cohort study was conducted in a group of 121 patients who desired aesthetic rhinoplasty and were operated on by one surgeon. The questionnaire contained five questions (E1-E5) based on a five-point Likert scale and a visual analogue scale (range, 0 to 10). Two questions were designed as trick questions to help the surgeon screen for signs of body dysmorphic disorder.

Results: All patients rated the appearance of their nose as improved after surgery. The visual analogue scale revealed a Gaussian curve of normal distribution (range, 0.5 to 10) around a significant improvement (mean, 4.36 points, p = 0.018). Also, question E1, question E2, and the sum of questions E1 through E5 showed a statistically significant improvement after surgery (p = 1.74 × 10–36, p = 4.29 × 10–33, and p = 9.23 × 10–31, respectively). The authors found a linear relationship between preoperative score on the trick questions and postoperative increase in visual analogue scale score. Test-retest reliability could be investigated in 74 of 121 patients (61 percent) and showed a positive correlation between postoperative (1 year after surgery) and repostoperative response (2 to 4 years after surgery).

Conclusions: The authors concluded that a surgeon performing aesthetic rhinoplasty can benefit from using this questionnaire. It is simple, takes no more than 2 minutes to complete, and provides helpful subjective information regarding patients’ preoperative nasal appearance and postoperative surgical outcome.


Utrecht and Leiden, The Netherlands; and St. Gallen, Switzerland

From the Department of Otolaryngology/Head and Neck Surgery, Center for Facial Plastic Reconstructive Surgery, Diakonessen Hospital Utrecht; Leiden Institute of Advanced Computer Science, Leiden University; and the Department of Ear, Nose, and Throat, Cantonal Hospital St. Gallen.

Received for publication April 3, 2013; accepted July 9, 2013.

Disclosure: No funds were received in support of this study. No benefits in any form have been or will be received. The authors have no financial interest to declare in relation to the content of this article.

Peter J. F. M. Lohuis, M.D., Ph.D., Department of Otorhinolaryngology/Head and Neck Surgery, Diakonessen Hospital, Bosboomstraat 1, 3508 TG, Utrecht, The Netherlands,

©2013American Society of Plastic Surgeons