Secondary Logo

Journal Logo


The Public Face of Rhinoplasty

Impact on Perceived Attractiveness and Personality

Lu, Stephen M., M.D., M.Div.; Tanna, Neil, M.D., M.B.A.

Plastic and Reconstructive Surgery: May 2019 - Volume 143 - Issue 5 - p 1124e–1125e
doi: 10.1097/PRS.0000000000005544

Division of Plastic and Reconstructive Surgery, Hofstra Northwell School of Medicine, Hempstead, N.Y.

Correspondence to Dr. Tanna, 600 Northern Blvd., Suite 310, Great Neck, N.Y. 11021,, Instagram: @drneiltanna, Twitter: @drneiltanna

Back to Top | Article Outline


We greatly appreciate the response from Drs. Barone, Cogliandro, and Persichetti regarding our work on the impact of rhinoplasty on how patients are perceived.1 Aesthetic “standards” can indeed fall into the trap of complete subjectivity or a false confidence in objectivity. We applaud the effort to develop a novel concept, so-called Appearance Pain, and the effort to capture the multidimensional aspects of appearance and perception, a subject of great interest.2 We recognize that our study utilized subjective measures (evaluator’s assessments) across a broad base of people toward building a consensus judgment on a patient’s postoperative appearance compared to her preoperative appearance. Large numbers and data analysis could indeed lead to tenuous claims of wider objectivity, which could potentially establish unreasonable or false expectations in patients. Our study should not be misinterpreted or misapplied in a way that suggests guaranteeing patients a specific relational, psychological, or social outcome.

Aesthetic judgments and decisions have escaped objectivity for millennia; the modern intersection of aesthetics and substantial surgical intervention calls for high standards on the part of the surgeon to counsel, screen, and prepare patients for the proposed procedure and its sequelae. We look forward to further clarification of App-Pain and its implementation in clinical practice.

Back to Top | Article Outline


Neither of the authors has a financial interest to declare in relation to the content of this communication.

Stephen M. Lu, M.D., M.Div.

Neil Tanna, M.D., M.B.A.

Division of Plastic and Reconstructive Surgery

Hofstra Northwell School of Medicine

Hempstead, N.Y.

Back to Top | Article Outline


1. Lu SM, Hsu DT, Perry AD, et al. The public face of rhinoplasty: Impact on perceived attractiveness and personality. Plast Reconstr Surg. 2018;142:881–887.
2. Lu SM, Bartlett SP. On facial asymmetry and self-perception. Plast Reconstr Surg. 2014;133:873e–881e.
Back to Top | Article Outline


Letters to the Editor, discussing material recently published in the Journal, are welcome. They will have the best chance of acceptance if they are received within 8 weeks of an article’s publication. Letters to the Editor may be published with a response from the authors of the article being discussed. Discussions beyond the initial letter and response will not be published. Letters submitted pertaining to published Discussions of articles will not be printed. Letters to the Editor are not usually peer reviewed, but the Journal may invite replies from the authors of the original publication. All Letters are published at the discretion of the Editor.

Letters submitted should pose a specific question that clarifies a point that either was not made in the article or was unclear, and therefore a response from the corresponding author of the article is requested.

Authors will be listed in the order in which they appear in the submission. Letters should be submitted electronically via PRS’ enkwell, at

We reserve the right to edit Letters to meet requirements of space and format. Any financial interests relevant to the content of the correspondence must be disclosed. Submission of a Letter constitutes permission for the American Society of Plastic Surgeons and its licensees and asignees to publish it in the Journal and in any other form or medium.

The views, opinions, and conclusions expressed in the Letters to the Editor represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the Journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such correspondence.

The Journal requests that individuals submit no more than five (5) letters to Plastic and Reconstructive Surgery in a calendar year.

©2019American Society of Plastic Surgeons