Aesthetic outcome after nasal reconstruction: patient versus panel perception.
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.


CONCLUSIONS
Patient subjective aesthetic outcome was significantly higher than that of a professional panel. Severity of nasal deformity was not an indicator for patient satisfaction.
Department of Plastic and Reconstructive Surgery, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Sanne E
SE
Moolenburgh
Marc A M
MA
Mureau
Stefan O P
SO
Hofer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009667:Nose Deformities, Acquired / Q000473:pathology / Q000601:surgery; D009669:Nose Neoplasms / Q000601:surgery; D017060:Patient Satisfaction; D015203:Reproducibility of Results; D012225:Rhinoplasty / Q000379:methods* / Q000523:psychology; D016896:Treatment Outcome