title: Secondary cleft rhinoplasty rejuvenates the nose: a suggestion from a panel survey.
abstract: BACKGROUND
  Cleft-lip nasal deformity (CLND) affects the overall facial appearance and attractiveness. The CLND nose shares some features in part with the aging nose.
  
  
  OBJECTIVE
  This questionnaire survey examined: 1) the panel perceptions of the role of secondary cleft rhinoplasty in nasal rejuvenation; and 2) the influence of a medical background in cleft care, age and gender of the panel members on the estimated age of the CLND nose.
  
  
  METHODS
  Using a cross-sectional study design, we enrolled a random sample of adult laypersons and health care providers. The predictor variables were secondary cleft rhinoplasty (before/after) and a medical background in cleft care (yes/no). The outcome variable was the estimated age of nose in photographs derived from 8 German nonsyndromic CLND patients. Other study variables included age, gender, and career of the assessors. Appropriate descriptive and univariate statistics were computed, and a P value of <.05 was considered to be statistically significant.
  
  
  RESULTS
  The sample consisted of 507 lay volunteers and 51 medical experts (407 [72.9%] were female; mean age ± SD = 24.9 ± 8.2 y). The estimated age of the CLND noses was higher than their real age. The rhinoplasty decreased the estimated age to a statistically significant degree (P < .0001). A medical background, age, and gender of the participants were not individually associated with their votes (P > .05).
  
  
  CONCLUSIONS
  The results of this study suggest that CLND noses lack youthful appearance. Secondary cleft rhinoplasty rejuvenates the nose and makes it come close to the actual age of the patients.
authors.affiliation: Department of Oral, Craniomaxillofacial, and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Niels Christian
authors.initials: NC
authors.lastname: Pausch
authors.forename: Poramate
authors.initials: P
authors.lastname: Pitak-Arnnop
authors.forename: Philipp Yorck
authors.initials: PY
authors.lastname: Herzberg
authors.forename: Kittipong
authors.initials: K
authors.lastname: Dhanuthai
authors.forename: Alexander
authors.initials: A
authors.lastname: Hemprich
mesh_terms: D000293:Adolescent; D000375:Aging; D001504:Beauty; D002971:Cleft Lip / Q000150:complications / Q000601:surgery*; D003258:Consumer Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000002:abnormalities / Q000601:surgery*; D015588:Observer Variation; D012060:Rejuvenation; D012086:Reoperation; D012225:Rhinoplasty / Q000379:methods*; D012938:Social Perception; D016896:Treatment Outcome; D055815:Young Adult