title: Functional and aesthetic concerns of patients seeking revision rhinoplasty.
abstract: OBJECTIVE
  To assess the subjective aesthetic and functional concerns of patients seeking revision rhinoplasty and to compare them with objective deformities found on evaluation by the surgeon.
  
  
  METHODS
  This prospective study used a questionnaire to systematically target the aesthetic and functional concerns of 104 consecutive patients seeking revision rhinoplasty. Analysis of the subjective data revealed the frequency of each concern, which was then compared with objective deformities found on evaluation by the surgeon.
  
  
  RESULTS
  The most common patient and surgeon aesthetic concerns were (1) tip asymmetry, (2) crooked middle third of the nose, and (3) upper third irregularity. A mean of 79% of patient concerns were also reported by the surgeon. Of the 64 patients describing subjective nasal obstruction, 60 (94%) had objective physical findings related to obstruction. The 3 most troublesome patient concerns were (1) tip asymmetry, (2) difficulty breathing or nasal blockage, and (3) crooked middle third of the nose.
  
  
  CONCLUSIONS
  Tip asymmetry was the most common deformity noted. Symptomatic nasal obstruction was the second most frequent reason for seeking revision rhinoplasty. Differences in patient and surgeon findings were largely due to differences in assessment skills and should be addressed by thorough explanation of nasal aesthetics.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Columbia College, New York, NY 10065, USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Yu
authors.forename: Alyn
authors.initials: A
authors.lastname: Kim
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Pearlman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D015508:Nasal Obstruction / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery*; D009666:Nose / Q000002:abnormalities*; D009667:Nose Deformities, Acquired / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery*; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011183:Postoperative Complications / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery*; D011446:Prospective Studies; D012086:Reoperation / Q000523:psychology; D012225:Rhinoplasty / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult