title: Current clinical practices of the Rhinoplasty Society members.
abstract: BACKGROUND
  As rhinoplasty remains among the most challenging and controversial operations in plastic surgery, we sought to elucidate present-day practice characteristics. Members of The Rhinoplasty Society were polled in preparation for the national meeting held in Boston, Mass, on May 2011. The goal was to provide information regarding surgical approaches used as well as technique and practice patterns used.
  
  
  METHODS
  Two electronic surveys were distributed to members of The Rhinoplasty Society in preparation for the annual meeting. All 76 members received the surveys as well as instructions for completion. The initial survey included 10 questions discussing the preferred approach for rhinoplasty and practice details. The second survey dealt with specific techniques used during rhinoplasty. Data were collected and reviewed.
  
  
  RESULTS
  The primary survey yielded a 61.8% response rate, whereas the secondary survey 48.7%. Of all surgeons, 72% reported doing the open approach for primary rhinoplasty more than 50% of the time, whereas the remaining 28% use the closed approach. For secondary rhinoplasty, 76% reported using the open approach in more than half of cases for which they were not the primary surgeons. In contrast, 53% used the closed approach in more than half the cases of secondary surgery if they were the initial surgeons. Revision rates for primary and secondary rhinoplasties were 9.1% and 7.8%, respectively. The difference was not statistically significant. On average, members performed 101 nasal surgeries per year. Previous patient recommendation was the most common reason for referral. Of the members, 54% reported using spreader grafts in more than half of the cases of aesthetic rhinoplasty and 75.7% when pertaining to functional rhinoplasty. Finally, 37.8% of responding members reported using tip grafts more than half the time when performing aesthetic rhinoplasty.
  
  
  CONCLUSIONS
  Of the responding members of The Rhinoplasty Society, the open approach is the preferred choice for both primary and other surgeons' revision rhinoplasties. Spreader grafts are commonplace in both functional and aesthetic rhinoplasties.
authors.affiliation: From the *Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas, TX; and †Academic Health Center School of Dentistry, Cleft Palate and Craniofacial Clinics, University of Minnesota, Minneapolis, MN.
authors.forename: Michael
authors.initials: M
authors.lastname: Lee
authors.forename: Jacob G
authors.initials: JG
authors.lastname: Unger
authors.forename: Joe
authors.initials: J
authors.lastname: Gryskiewicz
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Rohrich
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D006801:Humans; D009295:Nasal Bone / Q000601:surgery; D055171:Nasal Cartilages / Q000601:surgery; D009300:Nasal Septum / Q000601:surgery; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012225:Rhinoplasty / Q000379:methods* / Q000706:statistics & numerical data*; D012955:Societies, Medical / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States