title: Patient Satisfaction After Rhinoplasty: A Social Media Analysis.
abstract: BACKGROUND
  Compared to other cosmetic procedures, rhinoplasty has a relatively low patient satisfaction rate, due to the difficulty of the procedure, and potentially unrealistic patient expectations. Understanding the reasons behind patient dissatisfaction is key to improving outcomes. Previous authors have done surgeon-initiated surveys, expert ratings, and morphologic measurements, to measure rhinoplasty success. No study has analyzed online reviews by patients to identify reasons for dissatisfaction with rhinoplasty.
  
  
  OBJECTIVE
  The goal of this study was to analyze satisfaction patterns in rhinoplasty using online reviews.
  
  
  METHODS
  All primary rhinoplasty reviews on RealSelf (Seattle, WA), a social media website for patients undergoing cosmetic surgery, were reviewed. The researchers recorded patient gender, whether they were satisfied, and the reasons for satisfaction or dissatisfaction. Male and female patients were compared, using chi-squared analysis.
  
  
  RESULTS
  There were 2326 reviews for primary rhinoplasty (2032 females, 294 males). The overall satisfaction rate was 83.6%. Significantly more females than males were satisfied (87.6% vs 56.1%, P < .001). Among males, the most common reasons for dissatisfaction were residual dorsal hump, under-rotated tip, and a nose that was too small. Among females, the most common reasons for dissatisfaction were residual dorsal hump, under-rotated tip, and bulbous tip. Among dissatisfied patients, females were significantly more likely than males to precisely verbalize the morphologic or functional reason for their dissatisfaction.
  
  
  CONCLUSIONS
  We found that males had lower satisfaction with rhinoplasty, and were more vague when expressing reasons for dissatisfaction, than females. Social media provides a novel way to understand reasons for patient dissatisfaction after cosmetic surgery.
authors.affiliation: Dr I. Khansa is a Resident and Dr Pearson is an Assistant Professor, Department of Plastic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio. Dr L Khansa is an Associate Professor, Department of Business Information Technology, Pamplin College of Business, Virginia Tech, Blacksburg, Virginia.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Khansa
authors.affiliation: Dr I. Khansa is a Resident and Dr Pearson is an Assistant Professor, Department of Plastic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio. Dr L Khansa is an Associate Professor, Department of Business Information Technology, Pamplin College of Business, Virginia Tech, Blacksburg, Virginia.
authors.forename: Lara
authors.initials: L
authors.lastname: Khansa
authors.affiliation: Dr I. Khansa is a Resident and Dr Pearson is an Assistant Professor, Department of Plastic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio. Dr L Khansa is an Associate Professor, Department of Business Information Technology, Pamplin College of Business, Virginia Tech, Blacksburg, Virginia.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Pearson
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012225:Rhinoplasty / Q000523:psychology* / Q000706:statistics & numerical data*; D017678:Sex Distribution; D061108:Social Media / Q000706:statistics & numerical data*; D016896:Treatment Outcome