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Tip Asymmetry Most Common Reason for Rhinoplasty

Is top concern for patients and physicians, though the two don't always report same concerns

WEDNESDAY, Sept. 22 (HealthDay News) -- Tip asymmetry is the most common aesthetic deformity reported by both patients seeking revision rhinoplasty and by surgeons, though there are differences between patients' subjective concerns and surgeons' objective concerns, according to a study published in the September/October issue of the Archives of Facial Plastic Surgery.

In a prospective study, Kathy Yu, M.D., of Columbia College and Cornell University in New York City, and colleagues used a questionnaire to systematically target the aesthetic and functional concerns of 104 patients seeking revision rhinoplasty.

The investigators found that tip asymmetry was the most common patient and surgeon aesthetic concern, followed by crooked middle third of the nose and upper third irregularity, with a mean of 79 percent of patient concerns also reported by surgeons. The most bothersome patient concerns were tip asymmetry, difficulty breathing or nasal blockage, and crooked middle third irregularity. The investigators also found that 94 percent of 64 patients describing subjective nasal obstruction had objective physical findings related to obstruction. The authors write that differences in patient and surgeon findings were mostly due to differences in assessment skills.

"In conclusion, this study sheds light on the major concerns of patients seeking revision rhinoplasty and compares them with the surgeon's objective findings," the authors write. "These findings emphasize the importance of physician awareness of patients' concerns, understanding the causes of post-surgical nasal obstruction, and clearly explaining nasal aesthetics to patients seeking revision rhinoplasty."

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