Aesthetic outcome after nasal reconstruction: patient versus panel perception

SummaryBackgroundNasal reconstruction after extensive ablative therapy poses a reconstructive challenge. The aim of this study was to assess subjective aesthetic outcome after nasal reconstruction scored by patients and a panel. In addition, inter-rater variability as well as important parameters of good aesthetic outcome were analysed.MethodsA total of 39 consecutive patients treated between November 2001 and May 2005 for (sub) total nasal defects were included. All patients were photographed in a standardised setting. Subjective aesthetic outcome (eight different nasal characteristics on a five-point Likert scale) was assessed by reconstructed patients individually as well as an independent professional panel consisting of five plastic surgeons.ResultsThirty-three patients (87%) participated in the follow-up study. Questionnaire results demonstrated statistically significant lower panel satisfaction scores (3.5 ± 0.9) with total nasal appearance than patients (4.2 ± 1.3; P = 0.03). There was a high agreement among panel members as judged by a low inter-rater variability. No relationship between severity of nasal defects and aesthetic outcome was found by patients or professionals.ConclusionPatient subjective aesthetic outcome was significantly higher than that of a professional panel. Severity of nasal deformity was not an indicator for patient satisfaction.