Assessing the Expectations of Patients Demanding Rhinoplasty on Profile Photographs using Proportional Measurements and Simulation Programs

Abstract

Objective: The aim of this study was to define the desired profile measurements in patients who demand rhinoplasty and to assess the needs of extra profile surgeries in these patients. Material and Methods: Overall, 100 patients (60 women, 40 men) demanding rhinoplasty between January and December 2013 were included in this study. Standard profile photos were taken. Rhinoplasty and extra profile surgeries were simulated in those photos with both patient and surgeon decisions. These simulated photos were assumed as the desired profile view. In those photos, some angles or measurements were calculated to understand the desired proportions on the profile view. Then, these desired proportions were compared with the universal ideal proportions to understand the needs of extra profile surgeries in those patients. Results: It has been found that 43% of women and 27.5% of men would benefit from fat injections to the forehead. Sagittal lowering of the nasion was necessary in 25% of both men and women. Respectively in women and men, demands in; nasolabial angle increase were 85% and 75%, projection increase according to Goode ratio were 35% and 32%, according to Baum ratio, 80 and 75%. Lower chins vertical height was longer than the nose in 18% and 17%, nose was longer than the lower chin in 17% and 7.5% in women and men respectively. Lower 2/3rds of the chin was longer than normal in 21% of the patients in both women and men. In two different proportions, the chin was found to be retruded in 23%-36% and 30%-35% and protruded in 23%-26% and 25%-30% in women and men, respectively. Conclusion: Personal demands may vary from the universal ideals. Therefore, pre-surgical simulations become necessary to assess the extra surgery needs in patients demanding rhinoplasty. These simulations may help the surgeon to personalize the surgery according to the patients demand, and patient satisfaction may increase as a result this approach.