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Rodman and Kridel1 have addressed a truly important problem in facial plastic surgery—the lack of objective ways to evaluate its outcomes. Rhinoplasty is among the most difficult plastic surgical procedure to perform, and it has a relatively high revision rate. I congratulate the authors on their thoughtful and detailed attempt to develop a universally accepted classification for revision rhinoplasty. Such a classification is sorely needed because a revision rate that compares, for example, minor procedures done under local anesthesia with major revisions requiring multiple grafts provides little information to other surgeons or prospective patients. The late Jack Anderson, MD, of Tulane University, renowned for his contributions to facial plastic surgery, called rhinoplasty a “thinking man’s operation,” and the classification developed by Rodman and Kridel is a thinking man’s classification and a well-intentioned approach to an almost impossibly complex classification problem.
Larrabee WF. Classifying Revision Rhinoplasy Complexity—The Impossible Dream?. JAMA Facial Plast Surg. 2016;18(4):311-312. doi:10.1001/jamafacial.2016.0310