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Original Investigation
Mar/Apr 2018

Association of Rhinoplasty With Perceived Attractiveness, Success, and Overall Health

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
JAMA Facial Plast Surg. 2018;20(2):97-102. doi:10.1001/jamafacial.2017.1453
Key Points

Question  What is the effect of rhinoplasty on social perceptions of attractiveness, health, and success?

Findings  In this survey study of 473 blinded, naive observers rating independent patient images of 13 unique patient faces before and after rinoplasty, rhinoplasty was associated with patients appearing more attractive, healthier, and more successful.

Meaning  These findings highlight the positive perceptions of rhinoplasty.


Importance  To date, the impact of rhinoplasty surgery on social perceptions has not been quantified.

Objective  To measure the association of rhinoplasty with observer-graded perceived attractiveness, success, and overall health.

Design, Setting, and Participants  In a web-based survey, blinded casual observers viewed independent images of 13 unique patient faces before or after rhinoplasty. Delphi method was used to select standardized patient images, confirming appropriate patient candidacy and overall surgical effect. Observers rated the attractiveness, perceived success, and perceived overall health for each patient image. Facial perception questions were answered on a visual analog scale from 0 to 100, where higher scores corresponded to more positive responses. A multivariate mixed-effects regression model was used to determine the effect of rhinoplasty while accounting for observer biases. To further characterize the effect of rhinoplasty, estimated ordinal rank change was calculated for each domain.

Main Outcomes and Measures  The primary objective was to measure the effect of rhinoplasty on observer-graded perceived attractiveness, success, and overall health.

Results  A total of 473 observers (mean age, 29 years [range, 18-73 years]; 305 [70.8%] were female) successfully completed the survey. On multivariate regression, patients after rhinoplasty were rated as significantly more attractive (rhinoplasty effect, 6.26; 95% CI, 5.10-7.41), more successful (rhinoplasty effect, 3.24; 95% CI, 2.32-4.17), and overall healthier (rhinoplasty effect, 3.78; 95% CI, 2.79-4.81). The ordinal rank change for an average individual’s perceived attractiveness, success, and overall health was a positive shift of 14, 9, and 10 out of 100 rank positions, respectively.

Conclusions and Relevance  As perceived by casual observers, rhinoplasty surgery was associatedwith perceptions that in patients appeared significantly more attractive, more successful, and healthier. These results suggest patients undergoing rhinoplasty may derive a multifaceted benefit when partaking in social interactions. Furthermore, these results facilitate improved patient discussions aiming to provide more precise surgical expectations with an understanding that these results represent optimal outcomes.

Level of Evidence  NA.