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Original Investigation
Jan/Feb 2019

Assessment of Casual Observers’ Willingness to Pay for Increased Attractiveness Through Rhinoplasty

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Facial Plast Surg. 2019;21(1):27-31. doi:10.1001/jamafacial.2018.1526
Key Points

Question  What is the monetary value of changes in attractiveness achieved through rhinoplasty, as perceived by society?

Findings  This cross-sectional survey of 228 casual observers, analyzed using multilevel, mixed-effects linear regression, revealed a significant association between the change in attractiveness from a rhinoplasty and its monetary value as perceived by society. A rhinoplasty was valued at $6123.75 for 1 standard deviation increase in attractiveness, and $9223.05 for 2 standard deviations increase in attractiveness.

Meaning  Contingent valuation, or willingness to pay, is a well-established economic concept that may be useful for the valuation of cosmetic facial procedures.

Abstract

Importance  Contingent valuation, or willingness to pay, is an established economic concept that has been applied in other areas of medicine and may be useful for understanding the economic forces that determine the cost of cosmetic procedures.

Objective  To determine the monetary value of changes in attractiveness achieved through rhinoplasty, as perceived by society.

Design, Setting, and Participants  Cross-sectional survey administered via public online forums to 228 casual observers.

Main Outcomes and Measures  Participants were shown preoperative and postoperative photographs of 12 patients who underwent cosmetic rhinoplasty and 4 patients who did not undergo any surgery. They were asked to rate (1) the change in overall attractiveness of the patients, and (2) the monetary value they would associate with these changes.

Results  Completed surveys were obtained from 228 casual observers; 144 were female (63.2%); median age, 25 years (median income bracket, $50 000-$75 000). Multilevel, mixed-effects, linear regression was used to characterize the association between monetary value and change in attractiveness. There was a significant association between the change in attractiveness from a rhinoplasty and its monetary value as perceived by society. The baseline value of a rhinoplasty without any change in attractiveness was $3769.98 (95% CI, $3541.59-$4007.10; P < .001). To increase 1 standard deviation in attractiveness was worth an additional $2353.77 (95% CI, $2197.57-$2512.81; P < .001), while increasing 2 standard deviations in attractiveness was worth an additional $5453.07 (95% CI, $5052.57-$5865.51; P < .001).

Conclusions and Relevance  There is a significant association between the societally perceived value of cosmetic rhinoplasty and the change in attractiveness after surgery. The average value of a rhinoplasty in our study approximates the actual average cost of cosmetic rhinoplasty, suggesting that willingness to pay may be a useful concept for studying the value of cosmetic procedures.

Level of Evidence  NA.

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