Improvement of nasal breathing is considered to be the major aspect of functional rhinoplasty (fRPL). Nevertheless, simultaneous aesthetic modifications can be required to achieve sufficient functional enhancement. Thus, the aim of this study was to assess the influence of the subjective perception of the nasal appearance on the outcome of fRPL. Patients undergoing fRPL were asked to complete the German version of the Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty (D-OAR) preoperatively, 1, 3 and 12 months after surgery. The patients' satisfaction with the procedure's result was determined using a five-point Likert scale 1, 3 and 12 months after rhinoplasty. In total, 87 patients (42 males and 45 females) with a median age of 25 years undergoing fRPL were included in this study. Compared to males, females showed diminished VAS scores (4.03 ± 2.02 vs 2.71 ± 1.96, p = 0.006) and higher D-OAR scores during preoperative outpatient consultation (13.34 ± 5.00 vs 16.07 ± 5.62, p = 0.020). An increase in the VAS score and a decrease in the D-OAR score were observed independent of gender post-operatively. Significant correlations between the patients' satisfaction and the D-OAR score at each time point of assessment were demonstrated, whereas no significant correlation between the post-operative patients' satisfaction and the initial D-OAR score could be identified. These results demonstrate the importance of body image and the subjective perception of the nasal appearance in particular in patients undergoing fRPL which should be taken into consideration of surgeons preoperatively. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Keywords: Body image; Functional rhinoplasty; Outcome; Quality of life; Questionnaire; Rhinoplasty.