Crowdsourced Assessment of Aesthetic Outcomes of Dorsal Preservation Rhinoplasty.

Background: The inherent subjectivity in aesthetic outcomes presents a unique challenge in assessing rhinoplasty. Crowdsourcing has provided a new metric for objective analysis. The authors designed a retrospective study to compare the aesthetic outcomes of dorsal preservation rhinoplasty versus structural rhinoplasty.

Objectives: We aim to objectively quantify the relative aesthetic advantages of performing a dorsal preservation technique. Additionally, we aim to demonstrate the efficacy of using crowdsourcing as an efficient and reliable method for evaluating any plastic surgery aesthetic outcome.

Methods: Patients' preoperative and postoperative photos were divided two cohorts. Photos were evaluated by crowdworkers using a secure online rating platform on the overall nasal appearance, the dorsal profile, the dorsal aesthetic line symmetry, the dorsal contour, and rate their confidence on whether a patient had undergone surgery. A "delta" was calculated by comparing preoperative to postoperative states to represent an absolute value of improvement after surgery. Each cohort was compared using non-paired T-tests.

Results: The structural rhinoplasty cohort included 34 patients. The dorsal preservation cohort included 30 patients. Both cohorts demonstrated improved aesthetic outcomes (dorsal preservation [0.300, 95% CI 0.047]; structural [0.377, 95% CI 0.055]). When raters were asked to predict whether a patient had surgery, the correlation coefficient of the structural cohort (0.74) suggested that a crowdworker was better able to identify whether a patient had surgery. The correlation coefficient in the dorsal preservation cohort (-0.0554) suggested the raters were unable to identify which patients had surgery.

Conclusions: We found significant improvements in overall aesthetic outcomes with both techniques, while a more natural "unoperated" outcome was achieved when performing a dorsal preservation technique. We also provide evidence of the efficacy of using crowdsourcing as an efficient and reliable method for evaluating aesthetic outcomes.