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 vs structural rhinoplasty.

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

[METHODS] Patients' preoperative and postoperative photographs were divided into 2 cohorts. Photographs were evaluated by crowdworkers on a secure online rating platform based on the overall nasal appearance, dorsal profile, dorsal aesthetic line symmetry, and dorsal contour, and rated their confidence about 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 with 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 in those patients. The correlation coefficient in the dorsal preservation cohort (-0.0554) suggested that the raters were unable to identify which patients had surgery.

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