Casual Observers' Perception on the Aesthetics of the Butterfly Graft.

[OBJECTIVE] The butterfly graft is an effective technique for improving the internal nasal valve, however, there is hesitancy among surgeons due to possible aesthetic changes. This study aims to determine if average observers rated the post-operative appearance of the butterfly graft negatively.

[METHODS] An online survey was distributed by social media to non-medical observers in which they rated either the pre-operative or post-operative appearance of 22 patients' noses (11 butterfly graft, 11 spreader graft). A heat map was used to determine if the supratip region was rated as the least aesthetically appealing. Post-operative ratings and heat maps of the butterfly graft patients were compared to pre-operative ratings as well as ratings of the spreader graft group.

[RESULTS] 226 observers responded. There was no difference in the pre-operative and post-operative rating of the butterfly graft group (58.27 vs. 58.00, p = 0.88) or the number of supratip regions selected as least attractive (165 vs. 169, p = 0.60). Similarly, there was no difference in post-operative ratings between the butterfly graft group and spreader graft group (58.00 vs. 58.21, p = 0.63) or in selection of the supratip as the least attractive region (169 vs. 172, p = 0.74).

[CONCLUSION] The butterfly graft did not negatively affect observers' opinion of patients' noses.

[LEVEL OF EVIDENCE] 3 Laryngoscope, 133:2578-2583, 2023.