The Impact of Facial Asymmetry on the Surgical Outcome of Crooked Nose: A Case Control Study.

[BACKGROUND] Facial asymmetry is considered a reason for patient dissatisfaction with the outcome of rhinoplasty.

[OBJECTIVES] The aim of this study was to evaluate the impact of facial asymmetry on patient postoperative satisfaction with crooked nose and to investigate the relationship between visual perception of asymmetry and anthropometric measurements.

[METHODS] In this retrospective study, 61 rhinoplasty patients with crooked noses were assessed. Utilizing frontal view photos, pre- and postoperative nasal deviation angles were calculated. The patients were divided into 2 groups based on the visual presence of facial asymmetry. Moreover, anthropometric characteristics of the face were evaluated utilizing facial soft tissue landmarks. Patient satisfaction with surgery outcomes, including both aesthetic and functional aspects, was assessed employing the Persian version of the Standardized Cosmesis and Health Nasal Outcomes Survey.

[RESULTS] Based on the observations, 19 (30.2%) and 44 (69.8%) patients had I-type and C-type noses, respectively. In both groups, the deviation angle decreased significantly postoperatively (P < 0.001). Regarding the subjective evaluation of facial asymmetry, 22 (34.9%) and 41 (65.1%) cases had symmetric and asymmetric faces, respectively. Anthropometric measurements were also consistent with visual assessments of asymmetry. Satisfaction scores were significantly higher after surgery in all patients; however, there was no significant difference in the mean aesthetic improvement between symmetric (15.83 ± 2.68) and asymmetric faces (15.23 ± 4.46) (P = 0.531). The power of study was 97.8%.

[CONCLUSIONS] Rhinoplasty in patients with deviated noses and asymmetric faces may have comparable results with symmetric ones.