Patient Satisfaction After Rhinoplasty: A Social Media Analysis

Compared to other cosmetic procedures, rhinoplasty has a relatively low patient satisfaction rate, due to the difficulty of the procedure, and potentially unrealistic patient expectations. Understanding the reasons behind patient dissatisfaction is key to improving outcomes. Previous authors have done surgeon-initiated surveys, expert ratings, and morphologic measurements, to measure rhinoplasty success. No study has analyzed online reviews by patients to identify reasons for dissatisfaction with rhinoplasty.

The goal of this study was to analyze satisfaction patterns in rhinoplasty using online reviews.

All primary rhinoplasty reviews on RealSelf (Seattle, WA), a social media website for patients undergoing cosmetic surgery, were reviewed. The researchers recorded patient gender, whether they were satisfied, and the reasons for satisfaction or dissatisfaction. Male and female patients were compared, using chi-squared analysis.

There were 2326 reviews for primary rhinoplasty (2032 females, 294 males). The overall satisfaction rate was 83.6%. Significantly more females than males were satisfied (87.6% vs 56.1%, P < .001). Among males, the most common reasons for dissatisfaction were residual dorsal hump, under-rotated tip, and a nose that was too small. Among females, the most common reasons for dissatisfaction were residual dorsal hump, under-rotated tip, and bulbous tip. Among dissatisfied patients, females were significantly more likely than males to precisely verbalize the morphologic or functional reason for their dissatisfaction.

We found that males had lower satisfaction with rhinoplasty, and were more vague when expressing reasons for dissatisfaction, than females. Social media provides a novel way to understand reasons for patient dissatisfaction after cosmetic surgery.