A Comprehensive Analysis on the Readability of Rhinoplasty-Based Web Content for Patients

Background: Rhinoplasty is one of the most common cosmetic procedures performed by plastic surgeons and otolaryngologists. Previous studies have concluded that the readability of rhinoplasty information does not meet the recommended guidelines for the 8th grade reading level. In this study, we performed an updated readability analysis and a comprehensive online review of decision-making factors for patients considering rhinoplasty. Additionally, the differences between plastic surgery and otolaryngology-specific web pages were also analyzed in this study. Methods: This study analyzed 30 websites from universities and private practice webpages for decision-making factors, readability, and tone. These sites were identified by performing a depersonalized Google search using the search terms "nose job decision factors" and "rhinoplasty decision factors." An independent t-test was performed to assess the differences between webpages. Results: A total of 30 websites were comprehensively reviewed for a comparative analysis of readability for potential rhinoplasty patients. Decision-making factors were divided into 3 categories: individual factors, goals of the procedure, and technical considerations. These categories were then further divided into subcategories. The most common decision-making factor discussed was procedural considerations (83.3%), the least common being lifestyle (10%). Additionally, only 26.7% of web pages mentioned ethnic background and skin type as potential considerations before surgery. Less than half (40%) discussed the importance of setting realistic expectations for the procedure. Of the total sites analyzed in the study, 65.5% were ENT-based, 24.1% were plastic surgery-based, 3.4% were dental/oral maxillofacial surgeons, and 6.9% were combined plastic surgeons and ENT. Statistically significant differences between ENT- and plastic surgeon-based webpages were observed. Risks and complications were more frequently discussed on ENT web pages (P = .02). ENT sites also had more adverbs (P = .024) and more uses of passive voice (P = .006). Additionally, plastic surgery web pages appeared to elicit more of the emotion "disgust" after analysis utilizing IBM Watson Natural Language Understanding (P < .001). Conclusions: This study highlights the necessity for continued improvement in the readability of webpages designed for patients considering rhinoplasty. Additionally, there were statistically significant differences between decision-making factors presented on ENT-based webpages and plastic-surgery-based webpages. This study may aid surgeons in developing websites that are more accessible, equitable to patients, and contain a more comprehensive discussion regarding key patient decision-making factors and preoperative considerations.