The Effect of Smoking on Septoplasty and Septorhinoplasty Outcomes

Changes in patient-reported satisfaction and quality-of-life 6 months after rhinoplasty

BACKGROUND

Rhinoplasty is a challenging and demanding procedure in plastic surgery. Surgical success, patient satisfaction, and improved quality-of-life are important outcomes.

OBJECTIVES

This study aimed to evaluate patient-reported satisfaction with appearance, treatment, and decision outcomes as well as quality-of-life after rhinoplasty using validated questionnaires. The role of patient demographics on outcomes was also studied.

METHODS

Patients who underwent a primary rhinoplasty were selected for this cohort study. Patient-reported satisfaction with appearance, treatment, and decision as well as quality-of-life were evaluated with the Utrecht Questionnaire and FACE-Q at intake and 6 months postoperatively.

RESULTS

Overall, 380 patients were included. Patients reported a more positive subjective perception of nasal appearance (VAS score) at 6 months post-surgery compared with preoperative scores (7.9 ± 1.6 vs 3.2 ± 1.4, p < 0.05). Furthermore, higher quality-of-life and body image scores were observed at 6 months postoperatively compared with preoperative scores (7.7 ± 3.5 vs 15.2 ± 4.4, p < 0.05). Patients reported high satisfaction with treatment outcome (70.3 ± 23.4) as well as with their decision to undergo surgery (75.9 ± 23.4) on a scale of 0-100 at 6 months postoperatively. Patients reached similar postoperative scores regardless of their intake scores. Patients ≥30 years and patients with a history of cosmetic surgery were less satisfied postoperatively.

CONCLUSION

Despite differences in appearance satisfaction at intake, most patients showed greater satisfaction with appearance, treatment, and decision outcomes as well as quality-of-life 6 months postoperatively. However, older age and a history of cosmetic surgery influenced these outcomes negatively. These factors should be considered during preoperative management of outcome expectations.

Invited Discussion on: "The Effect of Smoking on Septoplasty and Septorhinoplasty Outcomes"

Drs. Erol and Koycu's manuscript entitled, "The Effect of Smoking on Septoplasty and Septorhinoplasty Outcomes" suggests that septoplasty and septorhinoplasty can be performed on patients who actively smoke with comparable results to non-smokers in terms of function, complications, and rates of revision. Still, many surgeons advise or require their patients to cease smoking before undergoing elective surgery. Smoking cessation's benefits center upon maintaining overall health and may indicate a patient's ability to follow postoperative instructions. Accordingly, it is uncertain if there will be an increase in surgeons offering these operations to active smokers.