Patient-Reported Aesthetic Satisfaction and Nasal Function Following Primary Rhinoplasty: A Retrospective Observational Study.

BACKGROUND: Patient-reported outcomes are central to rhinoplasty evaluation, but evidence from Kurdish and Middle Eastern populations remains limited. This study evaluated retrospectively reported nasal satisfaction, patient-perceived function, participant-reported postoperative complications, and exploratory associations with the reported 1-year outcome after primary rhinoplasty. METHODS: This retrospective questionnaire-based observational study included 400 patients who had undergone primary rhinoplasty at least 12 months earlier. During one survey, participants retrospectively rated their nose on a 1-10 visual analogue scale (VAS) for three reference periods: before surgery, at the time of surgery, and 1 year after surgery. Item-level questions assessed appearance, breathing, confidence, comments from others, and willingness to undergo rhinoplasty again. Complication status was derived from a single participant-reported field permitting one primary response and was not clinically adjudicated. Differences among the three recalled VAS ratings were analyzed using generalized estimating equations with patient clustering. An expanded multivariable linear regression modeled the recalled 1-year VAS score, and an exploratory logistic regression examined unwillingness to repeat surgery. RESULTS: The sample was predominantly female (298/400, 74.5%), with a mean age of 24.64 ± 5.40 years. Mean retrospectively reported VAS ratings were 4.84 ± 2.55 before surgery, 7.05 ± 2.20 at the time of surgery, and 7.65 ± 2.33 at 1 year. Compared with the recalled preoperative rating, adjusted mean differences were 2.21 points (95% CI 1.92 to 2.51) at the time of surgery and 2.81 points (95% CI 2.49 to 3.12) at 1 year (both Holm-adjusted p<0.001). At 1 year, 333 patients (83.2%) had a good-to-excellent global outcome, 302 (75.5%) reported easy breathing, and 74 (18.5%) were definitely willing to undergo rhinoplasty again. A primary participant-reported postoperative complication was recorded by 160 patients (40.0%). In the expanded model (n=399), age, recalled preoperative VAS, education, and participant-reported complication status were associated with the recalled 1-year VAS; the model explained 26.0% of outcome variance (adjusted R²=0.211). In exploratory analysis, participant-reported complication status was associated with greater adjusted odds of not being definitely willing to repeat surgery (OR=2.15, 95% CI 1.18 to 3.93). CONCLUSIONS: Participants rated the surgical and 1-year states more favorably than the recalled preoperative state. Because all three ratings were obtained retrospectively in one survey, they should not be interpreted as prospectively observed change. Within the limitations of a single-category, non-adjudicated participant-reported complication measure, complication status was associated with lower recalled 1-year satisfaction and greater odds of not being definitely willing to undergo the procedure again. These associations are exploratory and should not be interpreted causally.