Correcting for Rater Effects in Operating Room Surgical Skills Assessment.

Objective: To estimate and adjust for rater effects in operating room surgical skills assessment performed using a structured rating scale for nasal septoplasty.

Methods: We analyzed survey responses from attending surgeons (raters) who supervised residents and fellows (trainees) performing nasal septoplasty in a prospective cohort study. We fit a structural equation model with the rubric item scores regressed on a latent component of skill and then fit a second model including the rating surgeon as a random effect to model a rater-effects-adjusted latent surgical skill.

A Randomized, Multicenter, Evaluator-blind Study to Evaluate the Safety and Effectiveness of VYC-12L Treatment for Skin Quality Improvements.

Background: Skin quality may be assessed by degrees of skin smoothness, fine lines, and hydration. VYC-12L is a recently developed hyaluronic acid filler to improve skin quality.

Objective: This was a randomized, evaluator-blind study assessing safety and effectiveness of intradermal VYC-12L treatment for improving cheek skin smoothness, fine lines, and hydration.

Do Attending and Trainee Surgeons Agree on What Happens in the Operating Room During Septoplasty?

Surgeons must select cases whose complexity aligns with their skill set. To determine how accurately trainees report involvement in procedures, judge case complexity, and assess their own skills. We recruited attendings and trainees from two otolaryngology departments.

The Valuation of Rhytidectomy in Different Economic Markets.

This study demonstrates that the trend of how rhytidectomy is valued can be used to determine not only the pricing of this good but also how receptive developing economic markets are to the export of cosmetic facial plastic surgery. This study seeks to analyze and compare the value of rhytidectomy in an established market and an emerging market. A cross-sectional survey was administered through public online forums to 162 casual observers in the United States and 74 casual observers in India.

The Health Utility and Valuation of Cosmetic Rhinoplasty.

The importance of this study is to understand the impact of rhinoplasty as perceived by society and to conceptualize the health utility metric of cosmetic rhinoplasty in relation to other health interventions. This novel study seeks to measure and quantify the health state utility and valuation of cosmetic rhinoplasty. This is a cross-sectional survey administered through public online forums to 161 casual observers in America.

Revision Rhinoplasty: Conservation versus Deconstruction.

Revision rhinoplasty requires the surgeon to strike a careful balance between conservation and deconstruction. Contemporary rhinoplasty has focused on structural cartilage grafts. These grafts resist static and dynamic forces produced by tissue contraction, gravity, and pressure gradients during respiration.

Normal Gaze Patterns of the Face in Lateral View.

Current efforts to quantify the attentional distraction of facial deformities have been limited to deformities that are best perceived when the face is in frontal view, and there remains a paucity of knowledge of societal perception of the face in lateral view. To date, no attempts have been made to characterize the fixation patterns of the face in lateral view. To characterize the fixation patterns and gaze patterns of the face in lateral view.

How Old Do I Look? Exploring the Facial Cues of Age in a Tasked Eye-Tracking Study.

This is the first eye-tracking study to use a tasked age estimation paradigm to explore the facial cues of age as seen by casual observers. Determine where observers gaze on faces when tasked with estimating an individual's age. This was a prospective controlled experiment, which took place at an academic tertiary referral center.

Stretched Earlobe Piercings Negatively Impact Casual Observer Perceptions.

Patients with stretched earlobes seek reconstruction to mitigate social stigma. To date, there have been no studies measuring the impact of stretched earlobe piercings on casual observer perceptions. One-hundred seventy-three casual observers were enrolled via public-access web sites.

Assessment of the Influence of "Other-Race Effect" on Visual Attention and Perception of Attractiveness Before and After Rhinoplasty.

Importance: The "other-race effect" describes the phenomenon in which individuals demonstrate greatest recognition ability among faces of their own race. Thus, in our multicultural world, it follows that race influences social interactions. However, the association of race with perception of plastic surgery outcomes has not been studied.

Assessment of Casual Observers' Willingness to Pay for Increased Attractiveness Through Rhinoplasty.

Importance: Contingent valuation, or willingness to pay, is an established economic concept that has been applied in other areas of medicine and may be useful for understanding the economic forces that determine the cost of cosmetic procedures.

Objective: To determine the monetary value of changes in attractiveness achieved through rhinoplasty, as perceived by society.

Design, Setting, And Participants: Cross-sectional survey administered via public online forums to 228 casual observers.

Association Between Surgical Trainee Daytime Sleepiness and Intraoperative Technical Skill When Performing Septoplasty.

Importance: Daytime sleepiness in surgical trainees can impair intraoperative technical skill and thus affect their learning and pose a risk to patient safety.

Objective: To determine the association between daytime sleepiness of surgeons in residency and fellowship training and their intraoperative technical skill during septoplasty.

Design, Setting, And Participants: This prospective cohort study included 19 surgical trainees in otolaryngology-head and neck surgery programs at 2 academic institutions (Johns Hopkins University School of Medicine and MedStar Georgetown University Hospital).

Difficult Necks and Unresolved Problems in Neck Rejuvenation.

Neck rejuvenation attempts to correct the unattractive features that result from the process of facial aging. The aesthetic goals of surgery include creating a well-defined jaw contour, optimal cervicomental angle, smooth-appearing skin, and a healthy redistribution of soft tissue volume. Unique patient characteristics create inherent challenges that may limit the degree to which improvement can be made.

Association of Rhinoplasty With Perceived Attractiveness, Success, and Overall Health.

Importance: To date, the impact of rhinoplasty surgery on social perceptions has not been quantified.

Objective: To measure the association of rhinoplasty with observer-graded perceived attractiveness, success, and overall health.

Design, Setting, And Participants: In a web-based survey, blinded casual observers viewed independent images of 13 unique patient faces before or after rhinoplasty.

A Dual Approach to Understanding Facial Perception Before and After Blepharoplasty.

Importance: Blepharoplasty consistently ranks among the most common facial plastic surgery procedure sought by both men and women. Despite the popularity of blepharoplasty, there has been little research focused on quantifying how eyelid surgery changes facial perceptions.

Objectives: To quantify the effect of blepharoplasty on facial perceptions and measure patient-reported ratings of fatigue before and after surgery to compare observer and patient perceptions.

Association Between Patient Value Systems and Physician and Practice Attributes Available Online.

Importance: The relative value of facial plastic surgeon personal and practice attributes is relevant to the broader health care system because of increasing out-of-pocket expenses to patients.

Objective: To determine the relative value of specific facial plastic surgeon personal and practice attributes available online from the perspective of patients.

Design, Setting, And Participants: This study consisted of an electronic survey sent to patients by email using choice-based conjoint analysis; surveys were sent between December 2015 and March 2016.

Association Between Facial Rejuvenation and Observer Ratings of Youth, Attractiveness, Success, and Health.

Importance: Surgical procedures for the aging face-including face-lift, blepharoplasty, and brow-lift-consistently rank among the most popular cosmetic services sought by patients. Although these surgical procedures are broadly classified as procedures that restore a youthful appearance, they may improve societal perceptions of attractiveness, success, and health, conferring an even larger social benefit than just restoring a youthful appearance to the face.

Objectives: To determine if face-lift and upper facial rejuvenation surgery improve observer ratings of age, attractiveness, success, and health and to quantify the effect of facial rejuvenation surgery on each individual domain.

Association of Face-lift Surgery With Social Perception, Age, Attractiveness, Health, and Success.

Importance: Evidence quantifying the influence of face-lift surgery on societal perceptions is lacking.

Objective: To measure the association of face-lift surgery with observer-graded perceived age, attractiveness, success, and overall health.

Design, Setting, And Participants: In a web-based survey, 526 casual observers naive to the purpose of the study viewed independent images of 13 unique female patient faces before or after face-lift surgery from January 1, 2016, through June 30, 2016.

Prevalence of Body Dysmorphic Disorder and Surgeon Diagnostic Accuracy in Facial Plastic and Oculoplastic Surgery Clinics.

Importance: Body dysmorphic disorder (BDD) is a relative contraindication for facial plastic surgery, but formal screening is not common in practice. The prevalence of BDD in patients seeking facial plastic surgery is not well documented.

Objective: To establish the prevalence of BDD across facial plastic and oculoplastic surgery practice settings, and estimate the ability of surgeons to screen for BDD.

Surgical Nasal Implants: Indications and Risks.

Rhinoplasty often requires the use of grafting material, and the goal of the specific graft dictates the ideal characteristics of the material to be used. An ideal material would be biologically inert, resistant to infection, noncarcinogenic, nondegradable, widely available, cost-effective, readily modifiable, and easily removable, have compatible biomechanical characteristics, retain physical properties over time, and not migrate. Unfortunately, no material currently in existence meets all of these criteria.

Spreader Grafts in Functional Rhinoplasty.

Management of the middle vault is paramount to achieving optimal aesthetic and functional outcomes in rhinoplasty. The ideal treatment for middle vault complications, such as internal nasal valve collapse, inverted-V deformity, and middle vault dorsal asymmetry, is prevention. Risk factors for middle vault problems in rhinoplasty that may be identified in preoperative consultation include short nasal bones, long and weak upper lateral cartilages, thin skin, previous trauma or surgery, preoperative positive Cottle maneuver, tension nose deformity, and anteriorly positioned inferior turbinates.