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NYT Syndicate

Is a"nose job" worth it? And if so, how much?
A new study suggests that casual observers may think patients who undergo such procedures are more attractive, more successful and healthier.
"While we are not suggesting that (a nose job) is the only way to improve one's appearance, improving our attractiveness and health as compared to others conveys a competitive advantage," said study co-author and plastic surgeon Dr Lisa Ishii.
More than 220,000"nose reshaping" procedures known as rhinoplasty were performed in the United States in 2016, up 2 percent from the previous year, according to the American Society of Plastic Surgeons. The procedures are nearly as common as liposuction.
The new study examines how"casual observers" perceive people after they've had a nose job, said Ishii, a plastic surgeon and associate professor at Johns Hopkins School of Medicine in Baltimore.
"Patients seeking rhinoplasty do so for two main reasons: to improve their self-perception and to improve how others perceive them," she said."We wanted to measure the second one."
The researchers recruited 473 people online to evaluate the appearance of 13 rhinoplasty patients. Observers ranged in age from 18 to 73. Most were female and white, and highly educated.
The researchers deemed the patients' post-op results"optimal." They showed the observers photos taken before the nose reshaping and at least 6 months after. But they didn't reveal whether they were"before" or"after" images, and the observers never saw more than one picture of the same patient.
The patients were mostly female, with an average age of 34. Most"had nose problems that were visible to the casual observer and they wanted to look better," Ishii said.
She added that a prior study showed that the casual observer"actually picks up on even subtle nasal deformities."
Her team asked the observers to rate patients in terms of attractiveness, success level and overall health based on their photos.
On a scale of 1 to 100, the average patient's attractiveness rating improved by 14 points after remodelling, the researchers found. Ratings of success and health rose 9 and 10 points, respectively, after surgery.
Ishii called the degree of improvement significant, and said this gives patients information about how nose jobs may affect them.
"More attractive people are more successful," she said."It's up to patients to decide whether that's worth it to them."
Insurers don't usually cover nose jobs, however. The cost can range from $6,000 to $25,000"depending on the complexity of the procedure and the reputation of the surgeon," said plastic surgeon Dr Clinton Humphrey. He's an associate professor with the University of Kansas Health System.
"It is important not to misinterpret these study results," cautioned Humphrey, co-author of a commentary accompanying the new research.
"This study included only patients with what were judged by surgeons to be 'ideal' results. Rhinoplasty continues to be one of the most challenging cosmetic surgical procedures," he said.
"While I always strive to achieve the best possible outcome in every one of my rhinoplasty patients, I do not achieve an 'ideal' result every time," Humphrey said.
"It would be a mistake to read this study and conclude that every patient who undergoes rhinoplasty can expect to be perceived as more successful, healthier, and more attractive," he added.
Still, he said,"patients should feel reassured that what we as rhinoplasty surgeons consider to be 'ideal' results are also viewed very favourably by the average person. As a surgeon, this study tells me that when I execute a successful rhinoplasty, I have an opportunity to positively impact my patient in a really significant way."
The study appears in the journal JAMA Facial Plastic Surgery.
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