The impact of rhinoplasty on observer attention before and after rhinoplasty

Abstract Background Rhinoplasty is one of the most common plastic surgeries in the world. Despite the development of several ideal angles and ratios for objective assessment of facial aesthetics, how the face is perceived by a naive observer is an area of active study. Eye tracking technology offers an objective method to track the viewer's attention to facial features. Method Images of 14 patients (7 men, 7 women) before and after rhinoplasty at anterior, inferior, right and left lateral views were shown to 88 naive observers (44 men, 44 women). Faces were divided into 27 clinical aesthetic subunits. Images were presented in a random order. Faces remained visible for 5 secs and were separated by black screen for 750 msec. The fixation counts and fixation durations within subunits for faces before and after rhinoplasty were compared. Results In the anterior view, nasal dorsum was the first major area attracting attention before rhinoplasty, while after rhinoplasty the tip attracted more attention and viewers fixated less on the dorsum. In the inferior view, the columella area remained the first major feature attracting attention. There was a significant difference in attention to left and right lateral views. On right lateral view, observers had significantly lower fixation on nasal dorsum and lateral wall after rhinoplasty, while making significantly more fixation on right ala and columella. Conclusion This study showed that the regions that attract more attention on faces are changed after rhinoplasty. More precisely, rhinoplasty can play an important role to decrease attention from nasal dorsum.