Objective: Rhinoplasty is a complex and multi-faceted operation. There are great differences in methodologies between practitioners. This study has polled plastic surgeons, general otolaryngologists, and otolaryngogoly-facial plastic surgeons. By formulating a consensus on the pre-operative, operative and post-operative technique employed by these groups we hope to provide participants with benchmarks with which they can evaluate their own practice.

Design: A comprehensive questionnaire was sent to members of the following societies: The American Society of Plastic Surgeons, The American Academy of Otolaryngology, and The American Academy of Facial Plastic and Reconstructive Surgery. The survey focused on three main areas: a) background information b) intra-operative technique and c) Post-operative care.

Results: 923 surveys were returned out of 7000 surveys sent out for a 13% response rate. Plastic surgeons accounted for 68% of the response rate and ENT affiliations accounted for 28%, with a small minority (4%) being members of both groups. 35% of respondents have been in practice 20 or more years while 30% have been in practice 11-20 years. 52% of respondents are in private practice and 19% are in academic practices, while the rest are in singe- or multi-specialty practices. The number of rhinoplasties performed per year is spread fairly evenly up to 50 per year, however, only 9% of respondents do 50-100 cases per year and only 5% do more than 100 per year. Most prefer the open approach over the closed approach (33% open only and 42% doing both approaches, but primarily open). 39% of respondents use intranasal packing 80-100% of the time while 37% use packing 0-20% of the time. Nasal splints are used 83% of the time and generally are left in place for 4-7 days (88%). 80% of respondents use post-operative steroids while 10% rarely use them and 10% never use them. In addition to examining direct survey results, further sub-analysis was performed by cross-examining specific questions.

Conclusions: There is no uniform consensus regarding general rhinoplasty trends, including intra-operative techniques and post-operative care. Certain trends, however, can be seen in all areas. In general, the longer a surgeon is in practice and the more private practice oriented, the more likely closed techniques are favored. Sub-analyses show interesting trends comparing specialties and number of years in practice to other specific survey results. In general, facial plastic surgeons tend to perform more rhinoplasties per year than plastic surgery counterparts and are more likely to use post-operative steroids. These trends show that overall, there are some similarities amongst different specialties, but there are also statistically significant differences.