Functional Outcomes After Feminizing Rhinoplasty

Abstract

Introduction

Feminizing rhinoplasty, as part of facial feminization surgery (FFS), aims to align nasal appearance with gender identity. While nasal obstruction is a known complication of rhinoplasty, its impact on feminizing rhinoplasty is unclear.

Objectives and Hypotheses

This study investigates if feminizing rhinoplasty causes nasal obstruction secondary to structural modifications.

Study Design

Prospective cohort study.

Methods

IRB-approved study included males and females undergoing cosmetic rhinoplasty and transgender females undergoing feminizing rhinoplasty at Cedars–Sinai Medical Center. Nasal obstruction was assessed using the nasal obstruction and symptom evaluation (NOSE) survey preoperatively and 3-, 6-, and 12-months postoperatively, analyzed with a t-test.

Results

NOSE scores significantly decreased in all groups, with transgender females showing a 78, 84, and 77% reduction at 3-, 6-, and 12-months. No significant difference was found between cosmetic rhinoplasty and FFS groups postoperatively.

Conclusion

Decreases in average NOSE scores across groups suggest that feminizing rhinoplasty does not worsen nasal obstruction and may improve functional outcomes.

Keywords

feminizing rhinoplasty - gender-confirming rhinoplasty - facial feminization surgery

Publication History

Accepted Manuscript online:
16 April 2025

Article published online:
24 April 2025

• References

• 1 Mookerjee VG, Alper DP, Almeida MN. et al. Quantitative analysis of morphometric changes in feminization rhinoplasty utilizing a standardized forehead-rhinoplasty technique. Aesthet Surg J Open Forum 2023; 5: ojad095
• 2 Bellinga RJ, Capitán L, Simon D, Tenório T. Technical and clinical considerations for facial feminization surgery with rhinoplasty and related procedures. JAMA Facial Plast Surg 2017; 19 (03) 175-181
• 3 Springer IN, Zernial O, Nölke F. et al. Gender and nasal shape: measures for rhinoplasty. Plast Reconstr Surg 2008; 121 (02) 629-637
• 4 Berli JU, Loyo M. Gender-confirming Rhinoplasty. Facial Plast Surg Clin North Am 2019; 27 (02) 251-260
• 5 Grymer LF. Reduction rhinoplasty and nasal patency: change in the cross-sectional area of the nose evaluated by acoustic rhinometry. Laryngoscope 1995; 105 (4 Pt 1): 429-431
• 6 Sidle D, Hicks K. Nasal obstruction considerations in cosmetic rhinoplasty. Otolaryngol Clin North Am 2018; 51 (05) 987-1002
• 7 Kandathil CK, Saltychev M, Patel PN, Most SP. Natural history of the standardized cosmesis and health nasal outcomes survey after rhinoplasty. Laryngoscope 2021; 131 (01) e116-e123
• 8 Morrison SD, Capitán-Cañadas F, Sánchez-García A. et al. Prospective quality-of-life outcomes after facial feminization surgery: an international multicenter study. Plast Reconstr Surg 2020; 145 (06) 1499-1509