{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T13:36:16Z","timestamp":1777642576374,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,7,2]],"date-time":"2020-07-02T00:00:00Z","timestamp":1593648000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Facial Plastic Surgery &amp; Aesthetic Medicine"],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Importance:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This novel study seeks to measure and quantify the health state utility and valuation of cosmetic rhinoplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Setting, Participants:<\/jats:title>\n                    <jats:p>This is a cross-sectional survey administered through public online forums to 161 casual observers in America.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures:<\/jats:title>\n                    <jats:p>Participants were shown pre- and postoperative photographs of six patients who underwent cosmetic rhinoplasty and two patients who did not undergo surgery. Observers were asked to imagine that the external nose in each image was on their own face and rated (1) their health state utility and (2) how much they were willing to pay (WTP) to have the ideal nose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Established metrics of standard gamble and visual analog scale were explored in detail. Using these valuation and health utility data, we calculated WTP per quality-adjusted-life-year (WTP\/QALY). The WTP\/QALY for cosmetic rhinoplasty is $12,264 per QALY, which is significantly below cost-effective thresholds. Participants were willing to accept 10% risk of death to undergo cosmetic rhinoplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance:<\/jats:title>\n                    <jats:p>Calculating WTP\/QALY as a metric, we assess and quantify the social importance of rhinoplasty. This is the first study to demonstrate that elective cosmetic rhinoplasty can be a high-value intervention as perceived by society. Furthermore, the high percentage of risk of death that participants are willing to accept for cosmetic rhinoplasty suggests there is a profound psychosocial impact of external nasal deformity. These findings have implications for patients, surgeons, and health policy makers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/fpsam.2020.0011","type":"journal-article","created":{"date-parts":[[2020,4,13]],"date-time":"2020-04-13T16:51:12Z","timestamp":1586796672000},"page":"268-273","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["The Health Utility and Valuation of Cosmetic Rhinoplasty"],"prefix":"10.1177","volume":"22","author":[{"given":"Anisha R.","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaru","family":"Ishii","sequence":"additional","affiliation":[{"name":"Divisions of Rhinology and Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ira","family":"Papel","sequence":"additional","affiliation":[{"name":"Divisions of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theda","family":"Kontis","sequence":"additional","affiliation":[{"name":"Divisions of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Liao","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonlin","family":"Chen","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa E.","family":"Ishii","sequence":"additional","affiliation":[{"name":"Divisions of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,7,2]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"PR Newsire. AAFPRS 2018 annual survey reveals key trends in plastic surgery. 2019. https:\/\/www.prnewswire.com\/news-releases\/aafprs-2018-annual-survey-reveals-key-trends-in-facial-plastic-surgery-300782534.html. Accessed February18 2020."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2018.1526"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X05282638"},{"key":"e_1_3_3_5_2","volume-title":"Health Measurement Scales. A Practical Guide to Their Development and Use","author":"Streiner D","year":"1989","unstructured":"Streiner D, , Norman G. Health Measurement Scales. A Practical Guide to Their Development and Use. New York, NY: Oxford University Press; 1989."},{"key":"e_1_3_3_6_2","volume-title":"Theory of Games and Economic Behavior","author":"Von Neumann J","year":"1953","unstructured":"Von Neumann J, , Morgenstern O. Theory of Games and Economic Behavior. 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