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Invited Commentary |

The Role of Objective Outcomes in Surgery in Overcoming Cognitive Dissonance

Patrick J. Byrne, MD, MBA1
[+] Author Affiliations
1Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Facial Plast Surg. 2016;18(3):163-164. doi:10.1001/jamafacial.2015.2142.
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The quest for improved surgical outcomes in an era of evidence-based medicine compels us to measure and evaluate our outcomes. A heightened awareness exists, not only of the importance of objectively measuring our outcomes in terms of function and form, but also of the challenges in doing so.2

Rhinoplasty in particular is quite challenging given the highly subjective nature of the outcomes we seek. Do our interventions produce the desired effect? As surgeons we routinely perform maneuvers under the assumption that they are not only effective but optimal. Are they? Would our intuition stand up to scrutiny? In this issue of JAMA Facial Plastic Surgery, Ozucer and colleagues3 evaluate the efficacy of a very simple, routine, but rarely investigated maneuver: the use of postoperative taping after rhinoplasty. The authors performed a prospective randomized clinical trial in which they used ultrasonography to measure the thickness of the skin soft-tissue envelope after rhinoplasty, with and without taping. Reassuringly for most surgeons who place tape, the method seems to work.

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