Automated Assessment of Aesthetic Outcomes in Facial Plastic Surgery

We introduce a scalable, interpretable computer-vision framework for quantifying aesthetic outcomes of facial plastic surgery using frontal photographs. Our pipeline leverages automated landmark detection, geometric facial symmetry computation, deep-learning-based age estimation, and nasal morphology analysis. To perform this study, we first assemble the largest curated dataset of paired pre- and post-operative facial images to date, encompassing 7,160 photographs from 1,259 patients. This dataset includes a dedicated rhinoplasty-only subset consisting of 732 images from 366 patients, 96.2% of whom showed improvement in at least one of the three nasal measurements with statistically significant group-level change. Among these patients, the greatest statistically significant improvements (p < 0.001) occurred in the alar width to face width ratio (77.0%), nose length to face height ratio (41.5%), and alar width to intercanthal ratio (39.3%). Among the broader frontal-view cohort, comprising 989 rigorously filtered subjects, 71.3% exhibited significant enhancements in global facial symmetry or perceived age (p < 0.01). Importantly, our analysis shows that patient identity remains consistent post-operatively, with True Match Rates of 99.5% and 99.6% at a False Match Rate of 0.01% for the rhinoplasty-specific and general patient cohorts, respectively. Additionally, we analyze inter-practitioner variability in improvement rates. By providing reproducible, quantitative benchmarks and a novel dataset, our pipeline facilitates data-driven surgical planning, patient counseling, and objective outcome evaluation across practices.