Assessment of Functional and Aesthetic Results in Preservation and Structural Rhinoplasty

<b>Background:</b> The philosophy of preservation rhinoplasty (PR) is gaining popularity as an alternative to structural rhinoplasty (SR), prompting comparison of their effectiveness, patient satisfaction, and impact on quality of life. <b>Methods:</b> This study evaluated the outcomes of rhinoplasty performed using PR and SR, supported by the SCHNOS, ROE, NOSE, and WHOQOL-BREF questionnaires. Seventy-five patients were included (N = 47 (63%) female and N = 28 (37%) male), of whom 39 underwent SR. Surveys were completed preoperatively and at one and three months postoperatively. A single surgeon performed all procedures, and the results were subjected to statistical analysis. <b>Results:</b> Baseline ROE scores were identical in both groups (1.2 vs. 1.2; <i>p</i> > 0.05). At three months, PR demonstrated significantly higher ROE scores (3.8 vs. 3.7; <i>p</i> < 0.05). In the SCHNOS-Obstruction domain, PR showed better outcomes at one month (0.8 vs. 1.3; <i>p</i> < 0.01), whereas three-month scores were equal (0.5 vs. 0.5; <i>p</i> > 0.05). SCHNOS-Cosmesis and NOSE outcomes did not differ significantly at any point. WHOQOL-BREF results indicated significant postoperative improvement across all domains in both groups (<i>p</i> < 0.001). <b>Conclusions:</b> PR provides higher early satisfaction, but both PR and SR yield progressive improvement and comparable longer-term outcomes. Quality of life and self-esteem improved regardless of surgical technique.