Download PDF
Int Arch Otorhinolaryngol 2012; 16(04): 445-451
DOI: 10.7162/S1809-97772012000400004
Original Article
Thieme Publicações Ltda Rio de Janeiro, Brazil

Rhinoplasty and facial asymmetry: Analysis of subjective and anthropometric factors in the Caucasian nose

Bettina Carvalho
1   Medical Doctor. ENT Resident at HC/UFPR.
,
Annelyse Christine Ballin
2   ENT (ABORL). ENT Doctor.
,
Renata Vecentin Becker
3   Medical student at UFPR.
,
Cezar Augusto Sarraff Berger
4   ENT (ABORL). Teacher in the Rhinology department of HC/UFPR.
,
Johann G. G. Melcherts Hurtado
5   MD Education, Clinical Psychology and Physical Education. Coordinator of Medical Scientific Research at HC/UFPR.
,
Marcos Mocellin
6   PhD in ENT (Escola Paulista de Medicina, Brazil. Professor and Head of Department, at UFPR, Brazil.
› Author Affiliations
Further Information

Publication History

05 March 2012

22 July 2012

Publication Date:
10 December 2013 (online)

   Permissions and Reprints

Summary

Introduction: Anthropometric proportions and symmetry are considered determinants of beauty. These parameters have significant importance in facial plastic surgery, particularly in rhinoplasty. As the central organ of the face, the nose is especially important in determining facial symmetry, both through the perception of a crooked nose and through the determination of facial growth. The evaluation of the presence of facial asymmetry has great relevance preoperatively, both for surgical planning and counseling.

Aim/Objective: To evaluate and document the presence of facial asymmetry in patients during rhinoplasty planning and to correlate the anthropometric measures with the perception of facial symmetry or asymmetry, assessing whether there is a higher prevalence of facial asymmetry in these patients compared to volunteers without nasal complaints.

Methods: This prospective study was performed by comparing photographs of patients with rhinoplasty planning and volunteers (controls), n = 201, and by evaluating of anthropometric measurements taken from a line passing through the center of the face, until tragus, medial canthus, corner side wing margin, and oral commissure of each side, by statistical analysis (Z test and odds ratio).

Results: None of the patients or volunteers had completely symmetric values. Subjectively, 59% of patients were perceived as asymmetric, against 54% of volunteers. Objectively, more than 89% of respondents had asymmetrical measures. Patients had greater RLMTr (MidLine Tragus Ratio) asymmetry than volunteers, which was statistically significant.

Discussion/Conclusion: Facial asymmetries are very common in patients seeking rhinoplasty, and special attention should be paid to these aspects both for surgical planning and for counseling of patients.

Keywords

nose - anthropometry - rhinoplasty - facial asymmetry
 

  • References

  • 1 Chatrath P, De Cordova J, Nouranei R, Ahmed J, Saleh HA. Objective Assessment of Facial Asymmetry in Rhinoplasty patients. Arch Facial Plast Surg 2007; 9: 184-187
    CrossrefGoogle Scholar
  • 2 Pazos JAT, Galdanes ICS, Lopez MC, Matamala DAZ. Sexual dismorphism in the nose morphotype in adult chilean. Int. J. Morphol 2008; 26 (3) 537-542
    Google Scholar
  • 3 Patil SB, Kale SM, Jaiswal S, Khare N, Math M. The Average indian Female Nose. Aesthetic Plast Surg 2011; May 5
    Google Scholar
  • 4 Meyer-Marcotty P, Stellzig-Eisenhauer A, Bareis U, Hartman J, Kochel J. Three-dimensional perception of facial asymmetry. The European Journal of Orthodontics Advance Access . February, 2011
    Google Scholar
  • 5 Rhodes G, Proffitt F, Grady JM, Sumich A. Facial symmetry and the perception of beauty. Psychonomic Bulletin & Review 1998; 5 (4) 659-669
    CrossrefGoogle Scholar
  • 6 Zaidel DW, Cohen JA. The face, beauty, and symmetry: perceiveing asymmetry in beautiful faces. Intern. J. Neuroscience 2005; 115: 1165-1173
    CrossrefGoogle Scholar
  • 7 Farkas LG. Examination. In: Farkas LG, , editor. Anthopometry of the head and face. 2nd Ed. New York: Raven Press; 1994. . p. 3-56
    Google Scholar
  • 8 Doddi NM, Eccles R. The role of anthropometric measurements in nasal surgery and research: a systematic review. Clinical Otolaryngology 2010; 35: 277-283
    CrossrefGoogle Scholar
  • 9 Farkas LG, Katic MJ, Forrest CR. International anthropometric study of facial morphology in various ethnic groups/races. The Journal of craniofacial surgery . V. 16, n. 4 July 2005
    Google Scholar
  • 10 American Society of Plastic Surgeons (2007). Nose Surgery (Rhinoplasty) http://www.plasticsurgery.org/patients_consumers/procedures/Rhinoplasty.cfm
  • 11 Yao F, Lawson W, Westreich RW. Effect of Midfacial Asymetry on Nasal Axis Deviation. Arch Facial Plast Surg 2009; 11 (3) 157-164
    CrossrefGoogle Scholar
  • 12 Nouraei SAR, Pulido MA, Salch HA. Impact of Rhinoplasty on Objective Measurement and Psychophysical Appreciation of Facial Symmetry. Arch Facial Plast Surg 2009; 11 (3) 198-202
    CrossrefGoogle Scholar
  • 13 Reitzen SD, Morris LGT, Davis RE. Prevalence of Occult Nostril Asymmetry in the Oversized Nasal Tip. A Quantitative Photographic Analysis.Arch Facial Plast Surg 2011; 13 (5) 311-315
    Google Scholar
  • 14 Espinosa Reyes JA, Palacio M. Plástica Colômbia. La Punta Nasal http://www.plasticacolombia.com/articulos/anatomia_punta_nasal.php
    Google Scholar
  • 15 Hafezi F, Naghibzadeh B, Nouhi A, Yavari P. Asymmetric facial Growth and Deviated Nose. Ann Plast Surg 2010; 64: 47-51
    CrossrefGoogle Scholar
  • 16 Kim YM, Rha KS, Weissman JD, Hwang PH, Most SP. Correlation of Asymmetric Facial Growth with Deviated Nasal Septum. Laryngoscope 2011; 121: 1444-1148
    Google Scholar
  • 17 Naini FB, Moss JP, Gill DS. The enigma of facial beauty: Esthetics, proportions, deformity, and controvery. American Journal of Orthodontics and Dentofacial Orthopedics , September 2006; 277-281
    Google Scholar
  • 18 Freng A, Kvam E, Kramer J. Facial skeletal dimensions in patients with nasal septal deviation. Scand J Plast Reconstr Surg Hand Surg 1988; 22: 77-81
    CrossrefGoogle Scholar