Facial Plast Surg 2016; 32(04): 444-451
DOI: 10.1055/s-0036-1584234
Rapid Communication
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Nasofrontal Angle and Nasal Dorsal Aesthetics: A Quantitative Investigation of Idealized and Normative Values

Farhad B. Naini
1   Department of Orthodontics, Maxillofacial Unit, St. George's Hospital and Medical School, London, United Kingdom
,
Martyn T. Cobourne
2   Department of Orthodontics, King's College London, London, United Kingdom
,
Umberto Garagiola
3   Department of Orthodontics, Universita Degli Studi di Milano, Milan, Lombardy, Italy
,
Fraser McDonald
2   Department of Orthodontics, King's College London, London, United Kingdom
,
David Wertheim
4   Faculty of Science, Kingston University, Kingston upon Thames, London, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
05 August 2016 (online)

Abstract

This study is a quantitative evaluation of the influence of the lower component of the nasofrontal angle on perceived attractiveness and threshold values of desire for rhinoplasty. The nasofrontal angle of an idealized silhouette male Caucasian profile image was altered incrementally between 106 and 148 degrees. Images were rated on a Likert scale by pretreatment patients (n = 75), laypeople (n = 75), and clinicians (n = 35). The results demonstrated that a nasofrontal angle of approximately 130 degrees is ideal, corresponding to a lower component of 60 degrees, with a range of 127 to 142 degrees deemed acceptable. Angles above or below this range are perceived as unattractive, and anything outside the range of 118 to 145 degrees is deemed very unattractive. Reduced nasofrontal angles, simulating a nasal hump deformity, of less than 115 degrees were deemed the least attractive. In terms of threshold values of desire for surgery, for all groups a threshold value of 148 degrees indicated a preference for surgery: for patients, the threshold value was 121 degrees or less; for lay people, the threshold value was 124 degrees or less; and similarly for clinicians, the threshold value was 118 degrees or less. Clinicians were the least critical, and patients appeared to be less critical than lay people. This stresses the importance of using patients as observers, as well as laypeople and clinicians, in facial attractiveness research. From the results of this study, it is recommended that in rhinoplasty planning, the range of normal variability of the nasofrontal angle, in terms of observer acceptance, is taken into account as well as the threshold values of desire for surgery.

 
  • References

  • 1 Rohrich RJ, Muzaffar AR, Oneal RM. Preferred anatomic terms for rhinoplasty. In: Gunter JP, Rohrich RJ, Adams WP, eds. Dallas Rhinoplasty: Nasal Surgery by the Master. St. Louis, MO: Quality Medical Publishing; 2002
  • 2 Pearson DC, Adamson PA. The ideal nasal profile: rhinoplasty patients vs the general public. Arch Facial Plast Surg 2004; 6 (4) 257-262
  • 3 Naini FB. Facial Aesthetics: Concepts and Clinical Diagnosis. Oxford: Wiley-Blackwell; 2011
  • 4 Ioi H, Nakata S, Nakasima A, Counts A. Effect of facial convexity on antero-posterior lip positions of the most favored Japanese facial profiles. Angle Orthod 2005; 75 (3) 326-332
  • 5 Naini FB, Donaldson ANA, McDonald F, Cobourne MT. Assessing the influence of chin prominence on perceived attractiveness in the orthognathic patient, clinician and layperson. Int J Oral Maxillofac Surg 2012; 41 (7) 839-846
  • 6 Farkas LG, Kolar JC, Munro IR. Geography of the nose: a morphometric study. Aesthetic Plast Surg 1986; 10 (4) 191-223
  • 7 Farkas LG, Kolar JC. Anthropometrics and art in the aesthetics of women's faces. Clin Plast Surg 1987; 14 (4) 599-616
  • 8 Farkas LG. Anthropometry of the attractive North American Caucasian face. In: Farkas LG, ed. Anthropometry of the Head and Face. 2nd ed. New York: Raven Press; 1994
  • 9 Langlois JH, Kalakanis L, Rubenstein AJ, Larson A, Hallam M, Smoot M. Maxims or myths of beauty? A meta-analytic and theoretical review. Psychol Bull 2000; 126 (3) 390-423
  • 10 Naini FB, Cobourne MT, McDonald F, Donaldson AN. The influence of craniofacial to standing height proportion on perceived attractiveness. Int J Oral Maxillofac Surg 2008; 37 (10) 877-885
  • 11 Naini FB. The origin of the zero-degree meridian used in facial aesthetic analysis. Aesthet Surg J 2014; 34 (7) NP72-NP73
  • 12 Naini FB. Leonardo da Vinci's aesthetic analysis of nasal tip prominence. Arch Facial Plast Surg 2012; 14 (6) 463-464
  • 13 Powell N, Humphreys B. Proportions of the Aesthetic Face. New York: Thieme; 1984
  • 14 Orten SS, Hilger PA. Facial analysis of the rhinoplasty patient. In: Papel ID, et al. eds. Facial Plastic and Reconstructive Surgery, 2nd ed. New York: Thieme; 2002
  • 15 Papel ID, Capone RB. Facial proportions and esthetic ideals. In: Behrbohm H, Tardy Jr ME, eds. Essentials of Septorhinoplasty. New York: Thieme; 2004
  • 16 Lehocky BE. Anthropometry and cephalometric facial analysis. In: Mathes SJ, ed. Plastic Surgery, 2nd ed., Vol. II. Philadelphia, PA: Saunders Elsevier; 2006
  • 17 Sheen JH. Aesthetic Rhinoplasty. Vol. 1. St. Louis, MO: CV Mosby; 1978
  • 18 Rees TD. Aesthetic Plastic Surgery. Vol. 1. Philadelphia, PA: WB Saunders; 1980