Nasal tip alterations and their impact on perceived aesthetics and self-esteem: an eye-tracking and questionnaire-based study

Background The impact of nasal aesthetics on facial and smile attractiveness, as well as its influence on social perceptions, has not been adequately evaluated or understood. This study used eye-tracking and questionnaire to analyze people's visual perceptions in smiling and non-smiling patients with changes in the tip of the nose. Methods Two profile images were used, one smiling and non-smiling. The photos were edited in Photoshop to adjust the nose. The raters received guidance on using the eye-tracking hardware and then answered a questionnaire about psychosocial perceptions. Results For the happiness variable, the images with a smiling model were rated statistically differently (p < 0.001). Regarding self-esteem, differences were perceived when comparing the smiling and non-smiling images with a medium steep nose, also, there was a difference between smiling images at less and medium steep nose versus compared to smiling steeper nose (p < 0.001). Conclusions Images featuring a smile were perceived as happier than those without a smile. A more pronounced tip droop when smiling correlated with the lowest self-esteem ratings. Eye-tracking results consistently focused on the eyes and smile across all images.Level of Evidence: Not gradable. Conclusions Images featuring a smile were perceived as happier than those without a smile. A more pronounced tip droop when smiling correlated with the lowest self-esteem ratings. Eye-tracking results consistently focused on the eyes and smile across all images.Level of Evidence: Not gradable.