A comparison of aesthetic proportions between the healthy Caucasian nose and the aesthetic ideal

Background and objective: The aim of septorhinciplasty is to create a nose that is aesthetically pleasing to the patient and to maintain nasal function. Although a small number of population cohort studies have been performed on the ethnic nose, little is known of the aesthetics standards of nasal proportions in the general Caucasian population. The aim of this study was to establish parameters of the average nose in the healthy population and to compare them with those of the aesthetic ideals. Material and methods: Ethical approval was obtained to recruit a cohort of staff and students from the medical school. Two photographs were taken: anterior and right Lateral. The following measurements were made: intercanthal width, alar width, length of the nose (nasion-pronasion length), naso-labial angle, nasal tip projection, naso-facial angle and naso-frontal angle. These parameters were compared with published aesthetic ideals. Results and conclusion: Aesthetic nasal proportions of 50 healthy Caucasians were examined from a cohort of 57 volunteers. Results showed that the average nose did not conform to neo-classical facial canons. The alar width (average 3.6 cm)was significantly wider than the intercanthal width (average 3.0 cm, p<0.05). The nasal width-length ratio was also greater suggesting that the cohort average was shorter and wider than the aesthetic ideal. The Baum ratio was 2.5: 1, indicating that the average nasal tip was more projected that the aesthetic ideal (2.8: 1). The naso-frontal and naso-facial angles are both more obtuse, and in profile the average nose overall appeared more prominent, as a result of the reduced forehead projection. The only parameter where there appeared to be consistency between the average and the ideal nose was the naso-labial angle. This study shows that many aesthetic parameters from a cohort of healthy subjects differ from the widely used aesthetic standards. Rhinoplasty surgeons should, therefore, give thought to the frame of reference used when discussing aesthetic objectives with their patients. (C) 2005 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved.