The ideal nasolabial angle in rhinoplasty: a preference analysis of the general population

Overview

Textbooks give the ideal nasolabial angle as anywhere from 90 to 120 degrees. The authors asked whether the general public, rather than surgeons, has a narrower preference, and whether age, sex, race and education shift it. Volunteers ranked images of noses at set angles from most to least attractive.

Sections of note

• Prospective recruitment of 98 random volunteers from the general population.
• Each ranked three female angles (100, 105 and 110 degrees) and three male angles (90, 100 and 105 degrees) as most, moderately or least aesthetic.
• Analysis used the Pearson chi-square test and t test.
• The most aesthetic female angle was 104.9 plus or minus 4.0 degrees; the male was 97.0 plus or minus 6.3 degrees.
• Male respondents, younger volunteers, Native Americans and African Americans preferred a more acute male angle of 90 degrees.
• Female respondents, those over 50, college graduates, those with a previous rhinoplasty, and Caucasian and Asian respondents preferred a more obtuse male angle.
• Age, sex, race, education and prior rhinoplasty predicted preference for the male angle but not the female angle.

What it means for a patient

• Public preference clusters in a much narrower band than the textbook range, roughly 101 to 109 degrees for women and 91 to 103 degrees for men.
• Preference for the male nose varied by who was asked, so there is less agreement about male noses than female ones.
• Only three angles per sex were offered, so the study measures choice between those options rather than a free preference.
• Judgments came from images, not from real faces in motion, and the sample was 98 people.

Why this paper matters

Surgical targets are usually set from surgeon convention, and this study tests them against the audience patients actually face. Unanswered is whether these preferences transfer across countries or predict patient satisfaction after surgery.

Terms

• Nasolabial angle: the angle between the base of the nose and the upper lip in side view.
• Acute angle: a sharper angle, giving a more downward pointing tip.
• Obtuse angle: a wider angle, giving a more upturned tip.
• Prospective study: one that recruits and collects data going forward in time.
• Anthropometric: based on measurement of the human body.