The Value of Averageness in Aesthetic Rhinoplasty: Humans Like Average Noses

Overview

What makes a nose look attractive has resisted definition. Research on faces generally has found that averaged composites are rated attractive. This study tested whether that holds for the nose specifically, and whether measurable deviation from the average shape predicts lower ratings.

Sections of note

• Photographic series of the face were obtained from 80 Caucasian female volunteers aged 25 to 40.
• A mathematically averaged composite image was created from the first 40 volunteers.
• 41 panel members judged the attractiveness of each original nose and the composite on a 5-point scale from 1, very ugly, to 5, very pretty.
• Deviation of nasal shape from average was calculated by principal components analysis of standardized nasal landmarks.
• 21 of the 41 respondents were male, 51 percent; mean respondent age 35.3 years SD 15.6.
• The composite was rated significantly higher than the distribution of the 80 originals, 4.2 versus 2.8, t 31.24, P below 0.001.
• Ratings of individual noses correlated negatively with deviation from average shape, r -0.40, n 80, P below 0.001.

What it means for a patient

• An averaged nose was rated more attractive than almost any individual nose in this sample.
• The correlation of -0.40 is moderate, so distance from average explains part but not most of the variation in ratings.
• The authors suggest measuring deviation from average before and after surgery as an objective outcome measure.
• Limits: 80 Caucasian women aged 25 to 40 and 41 raters, so the finding is specific to that population.

Why this paper matters

Rhinoplasty aesthetics rest on proportion rules of uncertain origin, and this offers a mathematically defined alternative target. It also proposes a measurable outcome that does not depend on rater opinion. Whether patients themselves want an average nose, rather than a distinctive one, is a separate question.

Terms

• Averageness: How closely a shape matches the mathematical average of a population.
• Composite image: An image created by mathematically averaging multiple faces.
• Principal components analysis: A statistical method that reduces shape data to its main dimensions of variation.
• Nasal landmark: A defined anatomical point used for measurement.
• Likert scale: A response scale with ordered options, here five points.