The Relationship Between Inter-canthal Distance and Implant Height in Asian Rhinoplasty

Huang CJ, Yen CI, Chang CS, Chen HC, Hsiao YC.

PubMed 35449422 Publisher (DOI)Free full text (PMC)

What this paper says

Reviewing 223 augmentation rhinoplasty patients, an implant taller than 3 mm significantly reduced the ratio between the distance separating the inner eye corners and the distance between the pupils, by an estimated 1 to 2 percent.

Overview

Augmentation rhinoplasty is among the three most common aesthetic operations in Asia, and composite silicone and polytetrafluoroethylene implants are used in both first time and repeat cases. This series analysed the operation's effect on the distance between the inner eye corners and compared implant height against that change. Records came from one centre and one surgeon, 2011 to 2017, with follow up through 2018.

Sections of note

Retrospective review of 223 patients; level of evidence V.
All received an I-shaped composite implant, with or without a component extending between the brows.
One hundred and sixty nine had implants taller than 3 mm and 15 had implants under 3 mm.
There was no significant distribution difference between groups in gender, age, type of surgery or indication.
The paired difference in the intercanthal to interpupillary ratio was significant in the group with implants over 3 mm, 1.04 percent plus or minus 0.11, P less than 0.005.
The normalized ratio is estimated to decrease by 1 to 2 percent.
The authors state candidates with a wide intercanthal distance should be told these figures beforehand.

What it means for a patient

Raising the bridge narrows the apparent distance between the inner eye corners, which can suit a patient whose eyes appear widely spaced.
The effect is small, around 1 to 2 percent, and required an implant taller than 3 mm.
Group sizes were uneven, with only 15 patients in the shorter implant group.
This used an artificial implant, so the finding may not transfer to cartilage augmentation.

Why this paper matters

Raising the nasal bridge changes the perceived geometry of the surrounding face, and that secondary effect is rarely quantified. This study measures it for one implant type. Whether patients perceive the change is not addressed.

Terms

Intercanthal distance: the distance between the inner corners of the two eyes.
Interpupillary distance: the distance between the centres of the two pupils.
Composite implant: an implant combining two materials, here silicone with a polytetrafluoroethylene surface.
Glabellar component: an extension of the implant into the area between the eyebrows.
Augmentation rhinoplasty: surgery that builds the nose up rather than reducing it.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

Abstract

Augmentation rhinoplasty is one of the top three anesthetic surgeries in Asia. I-shaped silicone-polytetrafluoroethylene composite implants are feasible for both primary and secondary augmentation rhinoplasty in Asians. This series was to analyze and evaluated the effect of the rhinoplasty to the intercanthal distance and to compare the height of the implantation with those differences in ICD before and after rhinoplasty. We retrospectively reviewed data from a single medical center via a single surgeon (Hsiao YC), at Chang Gung Memorial Hospital, between 2011 and 2017 with follow-up through 2018. There were 223 patients who received augmentation rhinoplasty with an I-shaped composite silicone-polytetrafluoroethylene ePTFE-lined silicone dorsal composite implant (Implantech, Ventura, CA) with a glabellar component (chimeric technique) or without a glabellar component. There were 169 patients with the height of the I-shaped composite implant over 3 mm, and 15 patients were less than 3 mm. There was no distribution significance between two groups even in gender, age, type of surgery, or indication. The paired difference of ICD/IPD ratio was statistically significant in the group with the height of composite implant over 3 mm (1.04% ± 0.11, p < 0.005, 95%). The normalized ratio of the ICD to IPD is estimated to decrease by 1-2%. Appropriate candidates including those with a wide ICD should be informed about these data during preoperative decision-making.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Abstract as indexed by PubMed; the article is open access (PubMed Central).