The Impact of Age on Anthropometric Changes Following Rhinoplasty

Overview

Rhinoplasty results remain hard to predict, and the authors asked whether the patient's age is one of the factors. They retrospectively reviewed charts of rhinoplasty patients, divided them into decades of age, and measured standardized photographs with Rhinobase software at 3 months and again at 2 years after surgery to see how much the result drifted.

Sections of note

• Design: retrospective chart review with photographic measurement.
• 243 patients, median age 37.1 years, 68 men and 175 women.
• Age groups: 19 to 29 with 80 patients, 30 to 39 with 71, 40 to 49 with 48, and 50 to 61 with 44.
• The largest change was in the oldest group, in midfacial height, at 5.5 millimeters, p less than 0.001.
• Nasal length, tip projection and midfacial height all changed significantly in both the 40 to 49 and 50 to 61 groups.
• Stated conclusion: unfavourable age related changes in the long term after rhinoplasty can occur in patients above 40.

What it means for a patient

• The result seen at three months is not the final result, and in older patients it shifts more over the following two years.
• The changes measured, shorter nose, dropped tip and altered midface height, are the same directions in which faces age generally, so some of this may reflect facial aging rather than the surgery.
• Patients over 40 may reasonably discuss with a surgeon whether to build in extra support for tip projection.
• Limits: retrospective, no control group of non-operated people of the same ages, and photographic measurement only with no satisfaction or breathing data.

Why this paper matters

Rhinoplasty outcomes are usually reported at a single time point, which hides drift. Measuring the same patients at 3 months and 2 years and stratifying by age separates immediate result from durability. Whether the drift comes from graft settling, tissue laxity or normal aging is not distinguished here.

Terms

• Anthropometric measurement: measurement of physical dimensions and angles of the body.
• Tip projection: how far the nasal tip stands out from the plane of the face.
• Nasal length: the distance from the root of the nose to the tip.
• Midfacial height: the vertical distance across the middle third of the face.
• Wilcoxon test: a statistical test comparing paired measurements from the same subjects.