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Original Investigation |

Effect of Various Facial Angles and Measurements on the Ideal Position of the Nasal Tip in the Asian Patient Population

Ji Yun Choi, MD, PhD1; Jun Hee Park, MD, PhD1; Hedyeh Javidnia, MD2; Jonathan M. Sykes, MD2
[+] Author Affiliations
1Department of Otorhinolaryngology, Chosun University College of Medicine, Kwangju, Korea
2Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, University of California, Davis, Medical Center, Sacramento
JAMA Facial Plast Surg. 2013;15(6):417-421. doi:10.1001/jamafacial.2013.1244.
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Importance  Successful surgical correction of nasal tip position requires preoperative analysis. Perceived adequate nasal tip position depends on its relationship with other facial features. Nasal tip position can be affected by the subnasal contour, proportion of facial height, and relative facial size and shape. The relation of these factors to the nasolabial angle may not be as important as previously believed.

Objective  To investigate and compare the factors affecting the ideal location of the tip of the nose in Asian patients using standard photographic measurements.

Design  We analyzed measurements of profile photographs and compared different factors that affect nasal tip location, including the nasofrontal, nasolabial, nasomental, and Legan angles and the ratios of the dorsal height to tip projection, the radix height to tip projection, the glabella to subnasale, and the subnasale to mentum.

Setting and Participants  One hundred men, 100 women, 20 to 40 years old, seen for rhinoplasty at the Department of Otorhinolaryngology, Chosun University College of Medicine.

Main Outcome and Measures  Contribution of different facial measurements to the ideal nasal tip position.

Results  Nasolabial and nasomental angles exerted a statistically significant effect on ideal nasal tip position, whereas the Legane angle, the ratio of midface to lower face, and the ratio of nasal length to lower face did not show significant effects on nasal tip position.

Conclusions and Relevance  The nasolabial and nasomental angles have important effects on ideal nasal tip position and should be considered together during preoperative evaluation of the location of the nasal tip. Concurrent genioplasty should optimize rhinoplasty outcomes in appropriately selected patients.

Level of Evidence  NA.

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Figure 1.
Image Showing Landmarks and Measurements

Lateral diagrams show different landmarks, including dorsal height (DH), glabella (G), mentum (Me), nasion (N), nasofrontal angle (NFA), nasolabial angle (NLA), nasomental angle (NMA), pogonion (Po), radix height (RH), subnasale (Sn), and tip projection (TP).

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Figure 2.
Images Showing Different Tip Locations

A, Overrotated tip position in a 23-year-old woman. B, Ideal tip position in a 26-year-old man. C, Derotated tip position in a 19-year-old woman. Left side shows the frontal view; right side, the profile view.

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