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Nasal Aesthetics- A Cross Cultural Analysis
Niclas Broer, MD1, Angie Morillas, M.D.2, Samuel Buonocore, M.D.3, Neil Tanna, M.D.1, Jong Lio, M.D.4, John Persing, M.D.3.
1New York University, New York, NY, USA, 2Clinica Morillas, Lima, Peru, 3Yale University, New Haven, CT, USA, 4Boston University, Boston, MA, USA.


Purpose: Plastic surgeons may approach nasal aesthetic evaluation with the aid of seemingly objective linear and angular measurements. Ideal proportions and measurements that define an attractive nose, which are suggested in the literature, might not be applied on a cross-cultural basis. Given the variable anatomy and controversies in nasal aesthetics, the authors aimed to investigate to what degree these difference may be influenced by cultural and ethnic background.
Methods: Computerized images were generated to enable a user to alter the nasal width, root, tip, dorsum, and projection of the lips and chin. These were sent to Plastic Surgeons and general population in 50 different nations. Respondents were also asked to provide demographic information including gender, age, country of residence, ethnic background, and personal previous surgical history of rhinoplasty.
Results: A total of 1,226 responses were collected, including 720 plastic surgeons and 506 people from the general public. Latin American plastic surgeons prefer a smaller, narrower nose with a more projecting tip along with prominent lips and chins compared to North American and Western European surgeons. Similar trends hold true when comparing general populations from these groups, the main difference being that the general people from North America seem to prefer more projecting nasal roots. When comparing plastic surgeons to the general population, we were able to find significant differences with surgeons favoring a wider nasal root and apex and more projected nasal roots, tips, lips and chins.
Conclusions: There is no single set of parameters to define the ideal aesthetics of the nose. Cultural and ethnic factors influence aesthetic perceptions of patients and treating surgeons. It is therefore of utmost importance to consider these preferences when evaluating and treating patients with different ethnic backgrounds.


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