COSMETIC Gender and Nasal Shape: Measures for Rhinoplasty

Kiel, Germany; Gold Coast, Queensland, and St. Leonards, New South Wales, Australia Background: Gender-specific nasal shapes are recommended for rhinoplasty. This study was conducted to clarify whether there truly are gender-related differences and to determine optimal nasal shapes in a Caucasian population. Methods: The authors created female and male composite photographs of “average” (n 128 each), “optimal” (n 16 each), and “most unpleasant” (n 8 each) noses stratified on the basis of each photographed subject’s (n 311) own evaluation of the attractiveness of her or his nose, using a visual analogue scale. These composites were also assessed by 308 independent judges. Results: Optimal female noses showed a horizontally and vertically lower nasion and were concave to straight in profile as compared with optimal male noses, which had a vertically and horizontally higher nasion and a straight profile. A supratip break was not found in any of the composites. At least half of the judges rated average and optimal male composite noses as female. A significant majority mistook the composite of the most unpleasant female noses as male (frontal view, 62.0 percent; lateral view, 72.4 percent; p 0.001). Optimal and average female and male noses were found to be independently significantly more attractive than the most unpleasant ones (p 0.001, n 308 judges). Women and men with a straight or concave profile were significantly (p 0.017 and p 0.006, respectively) more satisfied with the appearance of their nose than those with nasal humps. Conclusions: Gender-related differences in nasal shape appear to be subtle, with nasion position being one of the main factors. A nasal hump and a supratip break are not desirable. (Plast. Reconstr. Surg. 121: 629, 2008.)