What makes a nose attractive? Many patients considering rhinoplasty at our Austin plastic surgery practice ask themselves this question. The goal of rhinoplasty is to create a nose that blends seamlessly with the other facial features directing attention of the observer to the patient’s eyes and lips. At The Piazza Center, Dr. Marcelo Antunes is an expert at creating an attractive nose that suits the patient’s face.
Throughout the ages, scientists and scholars have argued over what constitutes beauty and the ideal facial and nasal proportions. These challenges date back to Egyptians, Greeks and Renaissance artists. Over the years, angles in our face were determined to be “ideal” and have defined, for example, how turned up the nose should be or how far the tip of the nose should project from the face.
Traditional Measurements in Rhinoplasty
Nose and Face Proportions
The nose and face are always evaluated and measured from the frontal and profile views. Traditionally, the frontal view of the face can be divided into horizontal thirds and vertical fifths (see figure below). These guidelines give a general sense of the proportion of the ideal in respect to other facial features. The nose would be center block of the face.
Frontal View: Nasal contour
On the frontal view, the symmetry of the nose can be evaluated. A vertical line measured from the center of the root of the nose to the chin determines the presence of any asymmetry and crookedness on the nasal dorsum. A gentle curve should extend from the medial portion of the eyebrow towards the tip of the nose – the brow-tip line.
The width of the alar base and the bony sidewall are also evaluated on the frontal view. The width of the alar base should be about the same width as the space between both eyes – usually within 2-mm. The width of the sidewall should be about ¾ of the width of the alar base.
On frontal view, the nasal tip has two tip-defining points that represent light reflection from the skin overlying the domes of the nasal tip. The columella (skin between nostrils) is seen to hang just inferior to the alar rims, giving the lower part of the nasal tip a gentle “gull in flight” appearance on frontal view. Nostril show should not be excessive indicating the nasal tip is overly rotated.
These “guidelines” and “proper dimensions” on the frontal view must be evaluated always taking into consideration the entire face’s proportions. For example, if the face is long and narrow, narrowing the alar base may cause the nose to appear excessively long. Recognition of these nuances and the ability to modify the surgical plan will differentiate the dedicated rhinoplasty surgeon from the average surgeon.
Profile View: Nasal dorsum & nasal tip rotation – projection
On the profile view, the nasal dorsum transitions from the forehead with a slight depression that will form the nasofrontal angle. The nose should start superiorly at the level of the upper eyelid. Typically the dorsum should be straight and about 1-2mm less projected than the nasal tip. That is, if a line would be drawn from the nasal tip to the deep portion of the nasofrontal angle, the dorsum should be slightly behind that line. Also, on the profile view, the nostrils should be partially seen. The space between the edge of the alar rim and the edge of the columella is called “columellar show.” This space should ideally be between 2-4mm (see below).
Nasal tip rotation is the angle between the face and nose determined on the profile view. In women, the ideal angle would be about 95 to 115 degrees; and in men, about 90 to 95 degrees.
Other things to consider when establishing an ideal rotation, is the patient’s height – shorter patients can have more rotated noses when compared to taller patients.
Nasal tip projection is how far the tip projects from the face. There are a few formulas to determine that. One of the most common ways to determine the projection of the nasal tip is to use the 3-4-5 rule. In this rule, the nose is a triangle that has a 3 at the base, 4 at the height and 5 along the dorsum. With this rule, the projection of the nose would be 60% of the length of the dorsum.
The Ideal Nose? It’s the one that fits your face.
Despite this classic and traditional set of principles, beauty remains an elusive concept. Especially in such a globalized world where individual tastes, cultural influences, modern style and the media (and social media) can all overshadow the original formula.
So, what makes a beautiful nose? What makes it attractive? Is there a perfect nose? These are trick questions.
Beauty encompasses not only the proportions and the angles I mentioned, but also, and most importantly, harmony and balance between the facial features and how everything fits together. The Greeks and Egyptians had their perfect nose, as did the Romans, the Koreans and Turks. Our society too, is no exception. We have our own thoughts on what makes a beautiful nose, both for men and for women. In traditional rhinoplasty surgery, the simplest answer was that a beautiful nose is straight, symmetrical and relatively small. However, a quick look at some beauty icons can illustrate that there is more to beauty than math. Gisele Bundchen and Kate Beckinsale have two very different noses, but both noses are really beautiful and complement their facial features.
Closely related to the nose, an important, and often overlooked feature, is the chin. Like the nose, the chin should fit with the other facial proportions. Naturally, it should be delicate and round in women. In men, the chin is wider, forming a square shape. A small chin can sometimes create the impression of a bigger nose. And a bigger chin can make a beautiful nose look unattractive. This goes to show that balance and harmony is more important than any mathematical formula when taken isolated.
Nonetheless, surgeons that dedicate themselves to rhinoplasty avoid the “one-size-fits-all” approach. Youthfulness and attractiveness are still a common goal, but the latest trends highlight the patient preference, delicacy and the patient’s overall facial features, and very importantly, the patient’s ethnicity. The surgeon cannot rely solely on classic aesthetic standards. Today we understand that there are many types of attractive noses, some created by birth, and others by rhinoplasty. And the smallest change can produce huge perceptual impacts; rhinoplasty is always understood to be a surgery of millimeters.
And always remember: the perfect nose is the one that fits your face.