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Original Investigation
June 20, 2019

Social Perception of the Nasal Dorsal Contour in Male Rhinoplasty

Author Affiliations
  • 1Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head & Neck Surgery, Stanford University School of Medicine, Stanford, California
  • 2Department of Physical and Rehabilitation Medicine, Turku University Hospital, University of Turku, Turku, Finland
JAMA Facial Plast Surg. 2019;21(5):419-425. doi:10.1001/jamafacial.2019.0321
Key Points

Question  What are the social perception consequences of male rhinoplasty when specific modifications of the male nasal dorsal contour are carried out?

Findings  In this web-based survey study of 503 participants featuring 12 computer-simulated nasal dorsal contours of a male volunteer, the man in the photograph featuring the nose with the ski slope dorsal shape, nasofrontal angle of 130°, and nasolabial angle of 97° was deemed most attractive; this profile was also among the most frequently selected for other positive characteristics. Subset analyses also revealed statistically significant dorsal contour preferences by observers’ gender and age.

Meaning  This study’s results may potentially better inform rhinoplasty surgeons and their male patients on how changes to the nasal dorsal contour may not only affect the overall perception of a man’s social attributes, but also perception by observers’ sociodemographics.

Abstract

Importance  The social perception of nasal dorsal modification for male rhinoplasty is poorly understood.

Objective  To investigate the association of modifying the male nasal dorsum with the perception of such social attributes as youth, approachability, healthiness, masculinity/femininity, intelligence, successfulness, and leadership.

Design, Setting, and Participants  Using computer simulation software, 12 images with varied combinations of the nasal dorsal shape, nasofrontal angle (NFA), and nasolabial angle (NLA) were generated from a photograph of a male volunteer’s face in profile. These photographs were then sent to participants at a university clinic who were English-speaking adult internet users who were masked to the purpose of the study, which asked them to value different social attributes regarding the face in the photograph in a 16-question survey. The study was conducted in September 2018 and the data were analyzed thereafter until March 2019.

Exposures  Twelve photographs embedded in a 16-question survey.

Main Outcomes and Measures  Population proportions of responses and χ2 test and graphical analysis based on 95% confidence intervals.

Results  Of 503 respondents (survey provision rate, 100%), 412 (81.9%) were women, 386 (76.7%) were white, 32 (6.4%) were Hispanic or Latinx, 63 (12.5%) were black/African American, 10 (2.0%) were Asian/Pacific Islander, and the median age was 46 years (interquartile range, 32-61 years). The man with ski slope–shaped nose with an NFA of 130° and NLA of 97° was often associated with frequently perceived positive characteristics; specifically, he was judged to be the most attractive (95% CI, 18%-26%; P < .001). Participants also often associated superlative youth (95% CI, 15%-24%; P < .001), approachability (95% CI, 13%-20%; P = .002), and femininity (95% CI, 14%-22%; P < .001) with dorsal contours that did not feature a dorsal hump. The man with a dorsal hump–shaped nose with an NFA of 140° and NLA of 105° was associated by the highest proportion of participants with being the oldest (95% CI, 35%-44%; P < .001), least approachable (95% CI, 27%-35%; P < .001), least attractive (95% CI, 37%-42%; P < .001), and least healthy (95% CI, 26%-34%; P < .001). Subset analyses also revealed statistically significant dorsal contour preferences by observers’ age, gender, and race/ethnicity.

Conclusions and Relevance  A reduced dorsal slope combined with more acute NFAs and NLAs was associated with positively perceived social attributes. The results may be of interest to rhinoplasty surgeons and their male patients when planning changes to the nasal dorsal contour.

Level of Evidence  NA.

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