Health Questions and Answers

How does one “analyze” the nose preoperatively?

  • Quality of the “fabric” of the nose: such factors as skin quality and thickness, sebaceous prominence, and skin shading.
  • Comparison with classic perceptions of appropriate facial proportion: the nose should be about one third of facial height and about one fifth of facial width. If it is does not meet these criteria, is the “fit” of the nose to the face still maintained?
  • Frontal examination: nasal alignment and width, including whether the nose appears straight, twisted, C-shaped, or angulated. Does the nasal tip appear to be narrow, bulbous, ptotic, or asymmetric?
  • Lateral examination: the nasal profile, including the presence of a dorsal hump or saddle deformity. How does nasal length compare with width? Do the nasolabial, nasofacial, and nasofrontal angles, as well as the degree of projection of mentum, match the nasal architecture?
  • Nasal base and triangular or trapezoidal nature of the nasal architecture: Is the expected 2:1 columella-to-lobule ratio present? Is the alar base width about the same as the intercanthal distance?
  • Projection of the nasal tip compared with the projection of the mentum.

Reference:
Tardy ME Jr, Dayan S, Hecht D: Preoperative rhinoplasty: Evaluation and analysis. Otolaryngol Clin North Am 35:1-27, 2002.

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