A nose that is considered ‘ideal’ is one which is harmonious with the other favorable facial features. Our perception of beauty helps define what makes an ideal shape for a female or male nose. There is also always a bit of an artistic element to this, thus the ideal cannot always be boiled down to simple lines and numbers alone. However, artists and plastic surgeons alike can devise some guidelines or proportions that represent the aesthetic ideal by studying beauty and faces that are universally thought to be beautiful.
Artists have long made studies of beauty and aesthetic proportions and, today, facial plastic surgeons must similarly understand beauty in order to make changes that can enhance their patients’ beauty.
Of course, much to your relief no doubt, some lines, numbers and measurements do exist. Shown below are the lines and measurements that facial plastic surgeons use as a guideline to the aesthetic ideal as reprinted with permission from TheRhinoplasty Dissection Manual by Drs. Becker and Toriumi.
Major surface reference points
Major surface reference points are shown in the first two figures below. These will help you to understand the subsequent material on this article.
SURFACE ANGLES, PLANES & MEASUREMENTS
The “ideal” face, as shown below, can be divided into equal horizontal thirds:
Upper third: trichion to glabella
Middle third: glabella to subnasale
Lower third: subnasale to menton.
The “ideal” face, as shown below, can also be divided into equal vertical fifths:
Five equally divided vertical segments of the face.
The face must be in a standard position for reproducibility of measurements for the angles that follow. Some of these angles may change if the patient’s head is tilted down or up. The standard facial position used by most facial plastic surgeons is defined by the Frankfurt plane.
Plane defined by a line from the most superior point of auditory canal to most inferior point of infraorbital rim.
The naso-frontal angle is the angle formed where the nose and forehead meet. The nose can appear relatively short if an overly sharp naso-frontal angle divides the forehead from the nose, whereas the nose may appear longer with an overly shallow angle.
Angle defined by glabella-to-nasion line intersecting with nasion- to-tip line. Normal 115-130 degrees (within this range, more obtuse angle more favorable in females, more acute in males).
Forward protrusion of the nasal tip from the face (like Pinocchio) is known as nasal projection. Listed here are two reliable measurements of nasal projection:
Forward protrusion of nasal tip from face.
Goode’s method – A line drawn through the alar crease, perpendicular to the Frankfurt plane. The length of a horizontal line drawn from the nasal tip to the alar line (alar point-to-nasal tip line) divided by the length of the nasion-to-nasal tip line. Normal 0.55-0.60.
Crumley’s method – The nose with normal projection forms a “3-4-5 triangle.” ie., alar point-to-nasal tip line (3), alar point-to-nasion line (4), nasion-to-nasal tip line (5).
The nasofacial angle is one way of assessing the projection of the nose from the face. The nose is likely too far from the face if the nasofacial angle is large, or the opposite may be true if the nasofacial angle is too short. You can simply look at the nose in profile in order to get an impression about projection, but these measurements add ‘science’ to the art of facial analysis.
Angle defined by glabella-to-pogonion line intersecting with nasion-to-tip line. Normal 30-40 degrees. [PEARL: “Normal” projection with a 3-4-5 triangle described by Crumley (see above) gives a nasofacial angle of 36 degrees.]
The nose can often appear larger when set against a small chin. A surgeon may analyze the role that adjustments to the chin may play in achieving facial harmony by paying attention to the nasomental angle (in conjunction with other measurements).
Angle defined by nasion-to-tip line intersecting with tip-to-pogonion line. Normal: 120-132 degrees.
The lips should also be assessed by the surgeon to see whether they are in proper relationship to other facial parts.
Relationship of lips to nasomental line
Upper lip 4mm behind, lower lip 2 mm behind line from nasaltip-to-menton.
One desirable feature is a sharp mentocervical angle.
Angle defined by glabella-to-pogonion line intersecting with menton-to-cervical point line.
An acute nasolabial angle can lead to a droopy nose, whereas an obtuse nasolabial angle can lead to a short or ‘uplifted’ appearance.
Angle defined by columellar point-to-subnasale line intercepting with subnasale-to-labrale superius line; normal 90-120 degrees (within this range, more obtuse angle more favorable in females, more acute in males).
Too much or too little ‘columellar show’ is, from the side, undesirable. As shown here, there are a total of nine possible configurations for the alar-columellar relationship as there are three possible configurations for the columella (normal, hanging, or retracted) and another three possible configurations for the nostril rim or ala (normal, hanging, or retracted). One of these nine configurations must be diagnosed by the surgeon.