Asian Ideals of the Nose: A Conjoint Analysis
Asian rhinoplasty remains one of the most challenging aesthetic procedures given the variation in nasal morphology and the lack of clear ideal aesthetic standards. Traditionally, the ideal norms for the aesthetic nose in Caucasians are applied to this subgroup, which leads to a majority of Asian rhinoplasty to involve structural dorsal augmentation with tip work to address the thick soft tissue and lack of nasal dorsum. The purpose of this study is to help establish aesthetic nasal ideals in Asian males and females overall, and to determine whether Asian nasal preferences may be influenced by the country and culture of residence.
Methods/Technique: s:
Photographic consent was obtained from two adult volunteers (male and female) of Asian ethnicity. Using the Vectra 3D imaging, profile views were taken and Vectra 3D software was used to generate variations displaying different levels and combinations of nasal dorsal radix (DR) position, nasal dorsal height (DH), nasal tip projection (TP), and nasal tip rotation (TR) for each gender. A survey was created consisting of demographic questions and a series of paired profile images with varying nasal parameter combinations asking participants to select which nose they preferred. The survey was then distributed through the crowdsourcing platform and screened for Asian raters. Conjoint statistical analysis was performed with R.
Results/Complications:
A total of 564 responses from Asian participants were collected. Demographics include: 199 born in the United States (U.S.), 365 born in Asia, 262 male, and 302 females with an average age of 34 years. Overall raters (male and female/US born and Asia born) preferred low NR, straight line DH (0mm), more TP (0.55), and less TR (90-95°) in the male subject and preferred low and normal NR, slight concave DH (-2mm), moderate TP (0.5), and more TR (100-105°) in the female subject. When evaluating the male subject, the male raters preferred low NR, straight line DH (0mm), more TP (0.50-0.55), less TR (90-95°). When evaluating the female subject, the female raters preferred normal and low NR, slightly concave DH (-2mm), moderate TP (0.5), and more TR (100-105°). Preferences (NR, DH, TP, and TR) for US born and Asian born raters were similar when rating the male subject. For females, US born raters preferred a normal NR and more TR of 100-110° compared to Asian born raters who preferred low NR and less TR (100-105°). These findings were statistically significant. Of note, ethnicities responded included Vietnamese, Chinese, Japanese, Korean.
Conclusion: s:
In conclusion, Asian aesthetic ideals may differ from those of Western preferences regardless of cultural influences. Additionally, our data suggest that although patients may be Asian, their country of birth and the culture in which they grew up influence their ideal nose. Therefore, it is imperative to take this into consideration during the consultation and operative planning for Asian patients seeking rhinoplasty. 