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Redefining the Ideal Nasolabial Angle: Part 2. Expert Analysis

Brown, Matthew M.D.; Guyuron, Bahman M.D.

Plastic and Reconstructive Surgery: August 2013 - Volume 132 - Issue 2 - p 221e–225e
doi: 10.1097/PRS.0b013e3182958b40
Cosmetic: Original Articles

Background: The nasolabial angle is the angle between the line drawn through the midpoint of the nostril aperture and a line drawn perpendicular to the Frankfort horizontal plane while intersecting subnasale. Previous analysis by the authors’ department yielded closer ranges between men and women of 96 and 98 degrees, respectively. This study further refines the ideal nasolabial angle using the opinions of a highly select group of seasoned rhinoplasty surgeons.

Methods: Lateral photographs of 10 men and 10 women of various ethnic backgrounds who had undergone a rhinoplasty were studied. The photographs were digitally altered to various angles. Members of the Rhinoplasty Society evaluated the photographs. Raters selected their top choice based on the most aesthetically pleasing nasolabial angle. In addition, they were asked to estimate the angle of the photograph they selected as most ideal. Data analysis was performed using the distribution of means of ideal nasolabial angle values.

Results: Based on the 95 percent confidence interval for the ideal means, the ideal nasolabial angle would be 93.9 to 97.3 degrees for male subjects and 96.8 to 100.2 degrees for female subjects. Twenty-four raters provided angle estimations; the mean ± SD angle was 2.76 ± 2.49 degrees larger than the actual angle.

Conclusions: The authors’ results were consistent with their previous findings, indicating a much closer range of nasolabial angle between men and women than previously reported in the literature. The overestimation in the nasolabial angle versus actual may be one factor accounting for the difference between the authors’ findings and the previously accepted standards.

Cleveland, Ohio

From the Department of Plastic Surgery, Case Western Reserve University.

Received for publication October 18, 2012; accepted January 16, 2013.

Disclosure: The authors have no conflict of interest to disclose.

Bahman Guyuron, M.D., 29017 Cedar Road, Cleveland, Ohio 44124,

©2013American Society of Plastic Surgeons