The surgeon and patient use the preoperative consultations to develop
an agreement regarding the aesthetic goals of a rhinoplasty. This stud
y was designed to evaluate whether people do agree on what makes a nos
e attractive. Computerized video-imaging technology was used to create
nine case studies. The graphics software permitted precise modificati
on to either tip projection, tip rotation, or size of the dorsal hump.
Only one parameter was altered in each case. Two hundred fifty judges
were asked to identify the most attractive image in each case study.
Significant trends were observed in each case, but every image receive
d the preference of some judges. Most judges preferred midrange values
in eight of nine cases, but overrotation of the tip was preferred to
tip droop, overremoval of the dorsal hump was preferred to underremova
l, and overprojection of the tip was preferred to underprojection. The
discrepancy in what constitutes an aesthetic nose reinforces the need
for the surgeon to clearly understand the patient's specific requests
rather than to aim to produce a ''standard nose.''