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Alshawaf SM, McGuire C, ElAbd R, Fakih-Gomez N, Williams J, AlYouha S, Samargandi OA. Preferred Nasolabial Angle in Rhinoplasty: A Cross-Sectional Analysis. Aesthet Surg J 2024; 44:275-285. [PMID: 37738132 DOI: 10.1093/asj/sjad309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/05/2023] [Accepted: 09/18/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND The perception of an ideal nose is influenced by a variety of factors, with demographic characteristics playing a significant role in what is considered an ideal nose. The nasolabial angle (NLA) is considered one of the defining features shaping the nose. OBJECTIVES In this study we set out to capture the perception of the ideal nasolabial angle among Canadian, Saudi, Kuwaiti, and Lebanese populations. METHODS An online questionnaire-based cross-sectional study was conducted to investigate the ideal nasolabial angle among Canadian, Saudi, Kuwaiti, and Lebanese populations (n = 197). Participants were patients attending outpatient clinics, plastic surgery residents, and medical students. The questionnaire included demographics and the perception of respondents of the ideal NLA for each gender: male (85°, 90°, 95°, 100°, 110°) and females (95°, 100°, 110°, 115°). RESULTS The majority of respondents were female (81.2%), ages between 20 and 39 (84.3%). The mean and standard deviation of ideal NLA choices in both male and female models were 97.1 ± 6.39 and 109.5 ± 5.32, respectively. The ideal male NLA choices were found to correlate significantly with age (P = .044) and work status (P = .019). In choosing the ideal female NLA, age was a significant factor (P = .012). CONCLUSIONS Identifying the ideal NLA is essential to establishing aesthetic goals for patient and surgeon alike. It is important to understand the effects of demographics on the choice of the ideal NLA, which ultimately influences the planning and outcome of the rhinoplasty procedure. LEVEL OF EVIDENCE: 5
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The Perception of Esthetic Importance of Craniofacial Elements. J Craniofac Surg 2021; 33:142-145. [PMID: 34510066 DOI: 10.1097/scs.0000000000008122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT The human face is an important human structure, often judged by its esthetics. It serves great purpose, as it is and always has been involved in both cultural matters, such as art, as well as biological matters, such as exhibition of emotion and mate selection. Throughout history, there have been multiple studies on what makes a face attractive. Despite the myriad ways in which the face has been explored academically, there has been a lack of reports on which craniofacial elements are deemed the most important for attractiveness subjectively. To fill up this gap on the perception of the esthetics of the human face, as well as to provide a contemporary view on the matter, this research was conducted. Participants were asked to fill out a questionnaire with a visual analogue scale for each craniofacial element and questions about appearance satisfaction. A total of 299 participants were enrolled in this study. Eyes, hair and teeth were deemed to be the most important craniofacial elements for attractiveness. Women scored teeth, hair, and eyebrows significantly higher than men, men scored higher in satisfaction with their own appearance than women. Older people, married people and people in a relationship care less about the opinion of others regarding their appearance. The results from this study can be used to identify a focus in the future development of esthetically related matters, such as plastic surgery or art and will add to the academic knowledge on the perception of craniofacial beauty.
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Patel PN, Kandathil CK, Buba CM, Neves JC, Cobo R, Robotti E, López-Ulloa F, Ferraz M, Saedi B, Pham T, Saleh HA, Most SP. Global Practice Patterns of Dorsal Preservation Rhinoplasty. Facial Plast Surg Aesthet Med 2021; 24:171-177. [PMID: 33970690 DOI: 10.1089/fpsam.2021.0055] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Dorsal preservation rhinoplasty (DPR) has recently received significant academic attention in part due to theoretical benefits over excisional surgical methods. The purpose of this study was to assess the global practice patterns regarding this technique. Materials and Methods: An 11-item questionnaire was electronically distributed to regional academies/societies representing rhinoplasty surgeons worldwide. Respondent exposure to and use of DPR were assessed based on geographic location. Results: Eight hundred thirty-six responses were received. Despite early publications on DPR originating largely from Western Europe and the United States, Turkey and Mexico have the greatest use of DPR techniques currently. The familiarity across many regions with preservation techniques appear to be secondary to courses and conferences rather than incorporation into training. Mexico demonstrates the greatest exposure to DPR during training. One hundred twenty-five respondents had previously used but abandoned dorsal preservation techniques. Poor results, less predictability, and complications (largely hump recurrence) are cited as common reasons for this. Conclusion: There is variability in the global practice of DPR across regions and this will likely continue to evolve.
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Affiliation(s)
- Priyesh N Patel
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Cherian K Kandathil
- Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California, USA
| | | | | | - Roxana Cobo
- Department of Otolaryngology, Clinica Imbanaco Grupo Quiron Salud, Cali, Colombia
| | | | - Fausto López-Ulloa
- Department of Otolaryngology, Autonomous University of Queretaro, Querétaro, Mexico
| | - Mario Ferraz
- Clínica Dr. Mário Ferraz-Rinoplastia e Cirurgia da Face, Campinas, Brazil
| | - Babak Saedi
- Facial Plastic Division, Department of Otolaryngology, Tehran University of Medical Sciences, Tehran, Iran
| | - Tuan Pham
- Perth Facial Plastic Surgery and Cosmetic Surgery, Perth, Australia
| | - Hesham A Saleh
- Rhinology/Facial Plastic Surgery, Imperial College London, London, United Kingdom
| | - Sam P Most
- Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California, USA
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Kantar RS, Maliha SG, Alfonso AR, Wang MM, Ramly EP, Eisemann BS, Shetye PR, Grayson BH, Flores RL. Nasolabial Aesthetics Following Cleft Repair: An Objective Evaluation of Subjective Assessment. Cleft Palate Craniofac J 2019; 56:1157-1163. [PMID: 31117813 DOI: 10.1177/1055665619851432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Assess the weight and contribution of each of the parameters of the Asher-McDade Scale to overall subjective assessment of nasolabial aesthetics following cleft lip repair. DESIGN Retrospective cohort evaluation. SETTING Cleft and craniofacial center. PARTICIPANTS Forty-one patients who underwent unilateral cleft lip repair. INTERVENTIONS Unilateral cleft lip repair. MAIN OUTCOME MEASURES Nasolabial rating using the Asher-McDade scale and overall subjective assessment of nasolabial aesthetics using a rank score following unilateral cleft lip repair. RESULTS Strong interrater reliability was observed between the 3 raters. Significant association was determined on bivariate analysis between nasal form score (β = 27.06; P < .001), nasal symmetry score (β = 26.41; P < .001), nasal profile score (β = 28.75; P < .001), vermilion border score (β = 13.40; P = .012), and the ranking score. Adjusted β coefficients obtained from multivariate regression analysis were used to develop a modified nasolabial appearance score (over 5), that is, weighted for each of the 4 parameters: nasal form (over 8, adjusted β = 14.33), nasal symmetry (over 5, adjusted β = 7.96), nasal profile (over 5, adjusted β = 9.44), and vermilion (over 2, adjusted β = 3.31). Regression analysis between our modified nasolabial appearance score and patient ranking score demonstrated superior goodness of fit when compared to the Asher-McDade overall nasolabial appearance score (R2 = .80; P < .001 vs R2 = .69; P < .001). CONCLUSION The parameters evaluated in the Asher-McDade scale have different weights and contribute differently to overall subjective assessment of nasolabial aesthetic outcomes following cleft lip repair. Adjusting for their weights results in a modified score that demonstrates superior correlation with overall subjective assessment of nasolabial aesthetic outcomes.
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Affiliation(s)
- Rami S Kantar
- 1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Samantha G Maliha
- 1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Allyson R Alfonso
- 1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Maxime M Wang
- 1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Elie P Ramly
- 1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Bradley S Eisemann
- 1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Pradip R Shetye
- 1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Barry H Grayson
- 1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
| | - Roberto L Flores
- 1 The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA
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Shahbazi Z, Ardalani H, Maleki M. Aesthetics of Numerical Proportions in Human Cosmetic Surgery. World J Plast Surg 2019; 8:78-84. [PMID: 30873366 PMCID: PMC6409153 DOI: 10.29252/wjps.8.1.78] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Beauty is a universal phenomenon and debate over what constitutes beauty particularly beauty to human body, has raged since philosophy began. The beauty of individual features depends on "ideal" proportions, and it is suggested that expressing beauty in terms of geometry is possible. Assessment of some used parameters in facial surgeries and harmony of various facial features are essential to surgeon, who requires facial analysis. One of these parameters, is nasolabial angle, in patients undergoing rhinoplasty. This study based on theoretical definitions of beauty and proportions performed the search for the application of this numerical proportions in modern cosmetic surgery. METHODS Twenty-three samples [16 (69.5%) female and 7 (30.5%)] male] were enrolled from patients who underwent rhinoplasty, by a single surgeon. The nasolabial angle was measured in these patients from their lateral profile photographs with adobe Photoshop, before and after surgery. RESULTS Ideal post-operative angle was 111.54±26.5 degrees from this study and 18.8◦ increase in male and 14.68◦ increase in female were seen. There was no significant difference between men and women. CONCLUSION Our results showed that an ideal proportion can be very useful and practical to assess patient's preoperative expectations and to evaluate the results after surgery and satisfaction of cosmetic surgery process.
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Affiliation(s)
- Zhaleh Shahbazi
- Department of Art and Architecture, Hamedan Branch, Islamic Azad University, Hamedan, Iran
| | - Hossein Ardalani
- Department of Art and Architecture, Hamedan Branch, Islamic Azad University, Hamedan, Iran
| | - Mahsa Maleki
- Department of Art and Architecture, Hamedan Branch, Islamic Azad University, Hamedan, Iran
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Kalantar Hormozi A, Maleki S, Rahimi A, Manafi A, Amirizad SJ. Cosmetic Surgery in Iran: Sociodemographic Characteristics of Cosmetic Surgery Patients in a Large Clinical Sample in Tehran. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/0748806818764734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sociodemographic characteristics of cosmetic surgery patients are less studied in developing countries. Examining sociodemographic characteristics of cosmetic surgery patients in clinical settings can help surgeons identify their potential patients and highlights marketing opportunities for medical institutions. We conducted this study to determine the sociodemographic details of a large clinical sample from Tehran, Iran. The aim of this study was to present the demographic characteristics of Iranian patients undergoing cosmetic procedures. Tehran was selected from Iran as its most populated city and center of most medical facilities. The present study aimed to examine the sociodemographic characteristics of a large clinical sample (N = 744 patients; 900 cosmetic procedures) who underwent cosmetic surgery in Tehran, Iran. These surgeries were performed by 3 well-known plastic surgeons in Tehran. Sociodemographic details were gathered using patient’s cases and phone interview. A previously published questionnaire with modification was used. Findings suggest that most of the patients (90.7%) are women. Rhinoplasty (61.3%), facial fat injection (6.7%), blepharoplasty (6.3%), facelift (4.0%), and breast augmentation (3.8%) were the top 5 cosmetic procedures in the present sample. Approximately half of the sample (49.6%) was single, and most of married patients (80%) had children. A large number of patients (37.2%) were between 30 and 39 years old. In addition, a considerable proportion of the sample reported university education and being currently employed. This is the first study to document sociodemographic details in a large clinical sample from Iran as an understudied setting. We used insights from evolutionary psychology to explain the large sex differences in the number of cosmetic surgeries. In addition, we compared the findings with existing evidence from the United States and Saudi Arabia. Limitations and future directions are also discussed.
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Affiliation(s)
| | - Simin Maleki
- Hormozgan University of Medical Sciences, Qeshm, Iran
| | | | - Ali Manafi
- Iran University of Medical Sciences, Tehran, Iran
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Locatelli K, Boccara D, De Runz A, Fournier M, Chaouat M, Villa F, Mimoun M. A qualitative study of life events and psychological needs underlying the decision to have cosmetic surgery. Int J Psychiatry Med 2017; 52:88-105. [PMID: 28486875 DOI: 10.1177/0091217417703287] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective A thorough psychological assessment of patients requesting cosmetic surgery can help to protect them from the risk of postoperative dissatisfaction and the onset and/or aggravation of psychiatric disorders. This study seeks to shed more light on why people desire cosmetic surgery and thus help surgeons, psychiatrists, and psychologists to conduct assessments before surgery. Methods In-depth interviews were conducted with 35 subjects who requested cosmetic surgery. The interviews were recorded and transcribed and then analyzed qualitatively with Grounded Theory. Themes and categories were identified and compared in logical order, to build a consistent theoretical model. Results In each interview, we identified one or more recent events that the subjects considered to be contributing factors in their decisions to have cosmetic surgery. We observed that 33 of 35 patients said they sought cosmetic surgery at a time when they were experiencing, or had just experienced, one or more major changes in their bodies or their relationships. Recent life events triggered or strengthened specific psychological needs in the subjects: to cope with the past and with change, attain a consistent identity, find or regain a positive self-image, alter others' perceptions, define themselves in relation to others, or please themselves or others. Patients said that they chose plastic surgery to fulfill one or more of these needs. Conclusions This study identifies the role of recent events in inciting individuals to resort to cosmetic surgery. This factor provides new perspectives for surgeons to understand those patients and opens new avenues for research.
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Affiliation(s)
- Katia Locatelli
- 1 Centre de Recherches Psychanalyse, Médecine et Société, Sorbonne Paris Cité, Université Paris Diderot, Paris, France
- 2 Plastic, Reconstructive, and Cosmetic Unit, Hôpital Saint Louis, Paris, France
| | - David Boccara
- 2 Plastic, Reconstructive, and Cosmetic Unit, Hôpital Saint Louis, Paris, France
| | - Antoine De Runz
- 2 Plastic, Reconstructive, and Cosmetic Unit, Hôpital Saint Louis, Paris, France
- 3 Pratiques Professionnelles: Aspects Méthodologiques Ethiques et Juridiques, Université de Lorraine, France
| | - Mathilde Fournier
- 2 Plastic, Reconstructive, and Cosmetic Unit, Hôpital Saint Louis, Paris, France
| | - Marc Chaouat
- 2 Plastic, Reconstructive, and Cosmetic Unit, Hôpital Saint Louis, Paris, France
| | - François Villa
- 1 Centre de Recherches Psychanalyse, Médecine et Société, Sorbonne Paris Cité, Université Paris Diderot, Paris, France
| | - Maurice Mimoun
- 2 Plastic, Reconstructive, and Cosmetic Unit, Hôpital Saint Louis, Paris, France
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Atari M, Chegeni R, Fathi L. Women who are Interested in Cosmetic Surgery Want it all: the Association between Considering Cosmetic Surgery and women’s Mate Preferences. ADAPTIVE HUMAN BEHAVIOR AND PHYSIOLOGY 2016. [DOI: 10.1007/s40750-016-0053-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Development and Validation of the Expectations of Aesthetic Rhinoplasty Scale. Arch Plast Surg 2016; 43:365-70. [PMID: 27462570 PMCID: PMC4959980 DOI: 10.5999/aps.2016.43.4.365] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 05/25/2016] [Accepted: 06/21/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND There is a growing concern in the field of aesthetic surgery about the need to measure patients' expectations preoperatively. The present study was designed to develop and validate the Expectations of Aesthetic Rhinoplasty Scale (EARS), and to compare expectations between rhinoplasty patients with and without body dysmorphic disorder (BDD). METHODS In total, 162 college students and 20 rhinoplasty candidates were recruited. The measures included the newly developed EARS, a measure of psychopathology, and demographics. The DSM-IV structured clinical interview for BDD was used to confirm the diagnosis in rhinoplasty patients. RESULTS The EARS was constructed of six items based on their significant content validity. In the scale development phase, Cronbach's alpha was 0.87. The test-retest reliability coefficient of the scale was satisfactory (intraclass correlation coefficient, 0.94; 95% confidence interval, 0.82-0.98) over a four-week period. Scores on the EARS were significantly positively correlated with psychopathological symptoms (r=0.16; P<0.05). Moreover, comparison of EARS scores between BDD (M=25.90, standard deviation [SD]=6.91) and non-BDD rhinoplastic patients (M=15.70, SD=5.27) suggested that BDD patients held significantly higher expectations (P<0.01). CONCLUSIONS The expectations of aesthetic rhinoplasty patients toward surgery may play a crucial role in their postoperative satisfaction. While the value of patients' expectations is clinically recognized, no empirical study has measured these expectations in a psychometrically sound manner. The current study developed and validated the EARS. It may be easily used as a valid and reliable instrument in clinical and research settings.
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