Social Perception of the Nasal Dorsal Contour in Male Rhinoplasty

Abstract

The social perception of nasal dorsal modification for male rhinoplasty is poorly understood.OBJECTIVE To investigate the association of modifying the male nasal dorsum with the perception of such social attributes as youth, approachability, healthiness, masculinity/ femininity, intelligence, successfulness, and leadership.DESIGN, SETTING, AND PARTICIPANTS Using computer simulation software, 12 images with varied combinations of the nasal dorsal shape, nasofrontal angle (NFA), and nasolabial angle (NLA) were generated from a photograph of a male volunteer's face in profile. These photographs were then sent to participants at a university clinic who were English-speaking adult internet users who were masked to the purpose of the study, which asked them to value different social attributes regarding the face in the photograph in a 16-question survey. The study was conducted in September 2018 and the data were analyzed thereafter until March 2019.EXPOSURES Twelve photographs embedded in a 16-question survey. MAIN OUTCOMES AND MEASURESPopulation proportions of responses and χ 2 test and graphical analysis based on 95% confidence intervals. RESULTSOf 503 respondents (survey provision rate, 100%), 412 (81.9%) were women, 386 (76.7%) were white, 32 (6.4%) were Hispanic or Latinx, 63 (12.5%) were black/African American, 10 (2.0%) were Asian/Pacific Islander, and the median age was 46 years (interquartile range, 32-61 years). The man with ski slope-shaped nose with an NFA of 130°a nd NLA of 97°was often associated with frequently perceived positive characteristics; specifically, he was judged to be the most attractive (95% CI, 18%-26%; P < .001). Participants also often associated superlative youth (95% CI, 15%-24%; P < .001), approachability (95% CI, 13%-20%; P = .002), and femininity (95% CI, 14%-22%; P < .001) with dorsal contours that did not feature a dorsal hump. The man with a dorsal hump-shaped nose with an NFA of 140°and NLA of 105°was associated by the highest proportion of participants with being the oldest (95% CI, 35%-44%; P < .001), least approachable (95% CI, 27%-35%; P < .001), least attractive (95% CI, 37%-42%; P < .001), and least healthy (95% CI, 26%-34%; P < .001). Subset analyses also revealed statistically significant dorsal contour preferences by observers' age, gender, and race/ethnicity. CONCLUSIONS AND RELEVANCEA reduced dorsal slope combined with more acute NFAs and NLAs was associated with positively perceived social attributes. The results may be of interest to rhinoplasty surgeons and their male patients when planning changes to the nasal dorsal contour.LEVEL OF EVIDENCE NA.

The Social Perception of Microtia and Auricular Reconstruction

“…Use of a Web-based platform facilitated this statistical power-a strategy applied in previous studies. 8,9 Furthermore, using computer simulation and a controlled baseline set of constant facial features, expression, skin texture, grooming, lighting, and head tilt allowed us to carefully isolate the effect of ear morphology on social perception. This avoids the variability that may be inevitable with using actual preoperative and postoperative photographs of microtia patients, who naturally age and mature and otherwise may change through the staged perioperative process.…”

“…The VAS has been used as a quantitative tool in prior social perception research within facial plastic and reconstructive surgical literature. 8,9,12,13 Each survey was then distributed to a requested, nonrepeated sample size of 200 participants from within the Qualtrics survey corporation's participant database (Qualtrics LLC) (≥ 18 years). The participants were unaware of the purpose of the study, did not take the survey more than once or any other surveys from this study, and were reimbursed for responses.…”

“…2). The VAS has been used as a quantitative tool in prior social perception research within facial plastic and reconstructive surgical literature 8,9,12,13 . Each survey was then distributed to a requested, non‐repeated sample size of 200 participants from within the Qualtrics survey corporation's participant database (Qualtrics LLC) (≥ 18 years).…”

“…Prior studies from our research group have used the Web-based surveys to document the effects of nasal dorsal contour manipulation on social perception. 8,9 However, no prior studies have captured how the general public perceives microtia and whether the reconstruction thereof affects that perception.…”

“…Specifically, Web‐based methods to capture public perception have been previously employed, for example, to investigate the effect of facial paralysis 7 on perception of social attributes. Prior studies from our research group have used the Web‐based surveys to document the effects of nasal dorsal contour manipulation on social perception 8,9 . However, no prior studies have captured how the general public perceives microtia and whether the reconstruction thereof affects that perception.…”