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Jason A. Biller, MD; David W. Kim, MD

Arch Facial Plast Surg. 2009;11(2):91-97.

Objectives  To compare and characterize the ideal nasolabial angle, nasal tip width, and location of the eyebrow apex for Asian and white women.

Methods  From approximately January 1, 2005, to June 30, 2005, we photographed the faces of 2 Asian women and 2 white women of differing ages. Each model's image was modified to create different eyebrow shapes, unique nasolabial angles, and varying nasal tip widths. We subsequently recruited, and obtained demographic information from, volunteers from the general public to rate the modified images based on their aesthetic preferences.

Results  We found that neither the ethnicity of the models nor the ethnicity of the volunteers who rated them played a significant role in determining the ideal eyebrow apex location, nasolabial angle, or nasal tip width. However, generally speaking, a more lateral brow apex is preferable in younger faces, whereas a more medial apex is favored in older ones. Other preferences include a moderate nasolabial angle and a narrow nasal tip. As a result of individual variability, it has been difficult to establish a method to calculate a nasolabial angle that adequately portrays the apparent rotation of the nose in most people. We found that the angle formed by the line from the anterior columella to the subnasale and the line exactly perpendicular to the Frankfurt horizontal plane provides the best estimate.

Conclusions  When planning facial plastic surgery, the goals of the patient are of paramount importance. Although it is important to understand the ways in which people of different ethnicities and ages differ in their facial proportions as a group, facial harmony must be pursued on an individual basis.

Author Affiliations: Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco (Drs Biller and Kim). Dr Biller is now with the Department of Otolaryngology–Head and Neck Surgery, Kaiser Permanente, San Jose, California.