Nose and Aesthetic analysis Part 2
Evaluation of the middle 1/3 of the nose
The symmetry, contour, slope, volume and shape of the middle part of the nose are evaluated. It determines the relationship between the bone and cartilage forming the nose.
Evaluation of the lower 1/3 of the nose
Evaluation of the tip of the nose; parameters used for this; Projection, Rotation, Position, Volume, Nose tip definition, Width, Shape
Nose tip projection; It is the distance between the junction of the nose wing with the cheek and the tip of the nose in the profile of the face. Since the base of the nose is equilateral triangle, the width of the base of the nose is almost equal to the nasal projection.
nasal tip projection
Many methods have been developed to determine the nasal tip projection. These;
Byrad method; Accordingly, the ideal nasal tip – nasal tip projection = 0.67 x nose length.
Goode method; 55-60% of the line between the nasion and the nose wings-facial junction point gives the nose projection.
Crumley method; The nose is first compared to a right triangle with 3-4-5 ratios between its sides. In this triangle, the distance between the nasion and the tip of the nose is the hypotenuse. The other sides of this triangle are the lines between the nasion and the nose wings-facial junction, the nose wings-facial junction-nose tip. The nose projection should be as much as the edge with a ratio of 3 on a nose.
Baum ratios; The length of the perpendicular line drawn from the nose tip-pronasion to the nasion-subnasion line. It was found to be 2.8.
The mean projection of the nasal tip projection, measured horizontally between the subnasale and the tip of the nose, is 15.5±2.8mm. Nose over 20mm in an adult is large; Less than 14mm is also considered small.
Simon rate; The ratio of the distance between subnasion and nasal uronasion/distance between subnasion and upper lip was found to be 1.
The shape and aesthetic structure of the nasal tip is related to the shape and position of the LLC (lower lateral cartilage) cartilage in the nose.
nose projection
Nose length is difficult to change. However, nasal projection can be changed with surgical or medical aesthetic applications. The nose projection is the distance between the vertical line passing through the nose wings-face junction and the tip of the nose in side posture. The distance of the nose type to the face changes the nasal projection. Many methods are used in the projection evaluation of the nose.
Methods used in nasal projection;
In Goode’s method, a perpendicular line is drawn from the nasion to the nose wings, and a perpendicular line is drawn from the tip of the nose. Nasal projection should be 60% of the nose length. Here, the NA/TA ratio should be 0.55-0.60. B
Nose tip rotation angle; It is the angle between the perpendicular line passing through the nose wings and the line extending from the tip of the nose to it. It is 100 degrees for men and 105 degrees for women.
Nasal tip rotation should be evaluated together with the collumella, nasal wings and upper lip in profile evaluation.
Evaluation of the tip of the nose
The tip of the nose is best done by looking at the base of the face from the base of the nose to the nose. Normally, the tip of the nose should look like an equilateral triangle.
Classifications were made according to the shape of the nose tip. For example, Boxy, bulbous, piched type. Boxy in the first two pictures and pinch nose tips in the other two pictures.
Evaluation of columella; The part that appears under the nose wings in the profile evaluation of the face is called the columella-columella area. Normally, its visibility is 2-4 mm. While the nose wing should have a slight slope in profile, this slope can be angled.
In the front view of the face, the relationship between the columella and the nose wings is like a seagull’s wing. The structure of the nose wings and columella can change this appearance.
The relationship between the nostrils and the columella in the middle
The ratio between the tip of the nose and the base of the nose is 0.8. This rate increases with age. especially after the age of 30
Normally the upper, middle and lower parts should be equal to each other.
An angle is formed between the axis of the nostrils and the columella. Although this angle varies according to races, while it is 45-60 degrees in white races, this angle is wider in far eastern races.
soft triangle
Pictured below is the thin leather section painted in red. It does not have a skeletal structure like cartilage, but contains a small amount of subcutaneous tissue. It is one of the sacred structures of the nose.
The relationship between the upper lip and the nose
The length of the nose, its volume, and the shape of the lower 1/3 of the nose affect the upper lip. The opposite is true.
Up and down rotation of the tip of the nose, the length of the upper lip, the projection of the upper lip and the contour of the subnasale change the aesthetics of this anatomical region.
Laughing aesthetics and the effect of the nose
The tip of the nose moves downwards and backwards while laughing. This can be evaluated with normal and smiling photographs of the patient.
Apart from this, it causes changes in the shape of the nose with the contraction of many muscles, whether on the nose or on the face. For example, when smiling, the tip of the nose rotates significantly downward, the upper part of the nose tip becomes rounded, causing the nose to appear temporarily long. The movement and deformity of the tip of the nose while laughing depends on the depressor septi nasi muscle. In addition, during laughing, the muscle around the mouth, Orbicularis oris, shortens the upper lip, and it can reduce the projection of the tip of the nose with mimic movements.
A simple evaluation method can be used in the aesthetic analysis of the nose. For this, the relationship between nose length, nasal tip projection, nasal root projection and the general length of the face is examined.
For this purpose, an analysis list has been developed.
Mouth closure defects are evaluated first. For example, it is extremely important that the jaw is anterior or posterior, and the evaluation of the upper and lower jaws.
The percentages are: The most prominent point between the eyebrows, Glabella (Gs), the lowest point of the nose wings in the profile image (ABP), the lowest point of the anterior jaw-Menton (Mes), The junction point of the lips in the middle-stomion (S), the junction of the nose wings with the cheek (ACJ) ), the line passing through the eye cornea (CP), the upper eyelid fold line (SPF), the root of the nose (R) and the tip of the nose (T) are determined and marked.
Between glabella-subnasale (ABP can be used) midface height (MFH) and between Menton-subnasale (ABP can be used) lower face height is measured (LFH). In a balanced percentage MFH should equal LFH or LFH can be 3 mm more than MFH.
The distance between menton and stomion is measured. (SMes).
The RT distance, that is, the nose length, is measured (RT). The ideal nose length is defined as RTi. RTi=0.67 × MFH or RTi=SMes.
5. Nasal tip projection; (ACJ–T); The ideal nasal tip projection is RTi X 0.67.
The nasal root projection is measured as the CP–RP distance. The ideal nasal root projection is RTi × 0.28, which varies between 9-14 mm.
