Abstract
Background
Rhinoplasty is one of the most unforgiving operations in facial plastic surgery. The correction of nasal deviation in an asymmetrical face can be challenging because known facial landmarks may mislead the surgeon. Eyebrows trimmed asymmetrically in an effort to create a more symmetrical facial appearance may be overlooked by surgeons.
Objective
To define the relationship between the eyebrow position and external nasal deviation in patients with a crooked nose.
Design, Setting, and Participants
Analysis was made of the preoperative and 6-month postoperative life-size photographs of female rhinoplasty patients who had been referred to the senior author’s clinic between May 2014 and June 2019. The anthropometric landmarks on the life-size photographs were identifed. The most medial points of the eyebrows and most deviated part of the nose were marked and the distance from the mid-canthal point was measured.
Main Outcomes and Measure
The direction and amount of eyebrow shift were compared with the direction and amount of nasal deviation.
Results
Of the total 94 female rhinoplasty patients with at least one level external nasal deviation, 67 (71.2%) had ipsilateral eyebrow shift with external nasal deviation. The preoperative external nasal deviation amount was 1.81 ± 1.21 mm and preoperative eyebrow shift was 1.18 ± 1.06 mm (rS = 0.429, p < 0.001). The postoperative nasal deviation was 0.79 ± 0.92 mm, and the eyebrow shift was 0.54 ± 0.62 mm (rS = 0.570, p < 0.001).
Conclusion and Relevance
Patients may tend to trim their eyebrows towards the side of the external nasal deviation. After centralization of the crooked nose with rhinoplasty, asymmetric eyebrow shaping tendencies of the patients were also seen to be improved.
Level of Evidence IV
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References
Yang F, Liu Y, Xiao H, Li Y, Cun H, Zhao Y (2018) Evaluation of preoperative and postoperative patient satisfaction and quality of life in patients undergoing rhinoplasty: a systematic review and meta-analysis. Plast Reconstr Surg 141:603–611
Rohrich RJ, Villanueva NL, Small KH, Pezeshk RA (2017) Implications of facial asymmetry in rhinoplasty. Plast Reconstr Surg 140:510–516
Janis JE, Rohrich RJ (2005) Clinical decision-making in rhinoplasty. In: Nahai F (ed) The art of aesthetic surgery: principles and techniques, 2nd edn. Quality Medical, St. Louis, p 1515
Lindemann J, Schmadl A, Scheithauer MO, Hoffmann TK, Sommer F, Grossi AS, Stupp F (2019) Analysis of facial asymmetry in patients with crooked noses. Laryngorhinootologie 98:797–802
Guyuron B (2012) Correcting deviated noses, septoplasty, and turbinectomy. Guyuron B. Rhinoplasty. Elsevier, Edinburgh, pp 301–308
Katira K, Guyuron B (2014) The deviated nose and asymmetric eyebrows: an important trap to avoid. Plast Reconstr Surg 133:519–523
Gunter JP, Antrobus SD (1997) Aesthetic analysis of the eyebrows. Plast Reconstr Surg 99:1808–1816
Guyuron B (1988) Precision rhinoplasty: Part I. The role of life-size photographs and soft-tissue cephalometric analysis. Plast Reconstr Surg 81:489–499
Daniel RK, Kosins A, Sajjadian A, Cakir B, Palhasi P, Molnar G (2013) Rhinoplasty and brow modification: a powerful combination. Aesthet Surg J 33:983–994
Roxbury C, Ishii M, Godoy A et al (2012) Impact of crooked nose rhinoplasty on observer perceptions of attractiveness. Laryngoscope 122:773–778
Hafezi F, Naghibzadeh B, Ashtiani AK, Guyuron B, Nouhi AH, Naghibzadeh G (2014) Straight septum, crooked nose: an overlooked concept. Aesthet Plast Surg 38:32–40
Yi JS, Jang YJ (2015) Frequency and characteristics of facial asymmetry in patients with deviated noses. JAMA Facial Plast Surg 17:265–269
Perumal B, Meyer DR (2018) Facial asymmetry: brow and ear position. Facial Plast Surg 34:230–234
Carvalho B, Ballin AC, Becker RC, Berger CAS, Hurtado JG, Mocellin M (2012) Rhinoplasty and facial asymmetry: analysis of subjective and anthropometric factors in the Caucasian nose. Int Arch Otorhinolaryngol 16:445–451
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Gultekin, G., Koycu, A., Buyuklu, F. et al. An Overlooked Landmark for the Crooked Nose: Eyebrow Position. Aesth Plast Surg 44, 1718–1724 (2020). https://doi.org/10.1007/s00266-020-01786-z
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DOI: https://doi.org/10.1007/s00266-020-01786-z