Differences in Nasal Shapes and the Degree of Changes Over a Decade or More: A Paired Analysis

Abstract

Objectives: This study investigated age-related differences in nasal morphometry and the degree of changes within an individual over at least a 10-year period by pairing previous and recent three-dimensional reconstructed computed tomography (CT) images.

Methods: Forty-eight adult Korean patients who underwent at least two CT scans of the nasal region with an interval of at least 10 years were selected. Patients were categorized into six subgroups according to sex and age (20-39 years, 40-49 years, and ≥50 years) at the time of initial imaging. Eight nasal parameters were measured on the initial and recent images, and paired comparisons between the two images were performed based on the data. The differences in the degree of change by age were also analyzed.

Results: Over an average image interval of 12 years, men exhibited an increase in the nasofrontal angle (3.2°±5.4°, P=0.041), profile nasal length (1.7±1.7 mm, P=0.002), and nasal bridge height (1.2±1.6 mm, P=0.002). Conversely, they showed a decrease in the nasofacial angle (-2.3°±2.9°, P=0.010). Women also demonstrated an increase in the nasofrontal angle (2.5°±5.2°, P=0.010), profile nasal length (1.4±1.9 mm, P<0.001), and nasal bridge height (1.3±1.6 mm, P<0.001). However, they exhibited a decrease in the nasofacial angle (-2.0°±2.1°, P<0.001), glabella angle (-9.1°±9.8°, P<0.001), and pyriform angle (-8.5°±10.1°, P<0.001). With the exception of the nasal bridge height (P=0.036) and pyriform angle (P=0.022), the degree of changes in most parameters did not show significant differences across age groups.

Conclusion: Our findings indicate that the aging nose exhibits a greater nasal length with inferior angulation of the nasal tip, with an increase in the nasofrontal angle, profile nasal length, and nasal bridge height, along with a decrease in the nasofacial angle. The degree of most nasal morphologic changes demonstrated no significant differences by specific age group.

Keywords: Acquired Nose Deformity; Aging; Computer Generated 3D Imaging; Esthetics; Matched Pair Analysis.

Fig. 1.

Using reconstructed three-dimensional images, all parameters were marked with dashed and solid lines in different colors, and their definitions were listed. Based on that, the nasofrontal angle, nasofacial angle, nasolabial angle, profile nasal length, nasal bridge height, nasal tip protrusion, glabella angle, and pyriform angle were measured.

Fig. 2.

Parameter comparisons between the initial and latest computed tomography scans of the same individuals: (A) nasofrontal angle, (B) nasofacial angle, (C) nasolabial angle, (D) profile nasal length, (E) nasal bridge height, (F) nasal tip protrusion, (G) glabella angle, (H) pyriform angle. With an average of a 12-year image interval, men demonstrated an increase in the nasofrontal angle, profile nasal length, and nasal bridge height, while showing a decrease in the nasofacial angle. Women demonstrated an increase in the nasofrontal angle, profile nasal length, and nasal bridge height, along with a decrease in the nasofacial angle, glabella angle, and pyriform angle.

Fig. 3.

The degree of nasal area changes between the initial and latest groups is shown as violin plots in the three age-based subgroups: (A) nasofrontal angle, (B) nasofacial angle, (C) nasolabial angle, (D) profile nasal length, (E) nasal bridge height, (F) nasal tip protrusion, (G) glabella angle, (H) pyriform angle. Except for the nasal bridge height and pyriform angle, the degree of changes in most parameters did not show significant differences among age groups.