Rhinoplasty: a practical guide for surgical planning

Abstract

A method for determining the aesthetically proportioned nasal length, tip projection, and radix projection in any given face is described. The proportioned nasal length is two-thirds (0.67) the midfacial height and exactly equal to chin vertical. Tip projection is two-thirds (0.67) the surgically planned or ideal nasal length. Radix projection, measured from the junction of the nasal bones with the orbit, is one-third (0.33) the ideal nasal length. The preferred clinical reference for measuring radix projection is the plane of the corneal surface; the radix projects 0.28 times the ideal nasal length from this surface (range: 9-14 mm). These-dimensional relationships were confirmed from direct clinical measurements taken from 87 models and subsequently applied in 126 consecutive rhinoplasties. The significance of this dimensional approach to rhinoplasty lies in the fact that planned nasal dimensions are based on facial measurements that allow the nose to vary in size directly with the face. Furthermore, it removes the dorsum as the primary focus in dimensional assessment. Rather, the dorsal prominence may be consistently described relative to a plane connecting the "ideal" radix and tip.