Clin Exp Otorhinolaryngol.  2024 Feb;17(1):56-63. 10.21053/ceo.2023.01137.

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

• Kim Y
• Park JH
• Park M
• Lee E
• Hong SD
• Jung YG
• Ryu G
• Kim HY

• KMID: 2553056
• DOI: http://doi.org/10.21053/ceo.2023.01137

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.

Keyword

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

Figure

• 

  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.

Reference

1. American Society of Plastic Surgeons. 2014 Plastic surgery statistics [Internet]. American Society of Plastic Surgeons; 2014 [cited 2023 Dec 1]. Available from: https://www.plasticsurgery.org/news/plasticsurgery-statistics?sub=2014+Plastic+Surgery+Statistics.

2. Geelan-Hansen K, Were V, Miller M, Heckman WW. Use of functional rhinoplasty in the aging nose: medicare database analysis. Facial Plast Surg Aesthet Med. 2022; Jul-Aug. 24(4):271–5.

3. Toriumi DM, Rosenberger E. Rhinoplasty of the aging nose. Facial Plast Surg. 2016; Feb. 32(1):59–69.

4. Hong HR, Kim SH, Kim JH, Jang YJ. Aesthetic motivation of geriatric rhinoplasty the surgical outcome. J Craniofac Surg. 2015; Sep. 26(6):1936–9.

5. Zhuang Z, Landsittel D, Benson S, Roberge R, Shaffer R. Facial anthropometric differences among gender, ethnicity, and age groups. Ann Occup Hyg. 2010; Jun. 54(4):391–402.

6. Posen JM. A longitudinal study of the growth of the nose. Am J Orthod. 1967; Oct. 53(10):746–56.

7. Zankl A, Eberle L, Molinari L, Schinzel A. Growth charts for nose length, nasal protrusion, and philtrum length from birth to 97 years. Am J Med Genet. 2002; Sep. 111(4):388–91.

8. Smith SL, Buschang PH. Midsagittal facial soft-tissue growth of French Canadian adolescents. Am J Hum Biol. 2002; Jul-Aug. 14(4):457–67.

9. He ZJ, Jian XC, Wu XS, Gao X, Zhou SH, Zhong XH. Anthropometric measurement and analysis of the external nasal soft tissue in 119 young Han Chinese adults. J Craniofac Surg. 2009; Sep. 20(5):1347–51.

10. Mori A, Nakajima T, Kaneko T, Sakuma H, Aoki Y. Analysis of 109 Japanese children’s lip and nose shapes using 3-dimensional digitizer. Br J Plast Surg. 2005; Apr. 58(3):318–29.

11. Shastri D, Tandon P, Singh A. Nasal changes in different age groups. Natl J Maxillofac Surg. 2021; Sep-Dec. 12(3):367–71.

12. Sforza C, Grandi G, De Menezes M, Tartaglia GM, Ferrario VF. Age-and sex-related changes in the normal human external nose. Forensic Sci Int. 2011; Jan. 204(1-3):205.

13. Kwon SH, Choi JW, Kim HJ, Lee WS, Kim M, Shin JW, et al. Threedimensional photogrammetric study on age-related facial characteristics in Korean females. Ann Dermatol. 2021; Feb. 33(1):52–60.

14. Jomah J, Elsafi RA, Ali KS, Abdullah R, Gelidan AG. Nasal skin thickness measurements using computed tomography in an adult Saudi population. Plast Reconstr Surg Glob Open. 2019; Sep. 7(9):e2450.

15. Jang MS, Kim HY, Dhong HJ, Chung SK, Hong SD, Cho HJ. An analysis of Asian midfacial fat thickness according to age group using computed tomography. J Plast Reconstr Aesthet Surg. 2015; Mar. 68(3):344–50.

16. Richard MJ, Morris C, Deen BF, Gray L, Woodward JA. Analysis of the anatomic changes of the aging facial skeleton using computerassisted tomography. Ophthalmic Plast Reconstr Surg. 2009; Sep-Oct. 25(5):382–6.

17. Kim SJ, Kim SJ, Park JS, Byun SW, Bae JH. Analysis of age-related changes in Asian facial skeletons using 3D vector mathematics on picture archiving and communication system computed tomography. Yonsei Med J. 2015; Sep. 56(5):1395–400.

18. Park SS. Fundamental principles in aesthetic rhinoplasty. Clin Exp Otorhinolaryngol. 2011; Jun. 4(2):55–66.

19. Rohrich RJ, Hollier LH Jr, Janis JE, Kim J. Rhinoplasty with advancing age. Plast Reconstr Surg. 2004; Dec. 114(7):1936–44.

20. Lee HY, Cha S, Ban HJ, Kim IY, Park BR, Kim IJ, et al. The age distribution of facial metrics in two large Korean populations. Sci Rep. 2019; Oct. 9(1):14564.

21. Farkas JP, Pessa JE, Hubbard B, Rohrich RJ. The science and theory behind facial aging. Plast Reconstr Surg Glob Open. 2013; May. 1(1):e8–15.