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The Deviated Nose and Groomed Eyebrows: An Important Trap to Avoid
Kristopher Katira, MD
Bahman Guyuron, MD, FACS
University Hospitals Case Medical Center, Department of Plastic Surgery
2013-03-11
Presenter: Kristopher Katira, MD
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. Please make a statement as to how much of the above work represents the original work of the resident.
Director Name: Hooman Soltanian, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Background:
Midpoint of the distance between the medial eyebrows is a common midline reference during facial analysis for rhinoplasty. Failure to recognize asymmetrically positioned eyebrows, often altered by the patient to camouflage nasal asymmetry, can lead the surgeon to design the rhinoplasty using a faulty midline landmark.
Purpose:
To investigate the frequency of eyebrow asymmetry and test whether rhinoplasty patients groom their eyebrows to compensate for nasal deviation.
Methods:
Life-size photographs of 100 rhinoplasty patients were randomly selected from the senior author's practice. Nasal deviation from the midpoint of the intercanthal distance was measured at standardized levels on AP views corresponding to the nasal bones (NB), upper lateral cartilages (ULC), and nasal tip (T). The maximally deviated parameter (MAX) was noted. The direction of eyebrow shift was then compared to the direction of nasal deviation.
Results:
Of the 27 males and 73 female studied, 96 patients had measurable eyebrow asymmetry, including 96% of males and 96% of females. All 100 patients had at least one level of nasal deviation. The direction of eyebrow shift correlated significantly with the direction of deviation for NB (p=0.0018), T (p=0.0032), MAX (p=0.039)but not deviation of the ULC (p=0.54). Mean eyebrow shift distance for males (1.8 mm) and females (1.4 mm) was not significantly different (p = 0.056).
Conclusion:
The significant correlation between eyebrow asymmetry and nasal deviation patterns suggests that both genders groom their eyebrows to compensate for nasal asymmetry. This phenomenon must be recognized when planning rhinoplasty.
