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Factors Contributing to Nasal Differences in Identical Female Twins
James Gatherwright, Bardia Amirlak, Ali Totonchi, Bahman Guyuron
Department of Plastic Surgery, Case Western Reserve University, Cleveland, Ohio
2010-03-31
Presenter: James Gatherwright
Affidavit:
Director Name:
Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: Aesthetics
Introduction:Genetically identical twins offer a unique opportunity to evaluate the effects of endogenous and exogenous factors to nasal shape.There is a paucity of studies investigating their contributions.
Methods:At the Twins Day Festival in Twinsburg, Ohio, female identical twins completed a comprehensive questionnaire followed by the acquisition of standardized photographs.To create a more homogeneous group, males, african-american females, and individuals with a history of facial trauma and/or surgery were excluded. After adjustment for age and genetics, the relationship between nasal measurements and questionnaire items were evaluated using the SPSSŪ software. Subsequently, a panel independently evaluated inter-twin differences in aesthetic appearance.
Results:98 twins(49 pairs; 45.4+/-16.4years) were included in the final analyses. There was association between increased pack/years of smoking and increases in nasal height(p=0.002), base width(p=0.0136), tip width(p=0.005), nasion-nasal tip distance(p=0.006), and naso-labial(NL) angle(p=0.003).>2 children was associated with less alar flaring(p<0.001).A history of breast feeding was associated with an increased nasal profile length(p=0.042) and more acute NL angle(p=0.022). Exercising >1hr./day was associated with a decreased nostril height(profile) when compared to those who exercised <20 minutes/day (p=0.009).Either a history of polycystic ovarian disease or migraines was associated with decreased alar flaring(p=0.005 and 0.040 respectively).History of botox injections was associated with decreased nasofrontal groove depth(p=0.042). Increasing years of breast feeding and higher BMI were associated with increased nasal aesthetic score(p<0.05).
Conclusion:This study supports the role of non-genetic factors such as hormonal related influences in contributing to the shape of the aging nose.These findings prompt further investigation into putative interventions before and after rhinoplasty.
