Anthropometric analysis of the female Latino nose: Revised aesthetic concepts and their surgical implications

Objective: To determine whether the present aesthetic concepts set forth for rhinoplasty in white patients can be applied to the ethnic variations seen in Latino women and, if not, to develop a reproducible means of analysis to serve as a guide for surgical correction. Design: Cohort analytic study; criterion standard analysis of nasal aesthetics. Participants: Ninety-seven Latino women and 40 white women. Interventions: Patients were separated according to geographic area of origin, either the Caribbean, Central America, or South America. Anthropometric measurements were obtained and nasal indexes were calculated. Results were compared with previously reported data for African Americans and whites. All patients underwent complete nasal photographic analysis. Results: Caribbean subjects showed the greatest divergences from whites and resembled African-American anthropometric norms, whereas Central and South American subjects more closely resembled white norms. Two new aesthetic concepts were developed, the dorsal nasal breakpoint and the horizontal nasal axis, which have implications for aesthetic rhinoplasty. The breakpoint is a pivotal point along the nasal dorsum, structurally determined, which was found at different locations in all the groups studied. Caribbean subjects had breakpoints approximately halfway down the dorsum. Central and South Americans had breakpoints about two thirds of the way down the dorsum, and whites had breakpoints three fourths of the way down the dorsum. The horizontal rotation axis is present along a plane that connects the top of the ala with the tip. Rotation of the tip about this axis affects both the characteristics of the dorsal breakpoint and the final appearance of the nose. Conclusions: In general, Latino noses can be anthropometrically categorized as mesorrhine. When the geographically derived groups were examined individually, the Latino nose ranged from subplatyrrhine to paraleptorrhine. Surgical correction should be individualized, as each group requires correction of different nasal features. The dorsal breakpoint and the horizontal axis plane can act as nasal profile guides for surgical modifications that would achieve the current concept of the aesthetic nose.