An Overlooked Landmark for the Crooked Nose: Eyebrow Position
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ORIGINAL ARTICLE
RHINOPLASTY
An Overlooked Landmark for the Crooked Nose: Eyebrow Position Goknil Gultekin1
•
Alper Koycu1 • Fuat Buyuklu1 • Melike Bahcecitapar2
Received: 16 March 2020 / Accepted: 10 May 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract Background Rhinoplasty is one of the most unforgiving operations in facial plastic surgery. The correction of nasal deviation in an asymmetrical face can be challenging because known facial landmarks may mislead the surgeon. Eyebrows trimmed asymmetrically in an effort to create a more symmetrical facial appearance may be overlooked by surgeons. Objective To define the relationship between the eyebrow position and external nasal deviation in patients with a crooked nose. Design, Setting, and Participants Analysis was made of the preoperative and 6-month postoperative life-size photographs of female rhinoplasty patients who had been referred to the senior author’s clinic between May 2014 and June 2019. The anthropometric landmarks on the lifesize photographs were identifed. The most medial points of the eyebrows and most deviated part of the nose were marked and the distance from the mid-canthal point was measured. Main Outcomes and Measure The direction and amount of eyebrow shift were compared with the direction and amount of nasal deviation. Results Of the total 94 female rhinoplasty patients with at least one level external nasal deviation, 67 (71.2%) had
& Goknil Gultekin [email protected] 1
Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Baskent University, Bahcelievler Mh. Maresal Fevzi Cakmak Cad. 5. Sokak, No: 48, Ankara 06490, Turkey
2
Department of Statistics, Faculty of Science, Hacettepe University, Cankaya, Ankara 06800, Turkey
ipsilateral eyebrow shift with external nasal deviation. The preoperative external nasal deviation amount was 1.81 ± 1.21 mm and preoperative eyebrow shift was 1.18 ± 1.06 mm (rS = 0.429, p \ 0.001). The postoperative nasal deviation was 0.79 ± 0.92 mm, and the eyebrow shift was 0.54 ± 0.62 mm (rS = 0.570, p \ 0.001). Conclusion and Relevance Patients may tend to trim their eyebrows towards the side of the external nasal deviation. After centralization of the crooked nose with rhinoplasty, asymmetric eyebrow shaping tendencies of the patients were also seen to be improved. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Keywords Deviated nose Facial asymmetry Eyebrows
Introduction Rhinoplasty involves multiple important steps from the first counselling appointment of the patient to the postoperative visits. To understand the rhinoplasty patient’s desires and complaints, it is crucial to define the facial proportions, including the symmetry of facial structures [1–3]. Detailed exam
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