'Nose Noticeability' Affects Facial Attractiveness, Reports Plastic and Reconstructive Surgery
Eye-tracking study highlights need for holistic facial assessment in rhinoplasty

Attractiveness of the nose affects how people view the face – with attractive noses actually drawing less attention than unattractive noses, reports a study in the May issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS). The journal is published in the Lippincott portfolio by Wolters Kluwer.

"Using eye-tracking technology, we found that observers spend less time looking at attractive noses, shifting their focus to other areas – particularly the eyes," comments ASPS Member Surgeon Robert D. Galiano, MD, of Northwestern University Feinberg School of Medicine, Chicago. "That has direct implications for plastic surgeons performing rhinoplasty, emphasizing the importance of holistic assessment to enhance facial balance.

How does your nose affect the way others view your face?

Nose reshaping (rhinoplasty) is among the most frequently performed cosmetic surgery procedures. To assess how the appearance of the nose relates to overall facial attractiveness, the researchers obtained standardized facial photographs of 34 volunteer models representing a range of racial/ethnic backgrounds.

The images were viewed by 31 volunteer observers. Using eye-tracking technology, the researchers analyzed what parts of the model's face the raters viewed and how much time they spent looking at each area. The eye-tracking data were analyzed in comparison with ratings of nasal and facial attractiveness.

Attractiveness ratings had a significant impact on eye-tracking patterns. For models whose noses were rated unattractive, observers spent more time looking at the nose compared to models with attractive noses: 0.81 versus 0.72 seconds. Observers also shifted their gaze to unattractive noses more frequently.

'Attractive noses enhance facial harmony by blending into the face'

For models with unattractive noses, observers shifted their gaze to the mouth for a longer period: 0.65 versus 0.54 seconds. In contrast, for models with attractive noses, observers spent more time looking at the eyes: 1.92 versus 1.69 seconds.

In isolated images, noses were rated less attractive for models with asymmetry of the nasal tip. However, in full-face images, asymmetry was no longer significantly related to nasal attractiveness. Nasal attractiveness ratings were also unrelated to the "neoclassical canon" of angles and ratios traditionally thought to be associated with facial beauty.

The study "highlights the role of nasal symmetry and proportionality in facial attractiveness," according to the authors. "The most attractive noses received the least attention to themselves...while unattractive noses received prolonged visual attention." While that may seem counterintuitive, it is consistent with previous before-and-after studies in patients undergoing rhinoplasty – emphasizing "the importance of holistic assessment of nasal aesthetics."

"Simply put: unattractive noses stick out, and detract attention from other facial features, such as a person's beautiful eyes or mouth," Dr. Galiano adds. "Many of our rhinoplasty patients focus on specific things they don't like about their nose, without considering how the nose influences overall nasal perception. By showing how attractive noses enhance facial harmony by blending into the face, our study has practical implications for aesthetic surgery, particularly in guiding patient expectations and surgical planning."

Plastic and Reconstructive Surgery® is published by Wolters Kluwer.

Click here to read "Less Is More: Eye-Tracking Reveals How Nose Noticeability Influences Facial Attractiveness"

Article: "Less Is More: Eye-Tracking Reveals How Nose Noticeability Influences Facial Attractiveness" (doi: 10.1097/PRS.0000000000012531)