I am interested in Rhinoplasty. are measurements such as the golden ratio used to determine if the new nose is in harmony with the rest of the face?
Are Measurements Used During a Rhinoplasty Surgery?
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Yes and no
Measurements, proportions, ratios, angles and other factors are taken into account pre- and intraoperatively but the artistic judgement and experience of your surgeon is also important factors. Computer imaging acts as a discussion tool so that you and your plastic surgeon can be on the same page as far as the goals of the surgery. But there are many factors that affect the final outcome and they are not simply dependent on measurements.
Measurements and rhinoplasty surgery
Rhinoplasty is not a mathematical equation. There are guiding principals with proportions that are addressed at the time of the surgery with each individual patient. Symmetry is extremely important in the discipline of rhinoplasty. It is very important for the patient to communicate what the desired outcome is. Equally important, is that the surgeon communicates to the patient what can surgically be accomplished. Rhinoplasty involves sculpting the bony and cartilaginous framework of the nose to fit facial features and to make the nose look natural.
Are Measurements Used During a Rhinoplasty Surgery?
There are, IMHO, underlying aesthetic principles that make a face appear, young, old, male, female, attractive or less so. I use these principles as a guide to what I do in all plastic and cosmetic surgery and treatments including Rhinoplasty. In my mind this is what you pay your plastic and cosmetic surgeon for...the understanding of how to make your nose and face more naturally attractive.
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Golden ratio measurements during nose surgery?
The Golden Ratio is a mathematical ratio, represented by the Greek letter phi, found in art, architecture, and nature, and is thought to represent a classic, innate, harmony of measurement. Most plastic surgeons know this, and also know that most faces do not have the classic golden ratio measurements.
Some plastic surgeons are artistic, some are not; just as some have mathematics training and some do not. What we DO have in common is our rhinoplasty training, which is extensive and rigorous. Some will do many over their years of experience, and other may choose to do few because of preference, interest, type of practice, or other factors.
While your question is fascinating, actual golden ratio measurements are less important during rhinoplasty surgery than making proper surgical adjustments to the tissues each individual patient possesses, rather than trying to "fit" an anatomic cosmetic result into any mathematical ratio, even the highly desirable "golden" one! I believe the best artistic rhinoplasty surgeons have a natural sense of facial harmony and proper ratios between facial thirds, another ratio commonly discussed in plastic surgical discussions such as this. (And, BTW, most faces don't fit exactly into thirds either!)
Find a good, experienced ABPS-certified plastic surgeon or ABMS-member ENT or facial plastic surgeon and see how you like their rhinoplasty photographs. This would be much more "telling" than actual measurements fitting (or not) the golden ratio, just as certain art works or architectural examples are said to be based on the golden ratio, whereas actual measurements show they are "close, but not quite." What I assume you want are changes to your own nasal appearance that you find pleasing, not measurements that fit a predetermined ratio. Best wishes!
Rhinoplasty is guided by artistic eye, not by measurements.
1) Measurements are basic in plastic surgery, and they help distinguish normal appearance from abnormal. But trying to achieve beauty during a rhinoplasty is analogous to drawing or sculpture. It cannot be done by numbers or measurements. Either the surgeon can visualize the desired result or he cannot. And I am not sure this is something that can be taught.
2) Before a rhinoplasty, the surgeon should spend a long time examining the patients and then studying high quality photos of the patient's face. From this study, a detailed, personalized, step by step plan is drawn up. This kind of thoughtful planning, where the surgeon sees in his or her mind's eye what needs to happen, is essential for a good result. But it is not primarily about measurements.
Measurements are taken, and is one of the factors used to deliver a proportionate and natural looking result.
Measurements in rhinoplasty
There are textbooks that describe ideal facial proportions. I use computer imaging, with the patient present, to adjust the pre-operative photos so that the nose looks more appropriate for the patient's facial features. This images are re-looked at immediately prior to the operation, however I do not actually measure anything during the procedure. I watch the overall proportions, and the relationships between the various structures, as the alterations to appearance proceed. Some surgeons will measure certain things, such as the amount of cartilage to be left behind, during the operation.
Measurements for rhinoplasty
Measurements are a relative guide for rhinoplasty. I always prepare before surgery by analyzing the pre-op photos. Proportions are always taken into consideration. Occasionally measurements are taken. Finally, intra-operative findings and the behavior of the patient's tissues often require adjustments of pre-op plans in order to get the planned results. In the final analysis it is the artistic and surgical judgement of the surgeon which delivers the final result.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.