title: Population-based assessment of currently proposed ideals of nasal tip projection and rotation in young women.
abstract: OBJECTIVE
  There is no universally accepted quantitative metric that defines the ideal nasal tip rotation and projection.
  
  
  OBJECTIVE
  To identify the ideal nasal tip projection (NTP) and rotation by using 3 classic NTP methods (Crumley 1, Crumley 2, and Goode).
  
  
  METHODS
  Lateral facial portraits of normal-appearing white women aged 18 to 25 years were selected from a previously validated and attractiveness-scored database of images. Each image was digitally modified to fit the NTP ideals outlined by the Crumley 1, Crumley 2, and Goode methods with columellar facial angles (rotation metric) of 96°, 101°, 106°, 111°, and 116° (15 modified images per portrait). These variants were incorporated into electronic surveys that were distributed to traditional focus-group and online social-network participants. Analysis was performed using paired comparison analysis, a consumer preference research analytic. The traditional focus-group participants were undergraduate students at the University of California, Irvine, whose online social-network contacts were also used.
  
  
  METHODS
  Mean ranks.
  
  
  RESULTS
  There were no significant differences in preference between the traditional focus-group (n = 106) and online participants (n = 3872) (P > .05). The most preferred rotation variant for all 3 NTP methods was 106° (Crumley 1: mean rank, 2.11 [95% CI, 2.07-2.16]; Crumley 2: mean rank, 2.07 [95% CI, 2.02-2.12]; and Goode: mean rank, 2.05 [95% CI, 1.99-2.11]; P < .001). Crumley 1 was considered to be the most attractive NTP method (mean rank, 1.84 [95% CI, 1.82-1.85]; P < .001) overall and was the most preferred NTP method for faces of above-average attractiveness (mean rank, 1.78 [95% CI, 1.76-1.80]; P < .001). No significantly preferred NTP method was found for faces of average attractiveness (P > .05). The most aesthetic combination of tip rotation and projection was a columellar facial angle of 106° with the Crumley 1 tip projection.
  
  
  CONCLUSIONS
  To our knowledge, this is the first population-based study to attempt to simultaneously determine the ideal NTP and rotation. Each classic NTP method uses measurements dependent on both projection and rotation; thus, ideal rotation for each NTP method must be determined before comparison of the ideals. A rotation of 106° (columellar facial angle) was found to be the most aesthetic. The Crumley 1 method was determined to be the most attractive nasal tip variant overall.
  
  
  METHODS
  NA.
authors: Department of Otolaryngology-Head and Neck Surgery, New York University, New York, New York.
authors: Omar
authors: O
authors: Ahmed
authors: student, University of California, Irvine, Irvine.
authors: Amrita
authors: A
authors: Dhinsa
authors: student, University of California, Irvine, Irvine.
authors: Natalie
authors: N
authors: Popenko
authors: School of Medicine, University of California, Irvine, Irvine.
authors: Kathryn
authors: K
authors: Osann
authors: Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange.
authors: Roger L
authors: RL
authors: Crumley
authors: Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange.
authors: Brian J
authors: BJ
authors: Wong
mesh_terms: D000293:Adolescent; D000328:Adult; D001290:Attitude; D001504:Beauty; D002140:California; D003625:Data Collection; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D009666:Nose / Q000033:anatomy & histology* / Q000601:surgery; D010781:Photography; D012225:Rhinoplasty; D012399:Rotation; D060756:Social Networking; D055815:Young Adult