The Value of Averageness in Aesthetic Rhinoplasty: Humans Like Average Noses

Abstract Background The aesthetic ideal of the nose eludes clear definition. Averageness may be an important determinant of ideal nasal shape: research has shown that averageness plays an important role in the human perception of facial attractiveness. Objectives The aim of this study was to test whether an averaged nasal shape is attractive, and whether deviation away from average is associated with decreased attractiveness. Methods Photographic series of the face were obtained from 80 Caucasian female volunteers aged 25-40 years. A mathematically averaged composite image was created from the first 40 volunteers. Forty-one panel members were recruited to judge the attractiveness of the nose of each original image and the composite, based on a 5-point Likert scale ranging from 1 (very ugly) to 5 (very pretty). Deviation of nasal shape from average was calculated by principal components analysis of standardized nasal landmarks. Results Twenty-one respondents were male (51%). The mean age of the respondents was 35.3 [15.6] years. The rating of the composite was significantly higher than the distribution of ratings for the 80 original nose images (4.2 vs 2.8, t = 31.24, P < 0.001). The rating of the original nose images correlated negatively with deviation from average shape (r = –0.40, n = 80, P < 0.001). Conclusions In Caucasian females, a mathematically averaged nose is an attractive nose. Furthermore, the more an individual nose shape resembles the average shape, the more attractive it is rated. Calculating deviation from average before and after rhinoplasty may aid in objectively measuring aesthetic rhinoplasty outcome.