Cultural Considerations in Rhinoplasty: Assessing the Importance of Esthetic Nasal Parameters in the Indian Context

Background: The nose is one of the most important feature of the face and greatly influences its esthetics. To have a successful rhinoplasty, it is essential to have extensive knowledge of nasal anatomy and facial esthetic standards. This is because any unfavorable look, whether before or following the surgery, may attract unwanted gazes. On the other hand, two-dimensional (2D) photogrammetry has replaced the direct anthropometric technique for nasal analysis, but its accuracy and reliability are still unknown. This investigation seeks to evaluate the consistency among raters in 2D photogrammetry and to scrutinize both its reliability and precision compared to direct measurements. Materials and Methods: This cross-sectional study was done in the Department of Anatomy at Teerthanker Mahaveer Medical College in Moradabad for 1 year. This study included 640 volunteers (320 males and 320 females) across all six zones of the Indian population: SPSS v25 was used for evaluating the data, and a significance threshold of P < 0.05 was deployed to establish the level of statistical significance. Results: Males and females differed significantly in all nasal measurements using the direct approach, except nasal bridge length. However, when employing 2D indirect photogrammetry, anatomical nose width, and nasal bridge length did not display significant variations. Among the eight parameters examined, five nasal metrics exhibited a strong level of concordance, including nose height, morphological nose width, alar length, nasal tip protrusion, and nasal index. On the other hand, nasal bridge length and columella length showed a reasonable level of reliability in both methods. Conclusion: This research implies that nasal traits can differ among ethnicities and potentially affecting perceptions or evaluations. Furthermore, it is crucial to recognize that nasal metrics may vary not only among diverse ethnic groups but also within distinct regions of India, as well as between genders. The results of this research also suggested that 2D photogrammetry proves to be a reliable substitute for the direct method.