Ideal facial relationships and goals – are they still useful in preoperative analysis before rhinoplasty?

<b>Introduction:</b> Facial analysis is a critical component of plastic surgery. When planning a rhinoplasty procedure, a patient's current facial proportions, along with factors such as race, ethnicity, age and gender, must be considered. Achieving an ideal facial balance requires positioning these factors harmoniously for each unique patient.<b>Aim:</b> The aim of this study is to explore the impact of external nasal reshapingfollowing rhinoplasty on facial proportions, aligning them more closely withnormative values.<b>Material and methods:</b> A photographic analysis was conducted on images taken before surgery and six months postoperatively. Measurements were made using a semi-automated method, where facial topographic points were selected and angles and proportions were automatically calculated and compared to normative data. The study included 93 patients (76 women and 17 men) who underwent rhinoplasty. For each patient, the following parameters were assessed before and after surgery: nasofrontal, nasomental, legan facial convexity, nasolabial, nasofacial, mentocervical angles, Goode ratio, facial height ratios, nasal index and various nasal to facial proportions.<b>Results:</b> In female patients, rhinoplasty resulted in a significant decrease in nasofrontal angle, Legan facial convexity, undernose face ratio and intercanthal to nasal breadth ratio, while nasomental angle, lower facial height ratio and nasal index showed a significant increase. In male patients, significant changes were observed in Legan facial convexity, lower facial height ratio, undernose face ratio and intercanthal to nasal breadth ratio, all of which decreased postoperatively<b>Conclusions:</b> The key angles are essential for determining the ideal nasal position and must be carefully considered in preoperative evaluations. While traditional facial proportions are useful, they should be applied flexibly, considering each patient's unique features and aesthetic goals. The future of rhinoplasty combines these principles with personalized approaches that respect diverse beauty standards.