Even Unmanipulated Eyebrows Are Unreliable Landmarks for Evaluating Deviated Noses in Rhinoplasty

Area of Science:

• Plastic Surgery
• Facial Anatomy
• Rhinoplasty

Background:

• Eyebrows are often used as landmarks in rhinoplasty.
• Evidence regarding the reliability of unmanipulated eyebrows as landmarks is limited.

Purpose of the Study:

• To assess the reliability of unmanipulated eyebrows as landmarks for evaluating deviated noses.
• To compare the reliability of eyebrow-derived landmarks versus eye-derived landmarks.

Main Methods:

• Analysis of preoperative rhinoplasty patient photographs.
• Establishment of mid-canthal and mid-eyebrow lines.
• Measurement of distances from midlines to nasal midpoints.
• Observer ratings of perceived nasal deviation.

Main Results:

• Significant discrepancies (76%) between mid-canthal and mid-eyebrow lines.
• Anthropometric measurements of nasal deviation differed significantly between the two lines (P < 0.01).
• Perceived nasal deviation correlated with mid-canthal line measurements, not mid-eyebrow line measurements.

Conclusions:

• Unmanipulated eyebrows are not reliable landmarks for assessing deviated noses.
• The mid-canthal line is a more consistent and perceptually relevant reference than eyebrow-derived lines.
• Surgeons should utilize eye-derived midlines for deviated nose correction.