Automatic Apparent Nasal Index from Single Facial Photographs Using a Lightweight Deep Learning Pipeline: A Pilot...

Background and Objectives: Quantifying nasal proportions is central to facial plastic and reconstructive surgery, yet manual measurements are time-consuming and variable. We sought to develop a simple, reproducible deep learning pipeline that localizes the nose in a single frontal photograph and automatically computes the two-dimensional, photograph-derived apparent nasal index (aNI)-width/height × 100-enabling classification into five standard anthropometric categories. Materials and Methods: From CelebA we curated 29,998 high-quality near-frontal images (training 20,998; validation 5999; test 3001). Nose masks were manually annotated with the VGG Image Annotator and rasterized to binary masks. Ground-truth aNI was computed from the mask's axis-aligned bounding box. A lightweight one-class YOLOv8n detector was trained to localize the nose; predicted aNI was computed from the detected bounding box. Performance was assessed on the held-out test set using detection coverage and mAP, agreement metrics between detector- and mask-based aNI (MAE, RMSE, R²; Bland-Altman), and five-class classification metrics (accuracy, macro-F1). Results: The detector returned at least one accepted nose box in 3000/3001 test images (99.97% coverage). Agreement with ground truth was strong: MAE 3.04 nasal index units (95% CI 2.95-3.14), RMSE 4.05, and R² 0.819. Bland-Altman analysis showed a small negative bias (-0.40, 95% CI -0.54 to -0.26) with limits of agreement -8.30 to 7.50 (95% CIs -8.54 to -8.05 and 7.25 to 7.74). After excluding out-of-range cases (<40.0), five-class classification on n = 2976 images achieved macro-F1 0.705 (95% CI 0.608-0.772) and 80.7% accuracy; errors were predominantly adjacent-class swaps, consistent with the small aNI error. Additional analyses confirmed strong ordinal agreement (weighted κ = 0.71 linear, 0.78 quadratic; Spearman ρ = 0.76) and near-perfect adjacent-class accuracy (0.999); performance remained stable when thresholds were shifted ±2 NI units and across sex and age subgroups. Conclusions: A compact detector can deliver near-universal nose localization and accurate automatic estimation of the nasal index from a single photograph, enabling reliable five-class categorization without manual measurements. The approach is fast, reproducible, and promising as a calibrated decision-support adjunct for surgical planning, outcomes tracking, and large-scale morphometric research.