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Aesthet Surg J. 2020 Jan 21. pii: sjaa010. doi: 10.1093/asj/sjaa010. [Epub ahead of print]

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

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Drs van Zijl and Datema are ENT surgeons and Ms Touw is a medical student, Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.
Prof Perrett is a Professor and Mr Xiao is a Postdoctoral Research Fellow, School of Psychology and Neuroscience, University of St Andrews, St Andrews, UK.
Dr Lohuis is an ENT surgeon, Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Sveti Duh, Zagreb, Croatia.



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.


To test whether an averaged nasal shape is attractive, and whether deviation away from average is associated with decreased attractiveness.


Photographical series of the face were obtained from 80 Caucasian female volunteers aged 25-40 years. A mathematically averaged composite image was created using the first 40 volunteers. Forty-one panel members were recruited to judge the attractiveness of the nose of each original image and the composite, using a 5-point Likert scale ranging from 1 (very ugly) to 5 (very pretty). Deviation of nasal shape from average was calculated using a principal components analysis of standardized nasal landmarks.


Twenty-one respondents were male (51%). Mean (SD) age of the respondents was 35.3 years (±15.6). 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<.001). The rating of the original nose images correlated negatively with deviation from average shape (r = -.40, n = 80, P<.001).


In Caucasian females, a mathematically averaged nose is an attractive nose. Furthermore, the more an individual nose shape resembles average shape, the more attractive it is rated. Calculating deviation from average before and after rhinoplasty may aid in objectively measuring aesthetic rhinoplasty outcome.


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