Esthetic Nasolabial Angle according to the Degree of Upper Lip Protrusion in an Asian Population

Abstract

Background The positioning of the nasal tip is as esthetically important as the tip projection when rhinoplasty is being considered. It is not uncommon for Asians to have a protruding upper lip and teeth that affect the nasolabial angle (NLA). This study aimed to find the preferred NLA according to the degree of upper lip protrusion in an Asian population. Methods A left-side lateral photograph of each participant was used for simulation of six different tip angles by using a photoshop program. First, the angles of the upper lip protrusion were changed into 10, 20, and 30° by a perpendicular line to the Frankfort line in each image; then, the NLAs were changed into six different angles (from 75 to 110°) for each of the three angles of upper lip protrusion for each model. Newly transformed images of nasal tips, six for the male model and six for the female model, were made by using presentation software slides and were placed in a random order. Then, 120 Korean raters were asked to choose the most preferred image from among the slides. Results In 10° of upper lip protrusion, the preferred mean ± standard deviation (SD) NLAs for the male and female models were 88.7 ± 6.4° and 92.9 ± 6.9°, respectively. In 20° of upper lip protrusion, the preferred mean ± SD NLAs for the male and female models were 80.9 ± 6.9° and 83.9 ± 5.7°, respectively. In 30° of upper lip protrusion, the preferred mean ± SD NLAs for the male and female models were 78.4 ± 5.5° and 79.0 ± 5.4°, respectively. Conclusion In an Asian population, the preferred NLA was changed to a more acute angle according to the degree of upper lip protrusion.

Lip Lifting Efficacy of Hyaluronic Acid Filler Injections: A Quantitative Assessment Using 3-Dimensional Photography

“…After subgroup analysis, we further demonstrated that the post-treatment decrease in CLA was statistically significant only in Group B but not in Group A at both 4-week and 12-week follow-ups. CLA or NLA with the best esthetics generally shows a relatively wide range when the degree of upper lip protrusion is small [ 20 ]. However, when lip protrusion is marked, the aesthetically preferred CLA tends to fall within a narrow range, with a strong preference for more acute CLA related to the degree of upper lip protrusion [ 20 ].…”

“…CLA or NLA with the best esthetics generally shows a relatively wide range when the degree of upper lip protrusion is small [ 20 ]. However, when lip protrusion is marked, the aesthetically preferred CLA tends to fall within a narrow range, with a strong preference for more acute CLA related to the degree of upper lip protrusion [ 20 ]. Considering that surgical lip lift results in a significant decrease in the angle of the nasolabial region [ 21 ], a decrease in CLA found in our study implies the lip lifting effect of HA filler injections.…”

Lengthening of the Asian Nose

“…Asian noses are generally more rotated compared with Caucasian noses, with a more obtuse nasolabial angle. 4,5,8 This may lead to the appearance of an "upturned nose" as well as a shorter nasal dorsum-features that are not considered aesthetically pleasing in the Asian context. Consequently, decreasing the rotation of the nasal tip is an important aspect of Asian rhinoplasty.…”

“…In such cases, most Asian patients prefer a less acute nasolabial angle after correction instead of the Caucasian ideal of 90 degrees for men and 95 to 105 degrees for women. 8 Premaxillary augmentation is also a consideration in patients with premaxillary deficit. 9…”

“…As such, the tip projection and definition need to be recreated with cap grafts, often in a stacked fashion, to show up against the thicker skin and soft tissue envelope. 7,8,43 The CSEG and the dome-forming parts of the LLCs form a stable platform on which cap grafts can be mounted. We pin the first layer of graft onto the domal platform and suture the graft onto the LLCs with PDS 5-0 sutures at the four corners of the graft.…”