{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T10:31:30Z","timestamp":1784025090327,"version":"3.55.0"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facial Plast Surg"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Accurate assessment of facial symmetry is a key component of successful rhinoplasty surgery but is often overlooked by both surgeon and patient. Up to three-quarters of patients with a significantly crooked nose have been found to have concurrent marked facial asymmetry. Whilst not a contraindication to rhinoplasty, provided that facial asymmetry is identified in advance and expectations realistic, the correction of nasal deformities can improve perceived facial asymmetry. In the aging face, aside from soft tissue and bony resorption that can amplify facial asymmetry, there are specific surgical challenges to the aging nose; the normal tip support mechanisms deteriorate with age giving rise to distinctive changes to the aging nose\u2014typically tip ptosis and a hanging columella; bone quality becomes more brittle and skin overlying this area becomes thinner. There is also weakening of the external nasal valve thus causing functional impairment too. As a result, rhinoplasty techniques used in younger patients may not be suitable in the aging nose. In this article, the authors describe their experience and outline the evidence on the management of the aging patient with facial and nasal asymmetry.<\/jats:p>","DOI":"10.1055\/s-0041-1725106","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T01:17:48Z","timestamp":1614302268000},"page":"205-210","source":"Crossref","is-referenced-by-count":6,"title":["Restoring Balance and Symmetry to the Aging Nose"],"prefix":"10.1055","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4929-7178","authenticated-orcid":false,"given":"Samit N.","family":"Unadkat","sequence":"additional","affiliation":[{"name":"Department of Rhinology & Facial Plastic Surgery, Royal National ENT & University College Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hesham A.","family":"Saleh","sequence":"additional","affiliation":[{"name":"Department of Rhinology & Facial Plastic Surgery, Charing Cross Hospital, London, United Kingdom"},{"name":"Department of Rhinology, Imperial College London, London, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,2,25]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1001\/jamafacial.2015.0388","article-title":"Frequency and characteristics of facial asymmetry in patients with deviated noses","volume":"17","author":"J S Yi","year":"2015","journal-title":"JAMA Facial Plast Surg"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1001\/archfaci.9.3.184","article-title":"Objective assessment of facial asymmetry in rhinoplasty patients","volume":"9","author":"P Chatrath","year":"2007","journal-title":"Arch Facial Plast Surg"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"445","DOI":"10.7162\/S1809-97772012000400004","article-title":"Rhinoplasty and facial asymmetry: analysis of subjective and anthropometric factors in the Caucasian nose","volume":"16","author":"B Carvalho","year":"2012","journal-title":"Int Arch Otorhinolaryngol"},{"issue":"08","key":"ref4","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1080\/00207450590914464","article-title":"The face, beauty, and symmetry: perceiving asymmetry in beautiful faces","volume":"115","author":"D W Zaidel","year":"2005","journal-title":"Int J Neurosci"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1001\/archfacial.2009.33","article-title":"Impact of rhinoplasty on objective measurement and psychophysical appreciation of facial symmetry","volume":"11","author":"S A Nouraei","year":"2009","journal-title":"Arch Facial Plast Surg"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1001\/archotol.1971.00770060704004","article-title":"Studies on the support of the nasal tip","volume":"93","author":"J B Janeke","year":"1971","journal-title":"Arch Otolaryngol"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1055\/s-2004-815650","article-title":"Rhinoplasty in the aging nose","volume":"19","author":"T Romo III","year":"2003","journal-title":"Facial Plast Surg"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"278","DOI":"10.3109\/00016487109125364","article-title":"Morphological and histological changes responsible for the droop of the nasal tip in advanced age","volume":"71","author":"J Krmpoti\u0107-Nemani\u0107","year":"1971","journal-title":"Acta Otolaryngol"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1055\/s-0028-1082410","article-title":"The aging nose in rhinoplasty for facial rejuvenation","volume":"12","author":"W R Ries","year":"1996","journal-title":"Facial Plast Surg"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1055\/s-0028-1082411","article-title":"Surgical correction of the aging nose","volume":"12","author":"D M Toriumi","year":"1996","journal-title":"Facial Plast Surg"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1007\/s00266-012-9904-3","article-title":"Changes in the facial skeleton with aging: implications and clinical applications in facial rejuvenation","volume":"36","author":"B Mendelson","year":"2012","journal-title":"Aesthetic Plast Surg"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.asj.2008.02.007","article-title":"Aging of the bony orbit: a three-dimensional computed tomographic study","volume":"28","author":"D M Kahn","year":"2008","journal-title":"Aesthet Surg J"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/S0094-1298(20)30868-3","article-title":"Periorbital aesthetic surgery for men. Eyelids and related structures","volume":"18","author":"R S Flowers","year":"1991","journal-title":"Clin Plast Surg"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0094-1298(20)31464-4","article-title":"Management of the deviated nose. The importance of septal reconstruction","volume":"15","author":"J P Gunter","year":"1988","journal-title":"Clin Plast Surg"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1097\/PRS.0000000000003606","article-title":"Implications of facial asymmetry in rhinoplasty","volume":"140","author":"R J Rohrich","year":"2017","journal-title":"Plast Reconstr Surg"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"159","DOI":"10.12968\/denu.2008.35.3.159","article-title":"Facial aesthetics: 2. Clinical assessment","volume":"35","author":"F B Naini","year":"2008","journal-title":"Dent Update"},{"issue":"01","key":"ref19","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/SAP.0b013e31819ae02d","article-title":"Asymmetric facial growth and deviated nose: a new concept","volume":"64","author":"F Hafezi","year":"2010","journal-title":"Ann Plast Surg"}],"container-title":["Facial Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1725106.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,24]],"date-time":"2024-08-24T21:45:13Z","timestamp":1724535913000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1725106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,25]]},"references-count":17,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2021,4,12]]},"published-print":{"date-parts":[[2021,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1725106","relation":{},"ISSN":["0736-6825","1098-8793"],"issn-type":[{"value":"0736-6825","type":"print"},{"value":"1098-8793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,25]]}}}