隆鼻術—男性と女性の求めるものの違いについて—

Rhinoplasty: the differences in preferences between males and females

はじめに

　「鼻を高くしたい」。そのような希望で来院される患者は，「鼻を低くしたい」と希望される患者よりも，本邦においては圧倒的に多いと思われる。ただ，問診で詳しく聞いていくと鼻を高くしたいという希望者の中には，「鼻の根っこを高くしたい」と考えている患者と「鼻先を高くしたい」と考えている患者がおり，後者の方が多いように感じる。われわれ美容外科医は隆鼻術というと鼻根部を高くする手術を考えるが，それは狭義のものであり，広義には鼻尖部の高さを出すことまでもが隆鼻術とする方が，患者目線では正しいのかもしれない。

　さらに，その高さは男性が求めるものと女性が求めるものでは違うと，過去の文献でも述べられている 1）～3）。

　そこで今回，鼻根部から鼻尖部までの鼻の高さに求めるものの性差に関して，自験例を踏まえて検討した。

　Among patients who feel that they have a sharp nose or a high nasal bridge, some prefer a higher nasal root, while others prefer a higher tip. This study investigated whether there are differences in preferences between males and females in the preoperative planning of their noses. There are several numerical indicators for ideal nasal morphology, and the results of evaluations of these indicator differ slightly between the genders. This studyʼs hypothesis was that these differences stem from individual preferences, and the differences in these indices obtained pre- and postoperatively were thus examined.

　All three patients from our clinic (1 males, 2 females, age 21-35) reported being satisfied with the postoperative appearance of their noses, although each reported that their preoperative preferences were not fully achieved. It was determined that the ideal lateral morphology of the nose for females includes the following characteristics: lower brow ridges, a straight or concave dorsum, the tip projection point (TPP) slightly projected cephalically, a mild convex dorsum descending from the TPP to the base of the nasal column, the base of the nasal column positioned lower than the base of the alar, a slightly upturned upper lip, and a nasolabial angle of approx. 90°. It is important to use imaging software to obtain preoperative photographic images based on these characteristics, in order to achieve excellent cosmetic outcomes.