Evidence-Based Nasal Analysis for Rhinoplasty

The 10-7-5 Method

Íris M. Brito, MD; Yash Avashia, MD; Rod J. Rohrich, MD

Disclosures

Plast Reconstr Surg Glob Open. 2020;8(2):e2632 

In This Article

Abstract and Introduction

Abstract

Summary: Rhinoplasty is one of the top 5 aesthetic surgical procedures performed in plastic surgery. A methodical evaluation based on solid and up-to-date scientific evidence in different key areas of nasal and facial analysis is presented, the 10–7-5 method. This represents the most important preoperative step for a successful rhinoplasty. The 10–7-5 method for nasal analysis is a useful instrument that provides the rhinoplasty surgeon a deep comprehension of nasal anatomy. Understanding the nasal structures' main relationships and consequences of each surgical maneuver on nasal framework assists on establishing the appropriate surgical goals for each patient, both in primary and secondary rhinoplasty cases. This systematic analysis of patient's frontal, lateral, and basal nasal views provides a background to identify changes to ideal aesthetic proportions and how to surgically restore them while maintaining gender and ethnic congruency.

Introduction

Rhinoplasty is still one of the top 5 aesthetic surgeries performed, ranking third in 2018 with over 213,000 procedures performed.[1] A comprehensive preoperative clinical analysis, including evaluation of nasofacial proportions and systematic nasal analysis, is the most important initial step for a successful rhinoplasty.[2,3] A methodical evaluation based on solid and up-to-date scientific evidence in different key areas of nasal analysis is presented—the 10–7-5 method (Table 1). The senior author (R.J.R.) has extensively used this method both for primary and secondary rhinoplasty case analysis. It allows either the experienced or young surgeon to precisely appraise facial balance and nasal proportions and establish the correct surgical goals to each patient. An aesthetic pleasing result can only be achieved if patient's nasal features and primary areas of concern are managed in a customized approach. A systematic evaluation of patient's frontal (Figure 1), lateral (Figure 2), and basal (Figure 3) nasal views provides a background to identify changes to ideal proportions and how to surgically restore it maintaining gender and ethnic congruency (Video 1) (see Video, [online], which displays the 10–7-5 method for clinical nasal analysis).

Figure 1.

Clinical nasal analysis: Frontal view analysis of a 25-year-old patient before primary rhinoplasty and chin augmentation (10 key areas).

Figure 2.

Lateral view analysis (7 key areas).

Figure 3.

Basal view analysis (5 key areas).

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