Less Is More: Eye-Tracking Reveals How Nose Noticeability Influences Facial Attractiveness

BACKGROUND: Facial attractiveness significantly influences social perception. Previous studies have identified the eyes and mouth as primary focal points of attention, but the role of nasal aesthetics in overall facial attractiveness remains understudied. This study examines the relationship between nose shape, perceived attractiveness, and visual attention using eye-tracking technology. METHODS: Thirty-four models (mean age, 38 years) and 31 observers (mean age, 33 years) participated. Models underwent standardized 2-dimensional/3-dimensional imaging, and 17 anthropometric facial measurements were recorded. Observers viewed these images on an eye-tracker, recording fixation durations and revisit counts for the eyes, nose, and mouth. Observers also rated facial and nasal attractiveness using a 10-point visual analog scale. Gaze metrics were analyzed in relation to attractiveness ratings and anthropometric measurements. RESULTS: Models with noses perceived as unattractive received significantly more visual attention on the nose and mouth (total fixation duration: nose, 0.81 ± 0.14 seconds versus 0.72 ± 0.12 seconds [ P = 0.03]; mouth, 0.65 ± 0.13 seconds versus 0.54 ± 0.07 seconds [ P = 0.03]). Models with noses perceived as attractive received more visual attention on the eyes (total fixation duration: 1.92 ± 0.15 seconds versus 1.69 ± 0.27 seconds [ P = 0.02]). Nasal tip deviation ( P = 0.01) and longer upper lips ( P = 0.05) correlated with lower attractiveness ratings; traditional neoclassical canons and nasal width had limited impact ( P > 0.05). CONCLUSIONS: Noses perceived as attractive enhance facial harmony by reducing visual attention on themselves, allowing the gaze to focus on other dominant facial features, like the eyes. These findings highlight the importance of holistic facial assessments over isolated nasal evaluations during rhinoplasty consults. Future research should incorporate dynamic facial stimuli and diverse observer populations to further refine understanding of nasal aesthetic perceptions.