Cephalometric measurements are widely used and essential when planning rhinoplasty and other surgical and non-surgical facial interventions. They provide measurements and simulations, which are extremely useful both for more iterative communication with the patient, as well as for more accurate planning of surgical techniques and maneuvers to be used during surgery. Despite its importance in facial aesthetic evaluation, the different forms of implementation often generate misunderstanding by professionals when planning and simulating images because they suffer from slight distortions in relation to the real measurement. The main objective of the present study was to compare three measuring instruments used in the facial surgeon’s clinical practice: rigid ruler (RR), millimeter glasses (MG), and millimeter adhesive tape (MAT), evaluating whether there would be a difference between the measurements obtained by each of them in the analysis of digital photographic images. It was observed that in the profile view all the instruments used presented significantly different measurements from each other, and something similar was verified in the frontal view when comparing MG and MAT with RR. It was evident that the use of these widely disseminated objects, despite initially appearing useful, can bring different values to each other, eventually leading to inaccurate measurements, planning, and simulations. New studies are necessary to elucidate which of the methodologies would be the most appropriate for estimating real measurements.
