Ikegaya et al. Basic and Clinical Andrology
https://doi.org/10.1186/s12610-021-00121-z(2021) 31:3

RESEARCH ARTICLE

Open Access

Nose size indicates maximum penile length
Hiroshi Ikegaya1* , Motofumi Suzuki2,3, Hiroki Kondou1, Taketo Kawai3, Yusuke Sato3, Tadaichi Kitamura3 andHaruki Kume3

Abstract
Background: In a previous report, we investigated whether the size of male genitalia similarly exposed to serum
testosterone during aging could change with age and found that penile length almost stopped increasing duringadolescence and decreased in older males. In this report, to determine what factors other than age are related topenile length, we performed a multivariate analysis of the relationships between stretched penile length (SPL) andother measurements of genital organs, nose size, height and body weight in 126 adults in their 30s–50s.
Results: The most highly correlated factor with SPL was flaccid penile length (r = 0.565, P < 0.0001). The next
highest correlation was nose size (r = 0.564, P < 0.0001). The penile stretched rate correlated with FPL (r = − 0.690,
P < 0.0001) but not with SPL or penile circumference.
Conclusions: The fact that nose size is related to SPL indicates that penile length may not be determined by age,height or body weight but has already been determined before birth.
Keywords: Stretched penile length, Nose size, Aging, Cadaver

RésuméContexte: Dans un précédent article, nous avons examiné si la taille des organes génitaux masculins exposés defaçon similaire à la testostérone sérique pendant l’avancement en âge pourrait changer avec l’âge; nous avons
constaté que la longueur du pénis avait presque cessé d’augmenter à la période de l’adolescence et avait diminuéchez les hommes plus âgés. Pour déterminer quels facteurs autres que l’âge étaient liés à la longueur du pénis,nous avons réalisé, dans la présente étude, une analyse multivariée des relations entre la longueur du pénis étiré(LPE) et d’autres mesures des organes génitaux, de la taille du nez, de la taille et du poids corporels chez 126
adultes âgés de 30 à 50 ans.
Résultats: Le facteur le plus fortement corrélé avec la longueur du pénis étiré était la longueur du pénis flasque(r = 0.565, p < 0.0001). La corrélation suivante la plus élevée était la taille du nez (r = 0,564, p < 0,0001). Le tauxd’étirement du pénis était corrélé à la longueur du pénis étiré (r = − 0.690, p < 0.0001) mais n’était corrélé ni à lalongueur du pénis flasque ni à la circonférence du pénis.
Conclusions: Le fait que la taille du nez soit liée à longueur du pénis étiré indique que la longueur du pénis peut(Continued on next page)* Correspondence: ikegaya-tky@umin.ac.jp; ikegaya@koto.kpu-m.ac.jp
1
Department of Forensics Medicine, Graduate School of Medicine, Kyoto
Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji,Kamigyo-ku, Kyoto 602-8566, Japan
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Ikegaya et al. Basic and Clinical Andrology(2021) 31:3

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(Continued from previous page)ne pas être déterminée par l’âge, la taille ou le poids corporels, mais qu’elle a déjà été déterminée avant lanaissance.
Mots-clés: Longueur du Pénis étiré , Taille du Nez , Vieillissement , Cadavre

Background
Many unidentified dead bodies are discovered every
day, not just from acts of terrorism and natural disasters, and this is becoming a major problem worldwide[1]. In Japan, with a population of 120 million,
approximately 1000 people are discovered annually as
unidentified cadavers, and the police are required toinvestigate these cases.
In their initial investigations of unidentified corpses, thepolice seek to identify them using factors, such as age andgender, as well as by their belongings. These dead bodies
are often thought to be skeletons or highly decayed.
However, in fact, most of them are recently deceased.
Gender is relatively easy to determine by assessing thegenitals or DNA examination. However, it is very difficult to estimate age based on cadaver appearance.
Recently, some researchers reported the utility of computed tomography (CT) images for age estimation, especially for the living or nonskeletonized corpses [2, 3].
However, a body must be transported to obtain CT images, which requires time and effort and incurs costs.
We previously reported that postmortem serum
prostate-specific antigen (PSA) level and prostate
volume correlate with age and discussed the use of PSA
in an objective age estimation [4].
The age-related increase in serum PSA levels has been attributed mainly to prostate enlargement due to prolonged
exposure to serum testosterone during aging [5–7]. Testosterone is also related to the growth of the penis in newborn
infants [8].
Therefore, we also investigated whether the size of themale genitalia similarly exposed to serum testosterone
during aging could change with age in our previous
report. We found that penile length almost stopped increasing during adolescence, remained unchanged in
middle age, and decreased slightly in older males [9].
The saying “Big nose, big hose” suggests that nose size
indicates penile length. However, scientific reports thatprove this statement are not available to date.
In this report, to confirm the truth of this statement,
we analyzed the relationships between stretched penile
length (SPL) and nose size as well as the weight of male
genital organs in middle-aged people.
Materials and methods
One hundred twenty-six male forensic autopsy cases at
Kyoto Prefectural University of Medicine from April

2015 to March 2019 were used in this study. All cases
were in their 30s–50s, and their postmortem time waswithin 3 days. Height, weight, SPL, flaccid penile length(FPL), penile circumference (PC), right and left testicularweights, prostate weight, and nose size were measured at
the autopsy by one researcher during the period. SPL
was measured by manual traction [10]. SPL was measured at room temperature, which was maintained at22 °C, with the cadaver lying in the supine position andthe penis placed at a 90° angle to the body. The nose size
was defined as the longer distance between the midpointof the left and right medial ocular angles and the outsideof the left or right nose wings (Fig. 1).
This study was approved by the Institutional Review
Board of Kyoto Prefectural University of Medicine (ERBC-1491-1).

Statistical analysis

Relationships among age, height, body weight and factors related to the genital organs were analyzed using
Pearson’s linear correlation. To identify independentpredictive factors influencing SPL, multivariate analyses
were performed using linear regression models. Analysis
was performed using JMP software (SAS Institute Inc.,Cary, NC).

Fig. 1 The measurement of nose size. Nose size was defined as thelonger distance between the midpoint of the left and right medial
ocular angles and the outside of the left or right nose wings(indicated by arrow)Ikegaya et al. Basic and Clinical Andrology(2021) 31:3

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Table 1 Relationships among age, height, body weight and factors related to genital organs (multivariate analysis using linear
regression models)r Pearson correlation coefficient. p Dark gray-hatched cells represent p < 0.010). Gray cells indicate p < 0.050)

Results
Table 1 presents the relationships among age, height,
body weight and factors related to the genital organs.
The most highly correlated factors were stretched penile
length and flaccid penile length (r = 0.565, p < 0.0001).
The next highest correlation was noted for stretchedpenile length and nose size (r = 0.564, p < 0.0001). The
penile stretch rate was highly correlated with the flaccid
penile length (r = − 0.690, p < 0.0001) but not with thestretched penile length or penile circumference. Nose size
was correlated with all factors except penile circumference: height (r = 0.378, P = 0.083), body weight (r = 0.378,
P < 0.0001), left testis (r = 0.287, p < 0.0018), right testis(r = 0.268, p = 0.004), prostate weight (r = 0.212, p =0.0225), flaccid penile length (r = 0.228, p = 0.137) andnose size. Body weight was highly correlated with height(r = 0.424, p < 0.0001), left testis (r = 0.524, p < 0.0001),
right testis (r = 0.441, p < 0.0001), prostate weight (r =0.260, p = 0.0045) and nose size but not with stretchedpenile length, flaccid penile length or penile circumference. Age was weakly correlated with body weight (r = −0.270, p = 0.003), left testis (r = − 0.252, p = 0.0064) andright testis (r = − 0.226, p = 0.0145).
The linear regression model is presented in Fig. 2. The
relationship between stretched penile length and nose
size is presented in Table 2. The average stretched penile
length gradually increased in the longer nose sizegroups.

Fig. 2 Linear regression analysis of stretched penile length and nose size. SPL: stretched penile lengthIkegaya et al. Basic and Clinical Andrology(2021) 31:3

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Table 2 Relationship between nose size and stretched penile
lengthNose size (cm)nAverage SPL (cm)SD−4.50

27

10.37

1.56

4.51–5.00

75

11.40

1.77

5.01–5.50

18

12.33

1.16

5.51−

6

13.42

1.50SPL Stretched penile length, SD Standard deviation, n NumberDiscussion
In our study, nose size was not correlated with factors
related to body physiques but was correlated with SPL.
In previous reports, embryonic androgens and androgen
receptors were associated with penile growth [11, 12].
Penile growth is also consistent with SPL being associated with the second to fourth digit ratio, which has
been linked to androgen exposure [13]. In the field of
forensic medicine, it is widely known that the size of theskull, excluding the jawbone, is relatively unaffected byaging. Similar to the SPL, as a representative measurement of head parts, nose size may be also not determined by age or body size but has already been
determined before birth.
Our study also suggests that SPL and nose size can beused as indicators independent of age and postnatal
body size.
As expected, a significant correlation was foundbetween SPL and FPL. This finding is attributed to thefact that a person with a longer FPL may naturally havea longer SPL given the flexibility of penile tissue. Contrary to our data, showing that FPL was negatively correlated with penile stretched rate would suggest that theindividual had a different penile extension rate. The
same result was also noted in another report [13]. The
elasticity of a small, flaccid penis may be greater thanthat of a large, flaccid penis.
In contrast to SPL, a weak correlation with nose size
was found with FPL (r = 0.228, p = 0.0137). This finding
may be attributed to the fact that the contraction rate of
the penis varies slightly based on FPL in contrast to SPL,
which indicates the maximum length during erection. Inaddition, the absence of blood flow in the cadavers contributed to the variation in the measured values of FPL.
A high second to fourth digit ratio may indicate asmall penis [13]. In addition, there is a report that a highsecond to fourth digit ratio may indicate small testes[14]. In addition, a correlation may exist between testis
weight and nose size. Unfortunately, we did not analyze
the second to fourth digits in our present study. Only
weak correlations were noted between left and righttestis weights and nose size in our study.
Although our results are useless for forensic purposes,
understanding the growing process of the penis or facial

features may be very important for extrapolating fetal
androgen levels and following male genital functions.
This study is the first to demonstrate the relationshipbetween SPL and nose size but is limited in Japanesemale cadavers, and the reason why SPL and nose size
are related is still unclear. Therefore, we consider it aninteresting subject to pursue from now on.

Conclusions
Nose size was highly related to stretched penile length inJapanese male cadavers.
Abbreviations
BMI: Body mass index; CT: Computed tomography; FPL: Flaccid penile length;
PC: Penile circumference; PSA: Prostate-specific antigen; SPL: Stretched penile
lengthAcknowledgments
Not applicable.
Authors’ contributions
Conception and design: Suzuki M, Kitamura T and Ikegaya H. Drafting ofmanuscript: Ikegaya H and Suzuki M. Acquisition of data: Ikegaya H andKondou H. Analysis and interpretation of data: Ikegaya H and Kondou H.
Obtaining funding: Ikegaya H. Statistical analysis: Ikegaya H. Administrative,technical, or material support: Suzuki M. Supervision: Kitamura T. and Kume
H. Critically reviewed the manuscript for important intellectual content:
Kawai T., Sato Y., Kitamura T. and Kume H. All authors approved the final
version of the manuscript and agree to be accountable for all aspects of thework in ensuring that questions related to the accuracy or integrity of any
part of the work are appropriately investigated and resolved.
Funding
This research received no external funding.
Availability of data and materials
The datasets generated during and/or analyzed during the current study areavailable from the corresponding author on reasonable request.
Ethics approval and consent to participate
The study was approved by the Institutional Review Board of Kyoto
Prefectural University of Medicine (ERB-C-1491-1).
Consent for publication
Informed consent was obtained from legal guardians.
Competing interests
The authors declare that they have no competing interests.
Author details
1
Department of Forensics Medicine, Graduate School of Medicine, Kyoto
Prefectural University of Medicine, Kajii-cho 465, Kawaramachi-Hirokoji,Kamigyo-ku, Kyoto 602-8566, Japan. 2Department of Urology, Tokyo
Metropolitan Bokutoh Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo
130-8575, Japan. 3Department of Urology, Graduate School of Medicine, The
University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Received: 20 July 2020 Accepted: 11 January 2021

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