A higher nose allows you to slide back toward the widest part of the saddle, where you should plant your sit-bones. This reduces the pressure on tissue forward of the sit-bones because you're not sliding forward into the saddle.

Too much tilt can restrict pedaling movement because you're positioned too far back on the saddle. This can also compress the tissue forward of the sit-bones when you're in the drop.

My Brooks Pro lacks the three circular openings at the top. This makes the leather more stiff. I slowly reduce the tilt angle as the leather soften with use. The saddle is dialed in for maximum comfort when my hands are at the top of the bar. I shift my body around after 2 miles to allow blood to circulate around the seating area.