Ideal Beauty: Facial Analysis & Symmetry: Section 1
Why is the world so obsessed with the
beautiful? What makes them beautiful? What do they have that catches the
eye? Well it certainly isn't perfection -- there is no such thing,
remember? Although it is difficult to think otherwise sometimes, isn't
it? Is it the balance of their facial features? Some kind of measurement
system? Were they just destined to be beautiful? Some of us may greet
them with envy and dislike while most of us greet them with admiration.
If you cannot admire beauty how ever can you desire to embrace it?
So, what is it then?
Well, it depends
on who you ask. We often think perfect parts make perfect people.
what makes perfect parts? Is it round, perky breasts? Is it small hips?
it defined cheekbones or full lips? There
are graphs and charts and theories. But no amount of measurements can
suit everyone. Sometimes it is lack of typical features that makes one
stunning but most
times it is the balance that they have either achieved naturally or with
cosmetics, lighting, airbrushing, computer imagery or... surgery.
Truly there are some
extremely attractive people in this world. While my idea of what may be
attractive is surely different from the next person's why is it that the
whole world longs to be looked upon with admiration? Do we feel wanted
or needed when we are thought of as beautiful by others? Or are we
simply satisfied with ourselves when we look our best? Is it for our own
pleasure to gaze at a pretty reflection staring back at us? Do we inwardly
need to be approved of? Is it considered vain if we want it? There is
nothing wrong with wanting to be aesthetically pleasing...
All of this drives some of us
insane as we study beauty magazines that afterwards can make us feel
even less attractive. I do it, you do it, we've all felt that way at
least once in our lives. This shouldn't be about flawlessness, this
shouldn't be about what society deems worthy of our gaze. That's
nonsense! This is about what YOU think is pleasing to the eye.
do these thoughts come from? They must come from somewhere. Do they come
from within or is within influenced by someone else?
One's opinion of beauty may be influenced very early but beauty is
looked upon with interest by even infants. Infants who don't know what
an ideal weight or Chanel lip color means. Infants will gaze upon a
symmetrical face longer than an asymmetrical one. Even if that face is
not of it's mother or father. Children often stare at beautiful women
and mimic their moves -- even showing favoritism towards more attractive
Well children didn't learn it
from their parents, it is instinctive. They aren't born knowing the
Silver Chin Soft Tissue Assessment or Ideal Cheek
placement. Infants are
just born knowing what pleases the eye.
Even in the animal kingdom the
preferences are around who has the best plumes, mane or horns. Who
has the biggest this or that, the shiniest coat and brightest eyes.
mother birds will tend to feed the most brightly colored of their
offspring first, fearing the other may be sick so more energy is spent
on the pretty, healthy ones. Even when the healthy baby bird's
feathers are cut off the mother chooses to feed the other baby birds
first, then diverts her attention last to the affected one.
Even the unattractive peacocks will stand
next to the showier males in hopes to get the attention of peahens.
female peahen will be excited and attracted by the rich plumes of the
colorful, attractive peacock but may be taken by the unattractive peacock
in the confusion.
Even the lioness will choose the stronger, more
attractive males to contribute their genes. Each species chooses the
best of the group to produce their offspring with the best chance to
survive and prosper. So, why all this favoritism? I know, we are not
animals nor are we infants, but I am trying to point out that no matter
how we are brought up our eye favors the showier, shinier, newer model.
It is instilled within our very core.
Features & Symmetry
So what measurement system are we going by? Well there isn't
really a measurement system that dictates who is attractive and who is
not, it's more of what university professors, artists and plastic
surgeons deem "ideal" Where this may seem grossly
unfair, it does have fact to it regarding what pleases the eye.
What pleases the idea on a large scale tends to amount to about the same
measurements of the facial features in proportion to each other.
For instance the eyes in relation to the nose, the nose in relation to
the mouth, the mouth in relation to the chin and so on and so forth.
Is it as simple as
symmetry? If that is all it is what makes a person more symmetrical than the next?
Is it an oval face shape with exotic eyes, full lips and sharp
cheekbones? Is it being thin as a twig with glowing skin and a youthful
bright smile? Is it having no pimples? Let's look at symmetry...
Beauty is not an exact science but
according to some Plastic Surgeons there is a specific proportion system that
the ideal face tends to hover at. This includes facial
height, width and symmetry. First the face is evaluated from its frontal
view and then its lateral (side view). There are steps that can
determine the facial lateral width or projection (as in your profile)
and there is the oblique assessment for contours such as the cheek
bones, chin and nose.
(noun), plural -tries
[Latin symmetria, from Greek, from symmetros symmetrical, from syn- +
metron measure -- more at MEASURE] First appeared 1541
1 : balanced proportions; also : beauty of form arising from balanced
2 : the property of being symmetrical; especially : correspondence in
size, shape, and relative position of parts on opposite sides of a
dividing line or median plane or about a center or axis
**The below article is
from FACIAL ANALYSIS; Dept of Otolaryngology, UTMB, Galveston, TX
- October 1, 1997. *You will more than likely need a good Online
Medical Dictionary to translate the terminology used. This
dictionary will load in a new window for your convenience.
Just remember, if you
don't pass the evaluation -- don't take it to heart. I am not
all that symmetrical myself. Remember that beauty is also about attitude! So
make it a good one!
Frontal View Evaluation
Step 1. Vertical height -
has been well described that vertical height can be evaluated by
dividing the face into equal thirds.
The boundaries of the upper third
are the trichion and the glabella, with the mid third extending from the
glabella to the subnasale and the lower third from the subnasale to the
menton. The lower third can be further subdivided into thirds with the
stomion marking the inferior boundary of the upper third, and the lower
lip and chin forming the lower two-thirds. While some have advocated
evaluating only the mid and lower face in men with receding hairlines,
others have stated that the appropriate superior border for the upper
third can be determined in these cases by locating the most superior
movement of the frontalis muscle.
Step 2. Width - The
easiest way to evaluate the relative width of facial structures is to
divide the face into vertical fifths with each fifth being equal to one
eye width. This technique is also helpful at determining the appropriate
width of several individual subunits and will be discussed more later.
Also transverse distances at bitemporal and bigonial lines should be
equal and approximately ten percent shorter than the bizygomatic line
drawn through the malar eminences.
Step 3. Symmetry - A
midsagittal line is drawn and the symmetry of the various subunits
(ears, eyes, eyebrows, nose, and mouth) is compared. This is also a good
time to assess the overall facial shape which should be roughly oval.1
Lateral View Evaluation
Prior to evaluating the patient's profile, it is
important to assure appropriate head position. This has traditionally
been accomplished by placing the Frankfort horizontal line parallel to
the floor. The Frankfort horizontal line is drawn between the superior
aspect of the external auditory canal (or through the tragion) and the
infraorbital rim. A second technique to obtain the patient's natural
horizontal head position is to have them fix their eyes on a point at
Step 4. Vertical height - Again,
facial height is divided into thirds as in step 1, and the equality of
the thirds reassessed. The vertical placement of landmarks is also
determined in this step. As stated above, the lower third can be further
divided into thirds with the stomion separating the upper and mid thirds
and the pogonion lying in the center of the lower subdivision.
Step 5. Midface projection - To assess the
midface position relative to the upper face, a second line is drawn from
the nasion to the subnasale. This line should form an angle of 85 to 92
degrees when compared to the Frankfort horizontal line and is termed the
zero meridian.2,3 If this line is excessively anterior, the midface is
described as anteface, and if posteriorly, a retroface profile is
Step 6. Lower face position - The
position of the lower third of the face compared to the upper third is
then established, again with the zero meridian providing the reference.
A line is drawn from the subnasale to the pogonion. This line should lie
at a ten degree posterior angle from the zero meridian. If the pogonion
is placed significantly anteriorly, it is said to be protruding and if
Step 7. Nose-Lips-Chin Position - At
this point the relationship of the nose, lips and chin to each other is
evaluated using Rickett's E (esthetic) line.4 This line is drawn from
the nasal tip to the pogonion. The lips should lie just posterior to
this line with the upper lip approximately twice as far from the line as
the lower lip. If this is the case, no further evaluation of these
structures is indicated at this time. If not, one of the three
structures is malpositioned. Since the pogonion was evaluated in step 4
and 6, only the lips and nasal projection are further evaluated at this
time. A quick assessment of nasal projection is provided using Goode's
ratio which compares a line form the alar groove to the tip to a second
line from the nasion to the tip. The ratio of the former to the later
should be approximately 0.55 to 0.6.2 The anterior-posterior position of
the lips is quickly evaluated by the Holdaway H (harmony) line. This
line starts at the ideal pogonion and is drawn ten degrees anterior to a
line from the pogonion to the glabella. The lips are appropriately
positioned if they approximate this line.2,5
Step 8. Evaluation Of Individual
The exam now focuses on a more detailed evaluation of
the specific facial subunits including the forehead, eyes and eye brows,
nose, mouth, chin, neck and ears.
Forehead - Although the
forehead is rarely altered surgically, it is important to evaluate
because of its relationship to other parts of the face. Additionally,
certain aspects of the forehead may dictate the surgical approach as in
the case of a receding hair line or the presence or absence of deep
forehead creases. In regards to the normal contour of the forehead, men
tend to have more prominent glabellar and supraorbital rim regions with
women having a smoother transition into the midface.
Eyes and eyebrows - Again the eyebrows differ between sexes with the
ideal male brow placed at the supraorbital rim and fairly flat. The
female brow rest slightly superior to the rim and has a more prominent
arch located at the level of the lateral limbus. The brow should start
medially at a vertical line that passes through the alar groove and
medial canthus, and continue laterally to end along an oblique line from
the nasal ala through the lateral canthus at roughly the same height as
the medial brow.6,7 Careful exam to rule out brow ptosis is extremely
important if blepharoplasty is being considered. The intercanthal
distance is usually 30 to 35 mm and can readily be evaluated when the
frontal view is divided into vertical fifths with this distance equal to
one eye width.1 Both upper and lower lids should be carefully examined
both visually and manually to determine their shape and elasticity. The
upper lid margin should have its highest point at the junction of its
middle and medial thirds and the lower lids lowest point should be
between the middle and lateral thirds. The upper lid should cover 2 to 3
millimeters of superior iris and the lower lid margin usually
approximates the inferior iris.1
Lagophthalmos may be identified by having the
patient look down while tilting the head backward.8 The superior
palpebral lid crease identifies the attachment of the levator
aponeurosis into the orbicularis muscle and should be located
approximately 8 mm from the eyelash line.9 The presence and location of
fat pseudoherniation should be determined and an inferiorly displaced
lacrimal gland noted if present. Horizontal laxity of the lower lid can
be tested by pulling the lid away from the globe and then releasing it.
In the normal lid, it should snap back. If it returns slowly or not at
all, significant laxity exist and may alter the surgical plan. Also the
strength of the orbicularis muscle should be checked by having the
patient close their eyes tightly while the examiner attempts to open
In addition to the initial evaluation presented
above, the nose should be evaluated for dorsal deformities and
appropriate width on frontal view. Again, dividing the face into
vertical fifths helps quickly determine whether an acceptable lower
nasal width is present. The alar- alar distance should be equal to one
eye width (one fifth) in Caucasians with wider noses acceptable in Asian
and African-Americans. This distance may also be evaluated by
determining the length of the nose from nasion to tip, with the width
being approximately 70% of the length. On profile view nasal projection,
rotation and length as well as the nasofrontal, nasofacial and
nasolabial angles are more closely evaluated. The nasofrontal angle is
formed at the nasion by lines that extend from this point to the
glabella and to the nasal tip. This angle should ideally be 120 to 135
degrees. The position of the vertex of this angle (nasion) is also
important because moving it up or down will lengthen or shorten the
nose, respectively. Its usual position is at the level of the superior
limbus of the eye. Nasal tip projection is often difficult to determine
and many techniques have been advanced. Goode's ratio of
0.55-0.6:1comparing projection to nasal length has been presented above.
Another method involves the nasofacial angle which is formed by a line
along the nasal dorsum intersecting a line from the glabella to the
pogonion. The ideal nasofacial angle is 36 degrees. Nasal length, height
and projection may also be examined simultaneously by creating a right
triangle between the alar groove, the tip defining point and the nasion.
The projection, height and length should create sides with a ratio of
Finally, an easy but often inaccurate method of
determining projection compares it to the length of the upper lip from
subnasale to vermilion border with the two being roughly equal. The
fault with this technique lies in the variability of the upper lip
length. Tip rotation is assessed by evaluation of the nasolabial angle
which is formed by lines along the columella and upper lip that
intersect at the subnasale. The ideal nasolabial angle for women is 100
to 120 degrees and men between 90 and 105 degrees. Also on lateral view,
the alar and lobular lengths should be equal and there should be between
2 and 4 mm of columellar show. On basal view, the nose should have the
shape of an equilateral triangle and the columella should be
approximately twice as long as the lobule. The lobule should be 75% as
wide as the alar base and the nostrils should be roughly pear shaped.
Lips - The relative position of the lips as
compared to the nose and chin have been discussed. It must be remembered
that these structures as well as the patient's dentition will affect the
appearance of the lips. Other considerations include the width of the
lips, the interlabial gap and the degree of incisor show with smiling.
The oral commissures should be located along vertical lines drawn from
the medial limbus of the iris. Also, the lower lip should be slightly
fuller than the upper lip. When relaxed and with teeth in occlusion, the
lips should approximate one another with an interlabial gap of 3 mm
being the upper limit of acceptable. When smiling, there should be no
gingival show and no more than two thirds of the maxillary incisors
Chin and neck -
The relative position of the chin has been
determined in the initial evaluation and further evaluation is aimed
mainly at the shape of the chin and its relation to the neck. The
mentolabial sulcus depth is assessed by creating a line from the lower
vermilion border to the pogonion. The sulcus should lie approximately 4
mm behind this line. In regards to the neck, Dedo developed a
classification system based on the depth of the abnormality proceeding
from superficial, skin and fat, to deep, muscle (platysma) and bone
(chin or hyoid). Class I is the youthful, normal neck. Class II and III
represent early abnormalities of skin and fat accumulation respectively.
When platysmal abnormalities such as banding are identified, Class IV is
defined, and the loss of an appropriate mentocervical angle because of a
posteriorly positioned chin is labeled Class V. Finally Class VI results
from an inferiorly placed hyoid bone. This final class is particularly
important to identify because very little can be done surgically to
correct this abnormality.10 Lastly, the appropriateness of the neck
length can be determined by comparing the distance from menton to
suprasternal notch, to the head height measured from menton to vertex,
with the head being approximately twice as tall as the neck.
The auricular length should be slightly less than
twice its width and the long axis should be inclined approximately 20
degrees posteriorly. The external auditory canal should be located at a
level roughly halfway between the lateral canthus and the nasal base.
The superior aspect of the ear should be at the level of the lateral
brow and the inferior aspect at the level of the nasal base. The
auriculocephalic angle should measure approximately 20 to 30 degrees.11
Specific landmarks of the ear including the helix, antihelix, scaphoid
fossa, tragus, and lobule should be evaluated for obvious deformity. The
thickness and flexibility of the cartilage should also be estimated.
Dental occlusion -
As mentioned above, the patient's dentition may
play a significant role in overall cosmesis. Although an in depth
discussion is beyond the scope of this presentation, the dentition
should be evaluated and correction considered if abnormalities are
present that could cause aesthetic problems. Briefly, normal occlusion
is present when the mesiobuccal cusp of the maxillary first molar
occludes the buccal groove of the mandibular first molar. This is termed
Type I occlusion. Type II occlusion occurs when the mandibular teeth
occlude in a more posterior position and Type III occlusion is when they
are more anteriorly located.
credit: FACIAL ANALYSIS; Dept of Otolaryngology,
UTMB, Galveston, TX
- October 1, 1997.
Vertical Facial Dimensions
Thirds - Front
Thirds - Lateral
Vertical Facial Fifths --
Or "Rule of Fifths"
The face can be divided into fifths using
the width of the eye from corner to corner as a point of
measurement. Starting from the very outside edge of one ear to the
other -- the face ideally would be 5 eye widths apart. Of course,
since we are human and not designed by computers, it is perfectly fine
if you are not exactly 5 eye widths a part. The width of the base of the nose, at the
nostrils (or ala), should be 1/5 of the face, or one eye width.
Line (or Frankfort Plane)
determine the Frankfort Horizontal Line (red horizontal line), a lateral
photograph is taken and a vertical line is drawn from just in front of
your glabella to your chin.
This line would ideally be perfectly vertical.
The next line is drawn horizontally from right at the supratip to
above the auricular canal, right above the tragus.
Further Facial Analyses
- The width of nose at its base should be approximately
the distance between the eyes (medial canthus).
- The length of upper lip is about twice that of lower
lip and chin.
- Tip - Slight Upward Rotation : better
- Nasofacial angle = 36 degrees
- Nasofrontal angle = 120 degrees
- Nasomental angle = 130 degrees
- Mentocervical angle = 85 degrees
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2 | section 3
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UTMB, Galveston, TX - Dept of
- Facial Analysis; October 1, 1997