Anthropometric facial analysis of the African American woman

Ethnic variation in lower face anthropometry on facial computed tomography scans for patients seeking facial feminization surgery

BACKGROUND

Facial feminization surgery (FFS) is the most common form of facial gender-affirming surgery. One of the current knowledge gaps is the understanding of differences among racial groups in baseline craniofacial norms for transgender and nonbinary patients.

METHODS

All patients who sought consultation for FFS and underwent craniofacial computed tomography (CT) scans at a single institution between 2018 and 2023 were included. Patients who underwent previous facial surgeries were excluded. Chart reviews were conducted for patient characteristics, including race, age, hormone therapy duration, and prior gender-affirming surgeries. Racial categorizations included White, Latinx, African American, or Asian. Patients with other or multiracial identities were excluded. Lower face measurements were derived from preoperative facial CT scans. Comparative analyses were performed on all measurements among the racial groups.

RESULTS

In this study, 204 patients were included with an average age of 32.0 ± 10.2 years and a median hormone therapy duration of 2.0 years. The notable differences among the racial groups were: 1. Zygomatic width was the largest in Asian patients (13.5 ± 0.6 cm) compared to all other racial groups (p = 0.03), 2. Nasolabial angle was the smallest in African American patients (82.5 ± 13.1 degrees, p < 0.001), 3. Lower face height was the largest in African American patients (6.9 ± 0.7 cm, p < 0.001), and 4. Lateral mandibular flare was the largest in African American patients (0.4 ± 0.1 cm) and the smallest in Latinx patients (0.2 ± 0.1 cm, p < 0.001).

CONCLUSIONS

Specific target areas of FFS should be carefully considered to account for possible baseline ethnic differences. Relative facial proportions may also be a more salient surgical planning tool in transgender and gender nonbinary patients rather than absolute measurements alone.

The Quadrangular Cartilage in Rhinoplasty: A Surgically Focused CT Dimensional Analysis of Black African and Caucasian Populations

The apparent lack of quadrangular cartilage in Black African noses is commonly observed both from a radiological and clinical point of view. To the best of our knowledge, only a few research papers have been conducted on the facial proportions and structural anatomy of black people of Southern and Eastern Africa. The aim of this retrospective comparative study is a radiological assessment of the total amount of septal quadrangular cartilage by measuring its area in sagittal CT views, in two selected Black South African and Caucasian (CA) samples and the comparison with the literature in our hands. Statistical analysis was conducted, categorical variables are shown as frequencies and percentages, while continuous variables as means and standard deviations. Normal distribution of variables was verified using the Shapiro-Wilk test or by means of skewness and kurtosis values. Differences among unpaired groups were evaluated using the independent Student's t-test for normally distributed data (complemented by the Cohen's d to show the effect size with the following cutoff: d = 0.2, "small" effect size; d = 0.5, "medium" effect size; d = 0.8, "large" effect size) and Mann-Whitney U test in case of non-normal distribution. Statistical significance was defined as p < 0.05 setting the α-error probability at 5%. This study shows that, on average, there is 30% more cartilage available in CA compared with Black African noses and confirms the apparent lack of quadrangular cartilage and in Black African noses which is commonly observed in surgery. The need for an adequate amount of autologous septal cartilage makes cartilage availability a major concern before surgery and being able to preoperative accurately measure the amount of septal cartilage that is available to be harvested for other grafts in the surgery is essential.

Augmentation Rhinoplasty and Centrofacial Lipofilling: Our Experience (ARCL)

Introduction: Augmentation rhinoplasty traditionally represents a serious challenge for plastic surgeons. The association with centrofacial lipofilling is a great approach to achieve harmonious, aesthetic results. The aim of this article is to describe our personal association between Augmentation Rhinoplasty and Centrofacial Lipofilling (ARCL) in non-Caucasian patients. Materials and Methods: In this study, we retrospectively reviewed patients treated with ARCL at our institution between January 2019 and December 2023. We described our personal approach and technique. At a minimum follow-up time of one year, post-operative pictures were taken, and patients were reassessed, evaluating aspects such as global symmetry, shape and contour of the nose, and facial harmony and rejuvenation; finally, patients' satisfaction was investigated according to the ROE questionnaire and the modified S-GAIS. Results: A total of 307 patients were included in the study. They reported a significant satisfactory aesthetic result in nasal image and facial harmony, as the mean postoperative ROE and S-GAIS score show. None of the grafts extruded or collapsed. Wounds healed without reported major infection. Conclusions: This study has demonstrated that ARCL is a safe approach that contributes to improve functional and aesthetic outcomes, has a high patient satisfaction rate, and limited post-operative complications.

Enhancing Aesthetic Harmony: Comprehensive Anthropometric Lip Measurements in Youthful and Attractive Indonesian Adults for Precision Cosmetic Procedures

Lips are an important part of our perception of beauty, youthfulness and attractiveness. Aesthetic lips, as with the rest of the face, differs according to age, ethnicity and sex. The aim of this study was to evaluate the anthropometric measurements of the lips of young and attractive Indonesian adults. Photographs of faces were taken at an anterior neutral position for 100 participants; 47 men and 53 women volunteered to participate in this study. Seven landmarks were used in this study: stomion (st), sublabiale (sl), subnasale (sn), labiale superius (ls), labiale inferius (li), crista philtre (cp) and chelion (ch). Using these landmarks, lower lip height, upper lip height, philtrum length, upper vermillion height, lower vermillion height, cutaneous lower lip height, philtrum width and mouth width were measured. The results were analysed using independent t-test and Mann-Whitney test. Significant differences in lip size were observed between men and women in all the measurements st-sl (lower lip height), sn-st (upper lip height), sn-ls (philtrum length), li-sl (cutaneous lower lip height), sn-ls/ls-st (philtrum length and upper vermillion height) and ls-li/ch-ch (cutaneous lower lip height and mouth width) with a significance of p=0.003, p=0.007, p<0.001, p=0.05, p=0.005 and p=0.021, respectively. Male lip measurements of ch-ch (overall lip width) and ls-st/li-st (overall lower lip height) were significantly smaller than those of female lips. The lip ratios calculated in this study were congruent with aesthetic parameters reported in other populations. This study suggests that the same measurement standards cannot be used on different populations, but these ratios may offer a better framework for precision cosmetic procedures. We believe that the results obtained in this study on lip anthropometry will help in optimising the standard values that can be used for the Indonesian population aged 20 to 35 years.

Saudi Population Nasal Anthropometric Study: Local and International Comparison

Anthropometric measurements are essential for diagnosing and treating various craniofacial disorders during nasal reconstruction and esthetic surgery. Different people have unique individual esthetic features that are a mixture of different races and backgrounds. This study aimed to compare 12 different anthropometric measurements in the Saudi Arabian population with those in other local and international studies. This cross-sectional study was conducted with 420 volunteers from December 2022 to August 2023 in Riyadh, Saudi Arabia. Study samples were drawn from the general population, and 12 nasal anthropometric variables were measured, including 7 linear and 5 angular variables, by taking digital photographs from frontal and lateral views. Anthropometric landmarks and measurements were obtained as previously described by Farkas et al. Photographs were analyzed using Adobe Photoshop CS4 software, and facial landmarks were identified. Data were analyzed using an independent sample t test to assess the mean and SD with differences (P<0.05 indicated a significant value). After statistical analysis, the results were compared with previously published standards for other races. Exactly 420 Saudi Arabian volunteers were examined to compare nasal anthropometric variables. All 12 nasal anthropometric variables differed significantly between male and female individuals. Anthropometry of the nose has an enormous miscellaneous relationship between sexes and populations of different geographic areas. It is important to create average anthropometric measurements for different groups for successful plastic surgery and rhinoplasty.

Ethnic rhinoplasty: Preliminary results of our technique in the pursuit of the harmonious nose

INTRODUCTION

According to the American Society of Plastic Surgery, cosmetic surgery procedures for "ethnic patients" are annually increasing. Ethnic rhinoplasty traditionally represents a difficult challenge for plastic surgeons. Herein, we describe our personal technique to ethnic rhinoplasty to achieve a harmonious nose maintaining the characteristics of individual ethnicity and identity.

MATERIALS AND METHODS

In this study, we retrospectively reviewed ethnic patients treated with rhinoplasty at our institution between January 2019 and October 2022. We described our personal rhinoplasty technique step by step. At a minimum follow-up time of six months, postoperative pictures were taken, and patients were reassessed, evaluating aspects such as global symmetry and shape and contour of the nose. Finally, patient satisfaction was investigated according to rhinoplasty outcomes evaluation (ROE) questionnaire.

RESULTS

A total of 1321 patients were included in the study. They reported a significant satisfactory aesthetic result in nasal image, as indicated by the mean postoperative ROE score (92.12). No cases of nasal contracture were recorded. None of the grafts was extruded or collapsed. Wounds healed without reported major infection.

CONCLUSION

This study demonstrated that our approach is a safe procedure that contributes to improved functional outcomes with a high patient satisfaction rate and a low rate of postoperative complication. The creation of a solid base structure, nasal skin preparation, and an integrated patient approach are key elements of this surgery.

Management of Wide Alar Lobule Using Preservation Rhinoplasty Philosophy: Alar Coring Technique

A broad alar base disrupts nasal harmony and facial aesthetic balance and is an aesthetic concern for many patients. This wide appearance may be related to excessive nostril sill, alar flare, wide alar lobule, or a combination. Many techniques are described in literature to address the alar base with resultant scars to a variable degree. Management of alar lobule thickness is particularly challenging. Our technique presented here introduces a novel method to reduce the thickness of the alar lobule with excellent aesthetic outcome.

External Ear Anthropometry of Healthy Turkish Young Adults

PURPOSE

The aim of this study was to determine the external ear values in Turkish young adults with 2-dimensional photogrammetry.

METHODS

One hundred males and 100 females aged between 18 and 25 years were included in the study. Individuals were photographed from both sides. Ear length (superaurel-subaurel, spa-sba ), ear width (preaurel-postaurel, pra-pa ), and the angle between the vertical axis of the auricle and the line between spa and sba (ear incline angle, eia ) were measured in these photographs. Also, auricular index ( pra-pa / spa-sba ×100) was calculated.

RESULTS

The average values of the spa-sba, pra-pa , eia , and auricular index were found as 65.46±4.68 mm, 37.89±3.61 mm, 19.40±4.83 degrees, and 57.93±4.53 in males and 60.90±5.35 mm, 35.62±3.69 mm, 17.95±4.86 degrees, and 58.65±5.29 in females, respectively. While the values of spa-sba ( P =0.001 for the right side and P =0.001 for the left side), pra-pa ( P =0.001 for the right side and P =0.001 for the left side), and eia ( P =0.024 for the right side and P =0.041 for the left side) were statistically higher for males than females, there was no statistically significant difference between the sex and the auricular index ( P =0.404 for the right side and P =0.955 for the left side). Besides, there was no statistically significant difference between the sides for these 4 parameters ( P =0.760, 0.409, 0.225, and 0.521, respectively).

CONCLUSION

The authors believe that the results obtained for Turkish young adults can be used as reference values, which can be used in the diagnosis, follow, or surgical treatment of many diseases, forensic procedures, and planning esthetic surgery procedures.

The ideal shape of the female jaw angle: An online survey

The aim of this study was to determine the characteristics of an attractive white female jaw angle in the three dimensions. An online survey of photographs of celebrities and laypeople was used to rate their attractiveness using 6 questions and a 3-item Likert scale. If ≥ 80% of participants rated a model as having attractive aesthetic features, it was considered attractive. The following features were considered important: a gonial angle in profile of 125.5° and in anterior view of 142°, an intergonial-interzygomatic width ratio of 0.83 and the vertical position of the jaw angles at the level of the stomion or upper lip. Surgeons can use these consensus criteria to help design a jaw angle implant, define orthognathic surgical strategies, or shape the angle using injectables.

Long-term efficacy and safety of a hyaluronic acid dermal filler based on Tri-Hyal technology on restoration of midface volume

INTRODUCTION

Art Filler Volume (AFV) is a hyaluronic acid (HA)-based filler formulated with "Tri-Hyal" technology, a unique combination of three sizes of HA chains. This study assessed AFV efficacy and safety over 18 months when used to restore midface volume.

METHODS

During this open-label study, a maximum of 1.8 mL AFV was injected into each cheek area on Day 0 (D0). Subjects were evaluated at D21, when, if necessary, a retouch could be performed (maximum 1.2 mL per cheek). Subjects were evaluated at seven follow-up visits through to D540. The primary assessment was based on the evolution of the Medicis Midface Volume Scale (MMVS) grade on D21. Secondary outcomes were local and general adverse events, investigator- and subject-assessed Global Aesthetic Improvement Scale scores and changes in self-esteem.

RESULTS

Of the 79 healthy Caucasians enrolled (mean age 54.8 years), 25 required a second injection. In the intention-to-treat population, mean overall MMVS scores improved significantly from D0 (3.2 ± 0.4) to D21 (1.8 ± 0.6) and D42 (1.7 ± 0.6) (all p < 0.0001). MMVS scores for each cheek also improved significantly, irrespective of retouch on D21: 22% of injections showed a persistent benefit at D540 without retouch. The most common adverse events were pain on palpation (19%), erythema (15%) and edema (13%); most were mild or moderate and resolved within 2 weeks.

CONCLUSION

AFV produces a sustained objective and subjective midface volume restoration in female and male subjects, often without retouching, and was well tolerated.

Reducing the Alar Base While Minimizing Visible Sequalae: A Review of Three Alar Base Reduction Techniques over 35 Years

Importance: Although classically described and routinely performed, alar base reduction remains nuanced without consensus as to the gold standard. Objective: To compare the measurement of alar base reduction among three techniques and the incidence of postoperative dermabrasion in rhinoplasties performed for 35 years. Methods: A retrospective cohort study of patients who underwent rhinoplasty with alar base reduction between 1983 and 2020 by one surgeon. Dermabrasion rates for visible incisions were evaluated based on patient demographics and surgical technique. Results: Of 312 patients, 82% (258) were women. The mean age was 33 years (SD 11.9). Patients self-identified as White (54.5%), Hispanic (22.4%), African American (8.3%), Middle Eastern, (5.2%), Asian (4.8%), Indian (2.2%), Mediterranean (1.3%), or unspecified (1.3%). Alar flare reduction was used alone in 202 (64.7%) patients. Eighty-two (26.3%) patients underwent postoperative dermabrasion to visible incisions. Patients self-reporting Middle Eastern race were offered dermabrasion at a rate 3.7 × higher than other race groups (OR = 3.73, CI 1.23-11.194, p = 0.02). Conclusion and Relevance: Alar flare reduction, sill reduction, and V-to-Y advancement are techniques that can be used to narrow the alar base. Visible incisions are the most common downside but can be addressed with postoperative interventions including dermabrasion.

Facial Morphometrics in Black Celebrities: Contemporary Facial Analysis Using an Artificial Intelligence Platform

The diversity of patients pursuing facial aesthetic and facial gender-affirming surgery (FGAS) is increasing, yet there is a paucity of objective guidelines to facilitate surgical decision-making in patients of color. We conducted a quantitative analysis of black celebrities using standardized frontal photos of 21 female and 21 male celebrities. Celebrities were chosen from popular entertainment magazines and websites, including People Magazine, the Internet Movie Database (IMDb), Cosmopolitan, and Essence. For each celebrity, 100 facial landmarks were detected through a facial analysis artificial intelligence (AI) program. Black males had greater facial height, bizygomatic width, lower facial height, and bigonial width than females. However, the facial height to bigonial width ratio was similar between genders and approximated the golden ratio (1.618). Female faces demonstrated a greater mid-face height to total facial height proportion, and males had a greater lower facial height proportion. Females exhibited an upward-slanted medial brow and shorter total eyebrow length, nose height, and alar width. Forehead height above the lateral brow was greater in males, while central forehead height was similar to females. This is the first study that has utilized AI to provide ethnicity-specific facial morphometrics relevant to facial rejuvenation and FGAS in the black population.

Facial profile of young indian women from Maharashtra-A cross-sectional pilot study

Context

The anthropometric facial clinical proportions are used in the field of orthodontics, maxillofacial and plastic surgery for aesthetic or abnormality corrections. There is lack of enough literature on the facial profiles of Indians.

Aim

To assess correlations between facial parameters and stature of young Maharashtrian women by using anthropometry.

Settings and Design

It is a cross-sectional observational pilot study at Maharashtra Institute of Dental Sciences & Research, after approval from the Institutional Ethical Committee.

Methods and Material

The study included 15 students of 21-23 years age selected by simple randomisation. The facial parameters were measured by sliding vernier calipers after identifying facial landmarks by stickers. Facial height (FH) in thirds; upper FH (UFH), middle FH (MFH) and lower FH (LFH); facial width (FW) and stature or overall height (OH) were calculated to define average facial features.

Statistical Analysis

Multiple pairwise statistics and simple linear regression analyses were done for various dependent variables.

Results

The means of UFH, MFH, LFH and total facial heights (TFH) were found to be 5.2 ± 0.54, 5.35 ± 0.34, 5.16 ± 0.44 and 15.7 ± 0.98 cm, respectively. The TFH showed a moderate correlation with stature (P ≤ 0.05, r = 0.64) and a strong correlation with lower lip length (P = 0.001, r = 0.78). Facial width showed a negative correlation with facial shape (P ≤ 0.05).

Conclusions

The selected sample showed the statistically insignificant difference between UFH, MFH and LFH indicating equitable distribution among Indian women of Maharashtrian origin of 21-23 year age group. Longer TFH is positively correlated with higher stature and longer lower lip length.

Analysis of Neoclassical Canons in Adult Kenyans of Indian Descent

Study Design: Descriptive cross-sectional. Objective: To establish anthropometric norms and test the validity of four neoclassical canons among Kenyans of Indian descent. Methods: Using direct anthropometric landmarks, 3 vertical and 4 horizontal measurements were made on the faces of 130 adult Kenyans of Indian descent. The mean of each anthropometric measurement was calculated and a student t-test was used to identify significant gender differences. These results were compared to four neoclassical canons and the percentage of each canon and its variants were recorded. A chi-square test was then performed to assess any gender differences between these findings. Results: When comparing sexes, the anthropometric means of males were larger than those of females except for eye fissure length. In addition, only the upper third displayed sexual dimorphism. As for the neoclassical canons, the orbital canon was found to apply to 20.0% of males and 21.6% of females, followed by the naso-oral canon found in 16.4% of males and 17.6% of females, and the orbito-nasal canon present in 14.5% of males and 18.9% of females. The vertical canon was not found to be applicable to any participant. Conclusion: The facial morphometric measurements in this population differ from the described neoclassical canons since they do not apply to the majority of these individuals. Therefore surgeons should be guided by the observed population-specific differences during reconstructive and facial aesthetic surgery.

The Anthropometric Measurement of Nasal Landmark Locations by Digital 2D Photogrammetry Using the Convolutional Neural Network

Measuring and labeling human face landmarks are time-consuming jobs that are conducted by experts. Currently, the applications of the Convolutional Neural Network (CNN) for image segmentation and classification have made great progress. The nose is arguably one of the most attractive parts of the human face. Rhinoplasty surgery is increasingly performed in females and also in males since surgery can help to enhance patient satisfaction with the resulting perceived beautiful ratio following the neoclassical proportions. In this study, the CNN model is introduced to extract facial landmarks based on medical theories: it learns the landmarks and recognizes them based on feature extraction during training. The comparison between experiments has proved that the CNN model can detect landmarks depending on desired requirements. Anthropometric measurements are carried out by automatic measurement divided into three images with frontal, lateral, and mental views. Measurements are performed including 12 linear distances and 10 angles. The results of the study were evaluated as satisfactory with a normalized mean error (NME) of 1.05, an average error for linear measurements of 0.508 mm, and 0.498° for angle measurements. Through its results, this study proposed a low-cost automatic anthropometric measurement system with high accuracy and stability.

A Cross-Sectional Study to Determine and Compare the Craniofacial Anthropometric Norms in a Selected Kenyan and Chinese Population

Background: Craniofacial anthropometry provides essential data for diagnosis and treatment planning, with the norms for many races having been investigated. The results reveal that facial morphometry varies greatly because of geographical, ethnic, and racial variations. This study aims to gather the normative anthropometric data and compare the differences in facial morphometry between the Kenyan population and that of the Chinese. Methods: Four vertical measurements (trichion-nasion, nasion-subnasale, subnasale-gnathion, and superaurale-subaurale) and 6 horizontal measurements (zygion-zygion, exocanthion-endocanthion, endocanthion-endocanthion, pupil-pupil, alare-alare, and chelion-chelion) were obtained manually from subjects with no craniofacial abnormality. Results: A total of 180 participants (90 Kenyans and 90 Chinese) were included. Among the Kenyans, males generally had greater dimensions in comparison to the Kenyan females with the exception of the upper third, lower third, and intercanthal, and interpupillary distances. Among the Chinese, there was a significant difference between the 2 genders with the exception of intercanthal distance. All measurements were greater in Chinese males in comparison to the females. Comparison between races shows that Kenyans had greater vertical measurements with exception of the ear length for both genders. The Chinese males had increased facial width and intercanthal distance, while the Chinese females showed increased intercanthal distance compared to Kenyans. Kenyans exhibited hyperleptoprosopic-type face, while Chinese exhibited mesoprosopic-type face, with none of the 2 groups conforming to the neoclassical canons. Conclusion: Kenyans generally have greater craniofacial measurements versus Chinese, except for the facial width and intercanthal distance for males and interorbital distance for females.

Systematic Review and Meta-analysis of Facial Anthropometric Variations Among Cisgender Females of Different Ethnicities: Implications for Feminizing Facial Gender Affirming Surgery

BACKGROUND

Feminizing Facial Gender-Affirming Surgery (FFGAS) is gaining popularity among the diverse population of patients impacted by gender incongruence. However, most studies examining facial femininity are based on Caucasians. Thus, it is unclear if ethnic differences exist in anthropometric measures relevant to FFGAS procedures. This study aims to analyze ethnic anthropometric variations in the cisgender female face to identify differences that are potentially relevant to FFGAS.

METHODS

A systematic review and meta-analysis of the PubMed, EMBASE, and Cochrane databases was performed following PRISMA guidelines on June 25, 2021. Original studies reporting facial anthropometry in cisgender women were included. Anthropometric measures of interest included mandibular and zygomatic width, facial and forehead height, and nasolabial angle. A meta-analysis was performed using a linear mixed-effects model for each anthropometric measure.

RESULTS

A total of 1246 abstracts were screened, yielding 21 articles that met the inclusion criteria. Facial anthropometric data of 4792 cisgender females of 16 different ethnicities were analyzed. This meta-analysis demonstrated that compared with Caucasian cisgender women, Japanese, Chinese, and Korean cisgender women had a wider mandible (Japanese +20.13 mm [SE 4.43, P<0.001, P value adjusted for multiple comparisons (p-adj)=0.002], Chinese +16.22 mm [SE 4.39, P=0.002, p-adj=0.013]; and Korean +14.46 mm [SE 3.97, P=0.002, p-adj=0.014]). Further, when compared with Caucasian cisgender women, Chinese cisgender women demonstrated a larger zygomatic width, African American cisgender women tended to have smaller nasolabial angles, and Indian and Japanese cisgender women tended to have a smaller and larger facial height, respectively. However, following P value adjustment for multiple comparisons, these differences were not found to be statistically significant.

CONCLUSIONS

We found that mandibular width tends to be greater for Japanese and Chinese cisgender women relative to Caucasian cisgender women. This data may be useful in counseling patients during preoperative evaluations ahead of mandibular reduction. No other anthropometric features were found to be significantly different among the ethnic groups studied. This portends that current approaches to FFGAS, which emphasize patient-specific needs and maintenance of a harmonious appearance, may require minimal or no adjustment to account for ethnic facial anthropometric differences.

A cross-sectional study of the anthropometry of the face among Bonos and Ewes in the Bono region of Ghana

Background

Growth and development of craniofacial structures are of importance since their anthropometry is useful in maxillofacial surgery, plastic surgery, orthodontics and forensic medicine. Surgeons consider the specific facial structures of such patients to help obtain accurate results. Ghana is however less-endowed with data regarding facial anthropometry for the aforementioned applications. Therefore, the study aimed to bring out the differences between the facial measurements of the male and female participants in order to generate baseline data for Ghanaians, taking into consideration the Bonos and Ewes living in the Bono region of Ghana. Twenty-four anthropometric facial measurements were taken from a total of 291 healthy individuals (152 Bonos and 139 Ewes), aged 18–60 years using Shahe Vernier callipers.

Results

The study revealed Bono males had significantly longer faces than that of the Bono females (upper face height 2 and total face height). For maxillary height, mandibular width and mouth width, the mean values of Bono males were significantly greater than that of the Ewe males. There was a statistically significant difference concerning nasal length and anatomical nose width among the participants (p < 0.05). Bono male participants had significantly greater values than Ewe males in both endocanthion-exocanthion and endocanthion-endocanthion measurements.

Conclusions

The results of this study support the assertion regarding the existence of tribal variations and sexual dimorphism associated with facial measurements and have provided additional data for facial morphology for biometric and forensic applications as well as facial reconstruction especially among the study populations in Ghana.

Analysis of Nasal Morphology in Skeletal Class I and Skeletal Class II Malocclusion: An Observational Study

Background and objectives

The nose is one of the major focuses of face attractiveness. Through careful evaluation of the soft tissue drape, a treatment plan can be designed to enhance a patient's facial attractiveness. The aim of this study was to evaluate and assess the variations in nasal morphology among class I malocclusion and class II horizontal and class II vertical malocclusion.

Material and method

Lateral cephalograms of 27 patients were taken and consisted of three groups: skeletal class I malocclusion, class II horizontal malocclusion, and class II vertical malocclusion. The various linear and angular measurements specific to nose were assessed.

Results and conclusion

In class II and class I malocclusion, the nose is observed to be straight and convex, respectively. Additionally, compared to class II horizontal malocclusion, it is more convex in class II vertical malocclusion. Vertical growers or high-angle cases are more likely to have a nose with an increased inclination toward nasal dorsum convexity than horizontal growers or low-angle instances.

Expanding the Classic Facial Canons: Quantifying Intercanthal Distance in a Diverse Patient Population

Background:

The intercanthal distance (ICD) is central to our perception of facial proportions, and it varies according to gender and ethnicity. Current standardized reference values do not reflect the diversity among patients. Therefore, the authors sought to provide an evidence-based and gender/ethnicity-specific reference when evaluating patients’ ICD.

Methods:

As per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of PubMed, Medline, and Embase was carried out for studies reporting on the ICD. Demographics, study characteristics, and ICDs were extracted from included studies. ICD values were then pooled for each ethnicity and stratified by gender. The difference between men and women, and that across ethnicities and measurement types were compared by means of independent sample t-test and one-way ANOVA (SPSS v.24).

Results:

A total of 67 studies accounting for 22,638 patients and 118 ethnic cohorts were included in this pooled analysis. The most reported ethnicities were Middle Eastern (n = 6629) and Asian (n = 5473). ICD values (mm) in decreasing order were: African 38.5 ± 3.2, Asian 36.4 ± 1.6, Southeast Asian 32.8 ± 2.0, Hispanic 32.3 ± 2.0, White 31.4 ± 2.5, and Middle Eastern 31.2 ± 1.5. A statistically significant difference (P < 0.05) existed between all ethnic cohorts, between genders among most cohorts, and between most values stratified by measurement type.

Conclusions:

Our standards of craniofacial anthropometry must evolve from the neoclassical canons using White values as references. The values provided in this review can aid surgeons in appreciating the gender- and ethnic-specific differences in the ICD of their patients.

Historical Tools of Anthropometric Facial Assessment: A Systematic Raw Data Analysis on the Applicability of the Neoclassical Canons and Golden Ratio

BACKGROUND

The fundamental tenets of facial aesthetic surgery education have not changed in centuries. Research is beginning to demonstrate that the Neoclassical Canons and the Golden Ratio, Phi, have limited utilization in populations other than those of White European extraction.

OBJECTIVES

The purpose of this study was to analyze comparable raw data in the literature to determine (1) if there is interethnic variability in Neoclassical Canon and Phi measurements, and (2) if the measurements in these representative samples differ from the "ideal."

METHODS

A PubMed/Scopus search was performed. Manuscripts with raw data and individuals aged ≥16 were included. Measurements were extracted and employed to calculate the Neoclassical Canons and Phi. One-way analysis of variance (ANOVA) tests were conducted to compare mean measurements across 6 ethnic groups (P < 0.05).

RESULTS

Twenty-seven articles were included. Every continent was represented except Antarctica and Australia. Men were less commonly studied than women. Participant ages ranged from 16 to 56. Averaged Canons 2, 6-8 measurements had significant interethnic differences in males, whereas Canons 5-8 had significant differences across ethnicities in females. For men, there was significant interethnic variability in measurements of Phi 2, 5, 8, 10, and 17. For women, Phi 1, 2, 5, 8, 10, and 17 varied across ethnicities. No ethnic/gender group showed consistent approximation of the "ideal" for both the Neoclassical Canons and Phi.

CONCLUSIONS

Today, the utility of the Neoclassical Canons and Phi is limited. It is incumbent on our field to systematically study and define the anthropometric measures that define the "ideal."

What is Beauty?

PURPOSE

In the current study, the authors attempt to thoroughly investigate the concept of beauty from different perspectives in different historical periods and offer their personal thoughts about it.

METHODS

The authors performed a comprehensive and across-the-board literature review about 'beauty', including beauty from a philosophical perspective, beauty perception by human mind, beauty from a biopsychological perspective, beauty of the face, body and breast, models of beauty and beauty in cosmetic surgery.

RESULTS

From Plato to modern neuro-psychological studies, the concept of beauty has always been a theme for adamant debates and passionate thoughts. Different aspects of beauty, from intellectual to pure physical, have received a tremendous amount of attention. The true definition of the concept of beauty is still ambiguous, and there is not a unanimous explanation for it. It seems that the definition of beauty differs in every individual's mind and over the history of humankind.

CONCLUSION

Although beauty is a very important concept and the seek for achieving it is a very natural behavior, one must remember that the importance of beauty should not overshadow the fact that every human being is made up of similar internal organs. We strongly encourage the reader to look beyond the hedge, to be aware that each of us is made up of internal organs, beyond the external appearance. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266.

Acquired Facial, Maxillofacial, and Oral Asymmetries—A Review Highlighting Diagnosis and Management

Facial asymmetry refers to the absence of, or the deviation from the regular mirror image of facial structures, relative to a referenced midline axis. It can be attributed to a wide spectrum of deformities, including congenital, developmental, or acquired conditions, which can originate either prenatally or postnatally. Though highly prevalent, asymmetry commonly goes undiagnosed due to its subtle or relative nature. Among the spectrum of conditions, acquired cases are triggered postnatally, in previously normal individuals, thus subjecting them to sudden, eventful psychological and psychosocial disharmony. When detected early, timely management may help intervene progressive growth of these conditions. This, therefore, emphasizes the need for a thorough diagnostic workup including medical/dental history, clinical examinations, study models, photographic and radiographic records for a case-by-case basis to prevent severe functional and aesthetic complications. Recently, advanced diagnostic procedures, such as stereophotogrammetry, 3D stereolithographic models, skeletal scintigraphy (radionucleotide scans), 3D computed tomographic scans, cone-beam computed tomography, and magnetic resonance imaging, have provided innovative diagnostic instruments for numerous craniofacial defects. This descriptive review aims at focusing on the factors leading to frequently encountered conditions of acquired facial asymmetry and highlights their clinical evaluation, conservative and surgical interventions by a multi-disciplinary team of clinicians.

Lip Anthropometry of Healthy Turkish Young Adults

ABSTRACT

The lips play an important role in evaluating and recognizing the craniofacial complex and our perception of facial beauty and attractiveness. The aim of this study was to evaluate the anthropometric measurements of the lips of Turkish young adults and to look for sexual dimorphism. Anterior view photographs were taken of 100 females and 100 males who volunteered to participate in the study. Seven landmarks were determined, stomion (st), sublabiale (sl), subnasale (sn), labiale superius (ls), labiale inferius (li), crista philtre (cp), and chelion (ch). Then, using these landmarks, lower lip height (st-sl), upper lip height (sn-st), philtrum length (sn-ls), upper vermilion height (ls-st), lower vermilion height (li-st), cutaneous lower lip height (li-sl), philtrum width (cp-cp), and mouth width (ch-ch) were measured. It was observed that there was a statistical difference between genders in the parameters of st-sl, sn-st, sn-ls, li-sl, and ch-ch (P = 0.001, for these parameters). Besides, using these distances, 6 anthropometric ratios (ls-st/li-st, sn-ls/ls-st, li-sl/li-st, sn-st/st-sl, cp-cp/ch-ch, and ls-li/ch-ch) were calculated. Among the ratios investigated, sn-ls/ls-st, li-sl/li-st, and cp-cp/ch-ch were statistically significantly larger in males compared females (P = 0.012, P = 0.002, and P = 0.001, respectively). We believe that the results obtained in this study regarding lip anthropometry will help determine the standard values that can be used for the Turkish population aged 18 to 25.

Anthropometric analysis of linear parameters of the Indian nose: A cross-sectional study and comparison with literature

BACKGROUND

Many studies have been done to find out the accepted "ideal" appearance and proportions of the nose. However, much of this work has been limited to the facial architecture of the North American Caucasian population. Therefore, most beauty standards are driven by Western influences.

AIMS AND OBJECTIVES

To measure different standard linear parameters of Indian faces and compare them with the studies found in the literature, in an endeavor to help in preoperative planning in rhinoplasty while maintaining their ethnicity.

METHODS

This was a hospital-based cross-sectional study of 500 subjects. A total of 21 standard measurements were noted directly from the faces, and 11 proportional values calculated. Mean values with standard deviations were statistically used for comparisons with studies in the literature.

RESULTS

There were significant differences between male and female subjects of our study in 16 variables. The proportional indices calculated also revealed significant differences statistically in 6 out of 11 measurements between male and female subjects. Significant differences were found in most of the parameters when our data were compared with Indian American, North American white population, Korean, Chinese, and African American.

CONCLUSIONS

Facial measurements in the Indian population are different from those of other races, such as nasal index: (al-al × 100/n-sn), sn-prn x 100/ al-al index, and sn-prn x 100/n-Sn index, and it is important to have own set of parameters to act as standards guiding esthetic nasal surgeries while maintaining ethnicities. Our study is an attempt at the same. However, because of the huge diversity of the Indian population, it requires larger studies from different regions to achieve the final aim to create standards for cosmetic rhinoplasties.

Craniofacial Anthropometry of Healthy Turkish Young Adults: Analysis of Head and Face

ABSTRACT

The aim of this study was to evaluate the craniofacial anthropometric measurements of Turkish young adults between the ages of 18 and 25. Anterior view and side profile photographs were taken of 100 females and 100 males who volunteered to participate in the study and had no craniofacial anomalies, history of facial trauma, or history of orofacial surgery. Thirteen landmarks on the face and head were chosen, and these landmarks were identified on the photographs. Then, using these landmarks, a total of 19 distance measurements were made, 16 from the anterior view, and 3 from the side profile. There were statistically significant differences between the sexes in 13 parameters: 2 parameters (t-n and ft-ft) being higher in females and 11 parameters (v-n, v-t, t-gn, sn-gn, n-gn, st-gn, sl-gn, fz-fz, z-z, tr-tr and go-go) being higher in males. Also, 7 facial anthropometric ratios were calculated. There were statistically significant differences between the genders in all ratios. The literature reveals that craniofacial anthropometric measurements have been performed on many different populations and that there are numerous differences between the results of the studies conducted. We are of the opinion that the results obtained in this present study will contribute to the literature by helping to determine the standard values for the Turkish population between the ages of 18 and 25, which can be used in diagnosis, treatment and postoperative evaluation in areas such as forensic science, orthodontics, clinical genetics, maxillofacial surgery, and plastic surgery.

Relationship of Nasal Morphology With Different Dentoskeletal Patterns: A Systematic Review

Introduction:

The nose is considered by some clinicians as the keystone of facial aesthetics. A treatment plan can be customized to intensify the facial aesthetics of a patient through careful evaluation of the soft tissue drape. Hence, for getting a better outcome of the treatment plan, orthodontists are supposed to have in-depth knowledge and awareness of soft tissue changes, taking into notice the ethnic and racial variation in discrete cohorts. The objective of this study is to enlist the relationship of nasal morphology with different dentoskeletal (sagittal and vertical) patterns.

Materials and Methods:

A comprehensive electronic database search was performed till July 2020, of Cochrane Library, Embase, PubMed, Scopus, Google Scholar, Web of Science, Wiley Online Library, and ScienceDirect. Only articles published in the English language were included. After excluding all the irrelevant data through careful screening, a total of 15 articles were selected which discussed the nose–dentoskeletal pattern relation.

Results and Conclusion:

The nose is found to be convex in skeletal class II, straight in class I, and concave in class III. Those with increased vertical growth may have an increased tendency of a convex nasal dorsum. Maxillary and mandibular jaw length affect the nasal parameters more than the jaw position. Nasal length and nasal depth increase with the jaw length and mandibular and maxillary/palatal-plane inclination to the cranium. A long nose with increased nasal depth is expected in long faces and those with long upper and lower jaws. An upturned nose is found with an anticlockwise-rotated maxilla.

Craniofacial Anthropometry of Healthy Turkish Young Adults: Outer Canthal, Inner Canthal, Palpebral Fissure, and Interpupillary Distances

ABSTRACT

This study aims to examine the values of the orbital region in Turkish young adults by the two-dimensional photogrammetry. Anthropometric measurements of the eye and eyelid-related parameters were taken from 100 female and 100 male volunteer Turkish young adults, ranging in age from 18 to 25 years. Endocanthion (en), exocanthion (ex), and pupil (p) were identified on the photograph and the distances between these points were measured with the ImageJ program. The average values of the en-en, ex-en (R), ex-en (L), p-p, and ex-ex were found as 32.92 ± 2.84, 32.48 ± 2.06, 32.22 ± 2.01, 65.32 ± 3.77, and 97.75 ± 5.09 mm, respectively. There were statistically significant differences between the genders in all parameters. Although there are many studies examining these parameters, comprehensive studies are needed in different populations and in many cases. In this study, we believe that the results obtained for Turkish young adults can be used as reference values.

Anthropometric Analysis of Nasolabial Region and Age-Related Changes in Adult Women

PURPOSE

The nasal and labial characteristics along with the other facial characteristics are different between races. The purpose of this study is to identify nasal and labial features of Turkish women by anthropometric measurements and indices besides to detect variances with aging.

METHODS

The study was conducted with total 302 women volunteers whose ages were between 19 and 85. The women included were divided into 3 groups according to their ages; respectively young (ages between 19 and 44), middle-aged (45-59) and senior (>60). By using camera footages with the IT version 3.00 software program, anthropometric measurements of the nasolabial region was performed.

RESULTS

The mean nasal length of the included participants was measured as 38.56 ± 8.32 mm while mean nasal height was 50.05 ± 8.36 mm. Mean nasal root width was 13.24 ± 2.70 mm, mean morphological nasal width was 32.16 ± 5.80 mm and mean anatomical nasal width was 27.85 ± 4.92 mm. In addition, mean nasal depth was 19.55 ± 5.25 mm.In the middle-aged group of participants, the nasal length was more than senior group (P < 0.05). Nasal root width was increased with aging (P < 0.05). Morphological and anatomical widths of the nose were increased with aging but increase rate was lower in the senior group (P < 0.05). The nasal depth was lower in the young group in comparison with middle-aged and senior groups (P < 0.05). When nostril types were analyzed; ratios of 'teardrop', 'heart-shaped', 'annular' and 'triangular' types were 51.65%, 0.99%, 6.95%, and 40.39%, respectively.

CONCLUSIONS

To be acquainted with facial anthropometric features and measurements of nasolabial region which varies with races and aging; would have a significant importance in view of conserving the facial ratio and esthetics in the plastic and reconstructive surgery field.

Determination of intra-oral surface areas by cone-beam computed tomography analysis and their relation with anthrometric measurements of the head

Purpose

Determination of intra-oral surface areas might contribute to our understanding of the physiology of the oral cavity and oral diseases. In previous studies, the intra-oral surface area was determined using a laborious and technically challenging method. Our aim was to develop an easy and non-invasive method to determine the intra-oral surface areas.

Methods

In this study, we used cone-beam computed tomography (CBCT) and digital analysis in 20 human cadavers to determine various intra-oral surface areas, based on digital segmentation. Next, we explored whether there was a relationship between various intra-oral surface areas and anthropometric measurements of the head using Pearson correlation coefficient.

Results

Using CBCT and digital analysis, it was possible to determine various intra-oral surface areas. On average, the total intra-oral surface area was 173 ± 19 cm². Moderate, statistical significant correlations were observed between (1) the length of the head and the palatal surface area, as well as (2) the depth of the head and the surface area of the tongue. These correlations suggest the feasibility of estimating intra-oral surface areas without relying on CBCT imaging.

Conclusions

This study presents a technique for measuring the intra-oral surface areas by CBCT imaging in combination with digital analysis. The results of this study suggest that anthropometric measurements of the head might be used to estimate the surface areas of the palate and tongue.

Depiction of ethnic facial aging by forensic artists and preliminary assessment of the applicability of facial averages

Many characteristics of facial aging are common to all. The age of their onset and which characteristics tend to predominate varies among individuals depending on many factors including their genetic makeup, life experiences, environment in which they live, and the regional, ethnic, or socially perceived group to which they belong. Forensic artists are often asked to provide sketches, 2D or 3D digital renderings, or sculptures representative of how an individual may appear at an older age based on a provided photograph, victim or witness description, and/or cranial remains. The challenge escalates when the subject is a member of a regional, ethnic, or other socially perceived group to which the artist has had little or no exposure. We describe aspects of adult facial aging that are of particular relevance to the forensic artist, applicable software tools, and pertinent facial databases, especially those emphasizing non-white populations. We demonstrate that facial averaging offers two key advantages to the artistic portrayal of facial aging: first, the technique requires relatively small reference databases from groups that may present logistical challenges to collect and second, that a facial average provides a useful representation of the gestalt of the age and ethnicity cohort to which a subject belongs. The artist may use an average along with other available information such as photo reference books, eyewitness descriptions, photos of immediate family members, and cranial structure to guide production of a facial composite drawing, digital age progression, or sculpture of the subject in question.

Reframing Our Approach to Facial Analysis

Facial analysis is a foundational aspect of facial plastic and reconstructive surgery. Unfortunately, ideal proportions of beauty are commonly discussed without much thought regarding their historical derivation and associated cultural implications. Facial analysis often is limited to narrow ethnic and gender-normative aesthetics. As we evolve as a specialty that treats disparate patient populations and embraces a diverse community of surgical trainees, it may be time to reframe our approach to facial analysis education.

Assessment of Ideal Dimensions of the Ears, Nose, and Lip in the Circles of Prominence Theory on Facial Beauty

Importance

A theory on facial beauty might allow clinicians to achieve better results.

Objectives

To find the ideal vertical position of the ears, total lip length, lip pucker length, distance between the irises, and starting point for the nasal radix.

Design, Setting, and Participants

In this subjective survey, 11 sets of 43 total digitally adjusted pictures (DAPs) and line drawings of actual faces were ranked based on attractiveness by 419 clients at a facial plastic surgery clinic. The data were collected from July 13 to August 29, 2015, and were analyzed from September 17, 2015, to March 21, 2016.

Main Outcomes and Measure

Six groups of line drawings and 5 groups of DAPs of an actual person were used to test the ideal position of the ears to determine whether the face is organized into oblique and parallel relationships and whether the total lip length and the lip pucker length are associated with multiples of an iris width (IW), and to determine the start of the nasal radix and its association with the superior margin of the iris and distance between the irises.

Results

Of the 419 survey respondents, the ear aligned with the second oblique was considered the most ideal by the participants. The preferred total lip length was 4.0 IWs in the DAPs and 5.0 IWs in the line drawings. For the lip pucker length, 2.0 and 3.0 IWs were considered the best. The ideal start of the nasal radix was tangential with the superior margin of the iris. The distance of 5.5 IWs from iris to iris and 3.0 IWs from the horizontal level of the iris to the nasal tip was preferred.

Conclusions and Relevance

The face may be ideally organized into 3 parallel obliques. The IW, horizontal aperture of the eye, and then iris to iris distance may best determine the size and shape of progressively larger objects in the face. The absolute position of the eye was considered important by the participants in the ideal positioning of other objects in the face.

Level of Evidence

NA.

Nasal Analysis: Considerations for Ethnic Variation

As the United States continues to be more ethnically and racially diverse, it is important for the rhinoplasty surgeon to have an appreciation and understanding of nasal variations that exist to plan for and execute ethnically congruent results. The nasal analysis is a critical component of the patient evaluation, which has been used as a tool by surgeons to identify deviations from anatomical norms or canons. In this article, the authors describe common nasal anatomical variations that exist between ethnic groups as a guide for nasal analysis. Understanding these variations will facilitate and help define important cultural aesthetics, which can be used to plan for rhinoplasties in a diverse patient population.

ActivEarring: Spatiotemporal Haptic Cues on the Ears

The symmetric configuration and the sensitivity of ears in addition to the long tradition of earrings as adornment open up the possibility for smart ear-worn devices. Taking advantage of these attributes, past research mostly focused on creating novel unobtrusive sensing input devices and auditory displays placed on the ear. Meanwhile, the tactile sensitivity of the ear has long been overshadowed by its auditory capacity, presenting the opportunity to investigate how ears can be exploited for unobtrusive tactile information transfer. With three studies and a total of 38 participants, we suggest the design of ActivEarring, a ear-worn device capable of imparting information by stimulating six different locations on both ears. We evaluated the performance of ActivEarring in a semi-realistic mobile condition and its practical use for information transfer with spatiotemporal patterns. Finally, we demonstrate that ActivEarring can be incorporated in common jewelry design, and present three applications that illustrate promising usage scenarios.

Three-dimensional photographic analysis of the face in European adults from southern Spain with normal occlusion: reference anthropometric measurements

Background

Recent non-invasive 3D photography method has been applied to facial analysis, offering numerous advantages in orthodontic. The purpose of this study was to analyze the faces of a sample of healthy European adults from southern Spain with normal occlusion in order to establish reference facial soft tissue anthropometric parameters in this specific geographic-ethnic population, as well as to analyze sexual dimorphism.

Methods

A sample of 100 healthy adult volunteers consisting of 50 women (mean age, 22.92 ± 1.56 years) and 50 men (mean age, 22.37 ± 2.12 years) were enrolled in this study. All participants had normal occlusion, skeletal Class I, mesofacial pattern, and healthy body mass index. Three-dimensional photographs of the faces were captured non-invasively using Planmeca ProMax 3D ProFace^®. Thirty landmarks related to the face, eyes, nose, and orolabial and chin areas were identified.

Results

Male displayed higher values in all vertical and transversal dimensions, with the exception of the lower lip height. Larger differences between sexes were observed in face, mandible, and nose. Male also had higher values in the angular measurements which referred to the nose. No sex differences were found in transverse upper lip prominence or transverse mandibular prominence. No differences were found in the ratio measurements, with the exception of intercantal width/nasal width, which was higher in women than in men.

Conclusions

Reference anthropometric measurements of facial soft tissues have been established in European adults from southern Spain with normal occlusion. Significant sexual dimorphism was found, with remarkable differences in size between sexes

Electronic supplementary material

The online version of this article (10.1186/s12903-019-0898-y) contains supplementary material, which is available to authorized users.

Smile dimensions in adult African American and Caucasian females and males

OBJECTIVES

To test smile dimension variations in adult African American and Caucasian females and males.

SETTING AND SAMPLE POPULATION

The University of Alabama at Birmingham School of Dentistry and Hospital. Three hundred and ninety-four participants were recruited; African American females and males distributed over five age groups: 20-30, 30-40, 40-50, 50-60 and older than 60.

MATERIAL & METHODS

Three-dimensional surface imaging was used to acquire two images of each participant, one at rest and one upon smile. Landmarks were plotted on the lips and linear distances measured to assess the length of the upper and lower lips, mouth width at rest and upon smile, gingival and dental display upon smile.

RESULTS

Linear dimensions are larger in males than in females, and in African Americans than in Caucasians, except for the length of the upper lip that does not differ between male African American and Caucasian males, in any given age group. Gingival display and dental display decrease with age in all groups.

CONCLUSION

Norms should reflect race, age and sex in order to optimize treatment goals.

Anteroposterior and vertical soft tissue cephalometric norms of Iranians, interethnic comparisons, sex dimorphism, and the effect of age on cephalometric variables

INTRODUCTION

This study established about 50 anteroposterior and vertical cephalometric norms of five tracing analyses in Iranians, using a large sample.

METHODS

Lateral cephalographs of 130 subjects (85 females, 45 males, with an average age of 22.77 ± 2.55 years (range 20-29)) were traced manually using the Ricketts, Holdaway, Z-Merrifield, Epker, and Legan-Burstone soft tissue analyses. The role of age and sex on measurements, as well as the comparisons between Iranian norms with Caucasians from European decent, was determined statistically (α = 0.001).

RESULTS

Age had no significant effect (all P values > 0.01). Sexual dimorphism existed in terms of numerous parameters. Compared to analysis standards, upper lip to E-plane, nose prominence, upper lip thickness, nasomental angle, Z angle, interlabial distance, subnasale perp to chin, subnasale-stomion:stomion-menton, subnasale-lower lip:lower lip-menton, interlabial gap, and vertical lip-chin ratio were smaller in Iranians. Superior sulcus depth, skeletal profile convexity, upper lip strain, upper lip curvature, H-angle, soft tissue chin thickness, nasofacial angle, subnasale perp to upper lip, subnasale perp to lower lip, maxillary prognathism, lower face throat angle, upper lip protrusion, lower lip protrusion, mentolabial sulcus, and lower vertical height-depth ratio were greater in Iranians compared to the norm (P ≤ 0.001).

CONCLUSIONS

A great degree of sex dimorphism might exist among Iranians. Many textbook norms might not be the best options for diagnosis or treatment of Iranians.

Normative anthropometry and proportions of the Kenyan-African face and comparative anthropometry in relation to African Americans and North American Whites

Background

There is no normative craniofacial anthropometric data for the Kenyan-African population. The purpose of this investigation was to determine normative anthropometric craniofacial measurements and proportional relationships for Kenyans of African descent and to compare the data with African Americans (AA), North American Whites (NAW), and neoclassical canons.

Methods

Twenty-five direct facial anthropometric measurements, and 4 angular measurements, were taken on 72 Kenyan-African participants (age range 18–30 years) recruited at the University of Nairobi in Kenya. The data were compared with AA and NAW populations, and neoclassical canons. Descriptive statistics of the variables were computed for the study population.

Results

Significant differences between both Kenyan males and females were detected in forehead height (~ 5 mm greater for males, ~ 4.5 mm for females), nasal height (reduced by ~ 4 mm in males, ~ 3 mm in females), nasal width (8–9 mm greater), upper lip height (> 3 mm), and eye width (greater by ~ 3 mm) compared to NAW subjects. All vertical measurements obtained were significantly different compared with NAW. Differences were observed in comparison with AA subjects, but less marked. Mouth width was similar in all groups. Angular measurements were variable. Neoclassical canons did not apply to the Kenyan population.

Conclusions

Anthropometric measurements of NAW showed clear differences when compared with the Kenyan population, and variations exist with comparative AA data. The anthropometric data in terms of linear measurements, angular measurements, and proportional values described may serve as a database for facial analysis in the Kenyan-African population.

Automatic classification of human facial features based on their appearance

Classification or typology systems used to categorize different human body parts have existed for many years. Nevertheless, there are very few taxonomies of facial features. Ergonomics, forensic anthropology, crime prevention or new human-machine interaction systems and online activities, like e-commerce, e-learning, games, dating or social networks, are fields in which classifications of facial features are useful, for example, to create digital interlocutors that optimize the interactions between human and machines. However, classifying isolated facial features is difficult for human observers. Previous works reported low inter-observer and intra-observer agreement in the evaluation of facial features. This work presents a computer-based procedure to automatically classify facial features based on their global appearance. This procedure deals with the difficulties associated with classifying features using judgements from human observers, and facilitates the development of taxonomies of facial features. Taxonomies obtained through this procedure are presented for eyes, mouths and noses.

Anthropometric analysis of 3D ear scans of Koreans and Caucasians for ear product design

The present study measured 25 dimensions of the ear including the concha and ear canal for ergonomic design of ear products and compared with existing ear measurement studies. Scanning and casting methods were employed to produce 3D ear images for 230 Koreans and 96 Caucasians and measurements of the ear dimensions were obtained by identifying 21 landmarks on individual ear scan image. The Korean ear measurements were found significantly larger (mean difference d¯  = 0.4-3.7 mm) and more varied (ratio of SDs =1.01-1.55) than those of Caucasians in most of ear dimensions. The average ear length and ear breadth of male were significantly longer ( d¯  = 1.3-7.0 mm) and wider ( d¯  = 0.8-3.0 mm) than those of female. Use of gender- and ethnicity-composite ear data is recommended in product design due to the much larger intra-population variations (7.5-22.2 mm) than the corresponding inter-population variations. Practitioner Summary: The 3D ear measurements of Koreans and Caucasians were collected and compared with those of different ethnic populations. The distinct ear features of the populations identified in this study are applicable to ergonomic design of ear products with better fit and comfort. Abbreviations: CCW: cavum concha width; CV: coefficient of variation; EB: ear breadth; EL: ear length; SD: standard deviation; SE: sampling error; 3D: 3 dimensional.

Essential Anatomy and Evaluation for Functional Rhinoplasty

The nose, a prominent facial feature in defining facial beauty, is responsible for the fundamental physiologic functions of heating, humidifying, and filtering inspired air. When the normal balance of laminar and turbulent airflow become disturbed due to anatomic abnormalities, nasal obstruction may result. To successfully restore these basic physiologic functions, the surgeon must have a detailed understanding of the nasal anatomy and be able to successfully identify the specific cause of the nasal obstruction. This article discusses the fundamental surgical anatomy and the various diagnostic techniques and instruments at the surgeon's disposal.

Examining age, sex, and race characteristics of velopharyngeal structures in 4- to 9-year old children using magnetic resonance imaging

Objective

The purpose of this study was to quantify the growth of the various craniofacial and velopharyngeal structures and examine sex and race effects.

Methods

Eight-five healthy children (53 White and 32 Black) with normal velopharyngeal anatomy between 4 and 9 years of age who met the inclusion criteria and successfully completed the MRI scans were included in the study.

Results

Developmental normative mean values for selected craniometric and velopharyngeal variables by race and sex are reported. Cranial variables (face height, nasion to sella, sella to basion, palate height, palate width) and velopharyngeal variables (levator muscle length, angle of origin, sagittal angle, velar length, velar thickness, velar knee to posterior pharyngeal wall, and posterior nasal spine to levator muscle) demonstrated a trend toward a decrease in angle measures and increase in linear measures as age increased (with the exception of PNS to levator muscle). Only hard palate width and levator muscle length showed a significant sex effect. However, two cranial and six velopharyngeal variables showed a significant race effect. The interactions between sex, race, and age were not statistically significant across all variables, with the exception of posterior nasal spine to posterior pharyngeal wall.

Conclusion

Findings established a large age and race-specific normative reference for craniometiric and velopharyngeal variables. Data reveal minimal sexual dimorphism variables used in the present study; however, significant racial effects were observed.

Outcomes of external septorhinoplasty in a Turkish male population

Introduction

The first and one of the most important steps in facial plastic surgery is accurate preoperative facial analysis and recording of data that may help the surgeon to check the outcomes of his/her techniques, promoting a surgeon's professional development.

Objective

To evaluate the esthetic outcomes of external septorhinoplasty relevant to ethnic facial harmony and to investigate the relationship of the columellar incision scar with the type of skin and columellar incision type in a Turkish population.

Methods

In total, 28 consecutive adult male patients with a mean age of 32.14 ± 10.66 years (range: 18–61 years) were included the study. Primary outcomes were preoperative and postoperative photogrammetric facial analyses of the patients including measurement of nasofrontal angle, nasolabial angle and nasal projection ratios (Gode) assessed according to the data derived from the Rhinobase program. Results were compared to facial proportions of the Turkish population. Columellar incision scar scores related to the Fitzpatrick skin type classification of the patients and columellar incision types used for the external approach were secondary outcomes of the study.

Results

Mean preoperative and postoperative nasofrontal angles were 148.04° ± 8.18° and 144.50° ± 7.15°, respectively, while mean preoperative and postoperative nasolabial angles were 87.59° ± 14.01° and 98.50° ± 9.71°, respectively. Mean preoperative and postoperative nasal tip projection ratios were 0.56 ± 0.05 and 0.60 ± 0.06, respectively. The differences between pre- and postoperative measurements were all significantly different and were in accordance with Turkish nasal harmony. Columellar inverted “V” incisions were performed in 15 (53.6%) patients while “V” incisions were used in 13 (46.4%) patients. Fitzpatrick skin Type 4 was seen in 46.42% of the patients, Fitzpatrick Type 3 in 46.42% and Fitzpatrick Type 2 in 7.14% of the patients. No significant difference was seen between columellar scar scores according to skin type and columellar incision type used for external septorhinoplasty.

Conclusions

This study demonstrated that outcomes for nasofrontal angle, nasolabial angle and nasal tip projection ratios analyzed using the Rhinobase program in patients who underwent external septorhinoplasty were similar to reference values for the Turkish population.