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Defining facial beauty or attractiveness has been done for centuries. Most of the time it is discussed from an artist’s perspective looking at ratios, linear measurements, angles and proportions. While these all have merit surgery is not like making a painting or creating a sculpture. It is far less precise and the influence of how the overlying soft tissues responds to underlying structural changes is not always completely predictable.

Aside from specific numerical descriptions there are several basic facial shape concepts that can be gleaned from the acting and modeling fields…a world that certainly places great value on facial aesthetics. These basic facial reshaping principles comes from a lecture series that is performed in our Facial Implant course and the attached lecture slide highlights what they are. While the flavor of these facial concepts does change over time as part of overall societal influences the four basic facial shape concepts are: 1) a well defined and smooth jawline, 2) high cheekbones, 3) a proportionate nose and 4) smooth wrinkle free skin. And who there are some differences amongst the different races these basic facial shape concepts are relatively the same.

There are gender influences in the ideal shape of the jawline. (e.g., the male chin is more square and the female chin is more tapered, the jaw angles in the male are wider/flared while in the female they may be defined but less wide) But what is shared is a visibly straight jawline, a smooth linear connection between the chin and the jaw angles. This is a near universal lower facial shape feature that is desired as it creates a clear separation of the face from the neck.

The high cheekbone look is often requested but can be hard to explain. The cheeks are a very different region of the face because they are not a classic profile edge structure. This is well illustrated by the fact that no one describes how much projection they want in the cheeks like they do in chin augmentation. The cheeks are usually described as a type of geometric shape (various forms of an oval) whose longitudinal axis of orientation over the cheekbone can be variable. The high cheekbone look refers to when the orientation of this oval shape becomes more horizontal compared to the underlying zygomatic arch line.

The shape of the nose becomes more proportionate when its dorsal length falls into a better relationship with its tip projection. While the nasolabial angle may differ between men vs women (men are around 90 degree while women are more open at 100 degrees or greater) tip length or projection must not be excessive long or short compared to the length of the nose.

The appearance of the skin on the face, while not a facial shape characteristic, is still important as it affects how the shape of the face appears, This is  particularly relevant around the facial sphincters (eyes and mouth) and along the jawline. Procedures such as laser resurfacing and various types of facelifting procedures can help loose and wrinkled skin be redraped over improved facial skeletal support.

 Dr. Barry Eppley

Indianapolis, Indiana

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