58 Facial Analysis Flashcards
What are the important soft tissue reference points of the face with regards to facial analysis?
What are the important soft tissue reference points of the face with regards to facial analysis?
- Trichion (Tr): anterior hairline at the midline
- Glabella (G): most anterior point of the forehead on profile view
- Nasion (N): point of deepest depression at the root of the nose on profile view
- Nasal tip (T): most anterior point of nasal tip on profile view
- Columellar point (Cm): most anterior point of the columella on profile view
- Subnasale (Sn): point where the nasal columella merges with the upper lip
- Labrale superioris (LS): vermillion border of the upper lip
- Labrale inferiorris (LI): vermillion border of the lower lip
- Pogonion (Pg): most anterior point of the chin on profile view
- Menton (Me): lowest point of the chin
- Cervical point (C): innermost point between the submental area and the neck
What is the Frankfort horizontal plane?
What is the Frankfort horizontal plane?
A line drawn from the superior aspect of the external auditory canal to the inferior aspect of the infraorbital rim on a lateral view (Figure 58-2). In photographs, it is approximated by a line drawn from the superior tragus to the lower eyelid-cheek skin junction. This allows standardization for patient positioning in photographs as well as for facial analysis.
What is the facial plane?
What is the facial plane?
A line drawn from the glabella to the pogonion. The facial plane should intersect the Frankfurt horizontal plane at an angle of 80 to 95 degrees.
What is the zero meridian of Gonzales-Ulloa?
What is the zero meridian of Gonzales-Ulloa?
A line perpendicular to the Frankfort horizontal line that goes through the nasion. The pogonion should be within 5 mm of this line.
What are some important angles used for facial analysis?
What are some important angles used for facial analysis?
- Nasofrontal angle (Figure 58-3A): intercept of glabella (G) to nasion (N) line with nasion (N) to tip (T) line
- Nasofacial angle (Figure 58-3B): intercept of glabella (G) to pogonion (Pg) line with nasion (N) to tip (T) line
- Nasolabial angle (Figure 58-3C): intercept of columella point (Cm) to subnasale (Sn) line with subnasale (Sn) to labrale superioris (LS) line
- Nasomental angle (Figure 58-3D): intercept of nasion (N) to tip (T) line with tip (T) to pogonion (Pg) line
- Mentocervical angle (Figure 58-3E): intercept of glabella (G) to pogonion (Pg) line with menton (M) to cervical point (C) line
Figure: A, Nasofrontal angle. B, Nasofacial angle. C, Nasolabial angle. Male (i) and female (ii). D, Nasomental angle. E, Mentocervical angle.
What is the aesthetic triangle of Powell and Humphreys?
What is the aesthetic triangle of Powell and Humphreys?
This system incorporates the nasofrontal, nasofacial, nasomental, and the mentocervical angles to relate all the major components of the face in the evaluation of facial harmony (Figure 58-4). The nasomental angle is considered the most important measurement because it is dependent upon nasal projection as well as chin position and shows the interdependence of individual facial features.
Figure: Aesthetic triangle of Powell and Humphreys.
What are ideal measurements of the angles mentioned above?
What are ideal measurements of the angles mentioned above?
Nasofrontal angle: 115–130 degrees
Nasofacial angle: 36–40 degrees
Nasolabial angle: 90–95 degrees in males and 95–110 degrees in females
Nasomental angle: 120–132 degrees
Mentocervical angle: 80–95 degrees
What is the rule of thirds?
What is the rule of thirds?
The face can be divided into thirds of approximate equal vertical height on frontal view (Figure 58-5A). The distance from the trichion to the glabella should equal the length from the glabella to the subnasale, which should equal the length from the subnasale to the menton.
Figure: A, Facial height. The facial height is divided into equal thirds. B, Facial width. The facial width is divided into equal fifths.
What is the rule of fifths?
What is the rule of fifths?
The face can be divided into fifths of equal width on frontal view (Figure 58-5B). The width of one eye should equal one fifth of the facial width. In other words, the intercanthal distance should approximate the width of the nose as well as the width from lateral canthus to the ear.
What are the subunits of the face?
What are the subunits of the face?
Forehead, periorbital region, cheeks, nose, perioral region and chin, and neck
What are the subunits of the nose?
What are the subunits of the nose?
The nose is divided into nine (9) subunits. These are the paired sidewalls, ala, and soft tissue triangles, and the unpaired dorsum, tip, and columellar subunits.
What is the supratip break?
What is the supratip break?
The transitional area from the dorsum to the tip where the lower and upper lateral cartilages overlap is called the supratip break. The nasal tip should ideally lead the dorsum by 1 to 2 mm, leading to a break in the line of the dorsum. This is an aesthetic that is more important in women than men.
What is the double break of the columella?
What is the double break of the columella?
As the nasal tip transitions to the columella, it is seen making two breaks. The first break is the point at which the tip turns posteriorly and inferiorly onto the infratip lobule while the second break occurs where the infratip lobule transitions to a flatter and more horizontal columella. The second break corresponds to the junction of the medial and intermediate crura.
Where is the ideal location for the nasion?
Where is the ideal location for the nasion?
The nasion ideally should lie at the level of the supratarsal crease on profile view. If it is too low, it may lead to overestimation of nasal projection.
What are the characteristics of an ideal nasal base?
What are the characteristics of an ideal nasal base?
On base view, the nose should approximate an equilateral triangle. The columella should comprise two thirds of the height and the lobule comprises another third, leading to a columella : lobule ratio of 2 : 1.
The nostrils should be symmetric and appear pear shaped with the widest portion at the nostril sill. The width of the lobule should be 75% of the width of the nasal base. On lateral view, the alar : lobule ratio should be 1 : 1 and there should be 2 to 4 mm of columellar show.
What are the methods used to assess nasal projection?
What are the methods used to assess nasal projection?
Joseph: Described nasal projection in relation to the facial plane, defining the nasofacial angle, which is important in describing projection. The more acute the angle, the less the tip projection and vice versa.
Simons: Ratio of nasal projection to length of the upper lip should equal 1 : 1. The ratio of the length of the vermilion border (LS) to the subnasale (Sn) should equal the length of the nasal tip as measured from the subnasale (Sn) to the tip (T).
Goode: Ratio of tip projection to nasal dorsum length should equal 0.55 : 1 to 0.6 : 1. A vertical line is drawn from the nasion (N) to the alar facial groove (A). Tip projection is measured by the length of a horizontal line drawn from the nasal tip (T) perpendicular to the vertical line. Nasal dorsum length is measured from nasion (N) to tip (T) (See figure below).
Crumley: Ratio of tip projection to vertical height to nasal length should equal 3 : 4 : 5. Tip projection, vertical height, and nasal length are measured as described by Goode’s method, and these sides should form a right triangle.
Powell and Humphries: Ratio of nasal height to tip projection should equal 2.8 : 1. Height is measured by the length from nasion (N) to subnasale (Sn) and projection is measured by a line drawn perpendicular to the line of nasal height through the tip (T).
What accounts for an aesthetic eyebrow and what are the differences between the male and female brow?
What accounts for an aesthetic eyebrow and what are the differences between the male and female brow?
The female brow ideally should start medially directly above the nasal ala and reach its highest point at the lateral limbus or lateral canthus and should end at an oblique line passing through from the nasal ala to the lateral canthus. The medial and lateral aspects of the brow should be on the same horizontal plane. The medial aspect should be club shaped and gradually taper laterally. Female brows tend to be thinner, more arched, and positioned above the supraorbital rim while male brows tend to be thicker, straighter, and positioned at the supraorbital rim.
