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Journal of the Anatomical Society of India

Photometric Facial Analysis - A Baseline Study

Author(s): Jain SK, Anand C & Ghosh SK.

Vol. 53, No. 2 (2004-07 - 2004-12)

Dr. R.P. Govt. Medial College, Kangra at Tanda, H.P.

Abstract:

Thorough facial analysis is the foundation for successful rhinoplasty. Every surgeon doing nasal cosometic procedure must master the techniques of successful analysis. In the present study by applying photometrics, vertical and angular measurements of 100 adult Himachali males were taken and compared with North American population. Our study concluded with the fact that Himachali male has got bigger lower face and moreover angles of aesthetic triangle deviated a little from that of North American population.

Key words: Glabella , Nasion, Subnasale, Menton. Pogonion. Aesthetic triangle, & Rhinoplasty

Introduction:

The identification of aesthetic facial qualities began with ancient civilizations such as Egyptians and Greeks, who captured their ideals of beauty in artfrom, Peck and Peck (1970 ) . The classical Greek canons of facial proportions influenced anatomic scholars of Renaissance period, and many of these, with modifications, are still embraced as the basic foundation of aesthetic facial analysis today.

The favourable correction of nasal deformities constitutes one of the most challanging areas of facial aesthetic surgery. For such an important task baseline records and an understanding of their interplay are essential. Extensive literature is available for North- American and Europians, Powell and Humphries (1984) but similar baseline records are not available for Indians.

Consistent quality photographs are important not only to document pre and post-operative results, communicating with patients, but also are essential in preoperative planning and accurate evaluation of post operative results, Larrabee (1987).

Rhinoplastic surgery is catching up in India in a big way. Hence the current study was undertaken to fomulate a baseline record of nasal contours of the people in and around Kangra district of Himachal Pradesh, India.

Material and Methods:

To assist in analysis and documentation of nasal contours, techniques using dimensional assessments are extremely valuable. The standard at present is of reproductive photography.

Standardized views taken with a good quality 35mm single lens-reflex (SLR) camera is the most reliable choice in Photographic documentation. For this study we took hundred adult Himachali males, 18-49yrs of age. We took frontal and right lateral views, from a fixed distance and keeping in mind the soft tissue Frankfurt horizontal plane, Tweed (1946). We took tracing of these photographs and made certain lines and angles for vertical and angular measurements.

Vertical measurements: A vertical line drawn from nasion to pogonion and divided into two parts from nasion to subnasale and subnasale to pogonion. Distances between these were measured and converted into percent ratio. (Fig-1)

Fig - 1 shows the landmarks on face

Missing Image

1. Nasion (N).
2 : Subnasal (SN)
3: Menton (MN)
Angular measurements: Following angles were drawn and measured.

(a) Nasofronatal angle: It is formed by drawing a line tangent to glabella through the nasion that will intersect a line drawn tangent to nasal dorsum. (Fig2A)

(b) Nasofacial angle: It is formed by drawing a vertical line tangent to forehead at the glabella and tangent to the chin at the pogonion so that a line drawn along the nasal dorsum intersects it.

(c) Nasomental angle: It is formed by a line drawn through the nasal dorsum intersecting a line drawn from the nasal tip to soft tissue chin at the pogonion. (Fig 2C).

(d) Mentocervical angle: A vertical line tangent to forehead passing at glabella and second line intersecting tangent to the chin at Pogonion. (Fig. 2D).

Fig - 2A:(4) Nasaofrontal angle, 2B: (5) Nasaofacial angle.

Missing Image

 

Fig 2C:(6) Nasomental angle, 2D: (7) Mento cervical angle.

Missing Image

Angles of all hundered adult Himachali males were measured and an average of their angles were taken and tabulated.

Results:

While analysing the fine anatomy of nasal contours, it is important also to have an idea of general facial characterstics. Analysis of 100 Himachali males gave us an idea that the face of an adult Himachali male is: Symmetrical, Forehead flat, Lower face bigger than middle face, Glabella less prominent, Nose wide with bulbous tip & Prominent jaw line.

Analysis of 100 frontal view photographs showed that the distance between nasion to subnasale varied from 11 to 17 mm with an average of 13.7mm. while the distance between SN-MN varied from 11 to 22 mm with an average of 16.9mm (Table-I).

Table I: Vertical measurements (mm)

Length Minimum Maximum Average
N-SN 11 17 13.7%
SN-MN 11 22 16.9%

Percent ratio of these length N-SN and SN-MN to full length i.e nasion to menton ( N-MN) varied from 36.3 to 52% with an average of 44.63% for N-SN and 48% to 63.7% with an average of 55.37% (Table-II).

Table II:Vertical measurements (%)


Percent ratio
Minimum Maximum Average
N-SN/total length (N-MN) 36.3 52 44.63%
SN-MN/total length (N-MN) 48 63.7 55.37%

Analysis of 100 right lateral photographs showed that values of nasofrontal, nasofacial, nasomental and mentocervical angle varied as follows:

Table III: Angular measurements

Angle Minimum Maximum Average
Nasofrontal 100 160 134%
Nasofacial 20 45 33.26%
Nasomental 112 142 128%
Mentocervical 75 120 99.88%

Discussion:

Leonardo da Vinci divided the face into thirds, from the frontal hair line to the root of the nose, the nasal root to nasal base and the nasal base to the bottom of the chin, Larrabee (1987). Because the frontal hairline may be absent in some individuals the proportions of the mid and lower face need only be analysed, Powell and Humphries (1984). Farkas et al (1985) performed anthropometric studies on different ethnic populations to assess the validity of the classical Greek canons for beauty and have produced tables of multiple normal values for various facial proportions. Powell and Humphries (1984) contributed their concept of Aesthetic triangle to facial analysis and included nasofrontal, nasofacial, nasomental and mentocervical angles in this system.

Photographic documentation as used here is the most convenient and helpful method for facial analysis and to compare pre and post operatively for facial plastic surgery as has been documented by others, Larrabee

Percent ratio of these length N-SN and SN-MN to full length i.e nasion to menton ( N-MN) varied from 36.3 to 52% with an average of 44.63% for N-SN and 48% to 63.7% with an average of 55.37% (Table-II). (1987) and Andrews & Schoenrock (1998).

The present study shows that lower third of face is bigger than middle face having respective values of 55.37% and 44.63%, which well correlates with the study of Powell and Humphries (1984) on North American population having values for lower and middle third of face 53% and 47% respectively (Table-IV).

Table-IV: Comparison of Percent ratio of vertical facial height

Percent ratio Himachali Population North American Population
N-SN (Middle face) 44.63% 47%
SN-MN (Lower face) 55.37% 53%

Interfacial evaluation as done by calculating the angles of aesthetic triangle i.e. nasofrontal, nasofacial, nasomental and mentocervical well correlates with the study of North American population done by Powell and Humphries (1984), with a specific remark that values of Himachali males for all the angles are towards the higher side except the nasofacial angle, the average of which is slightly lower. (Table-V)

Table - V:

Angle Present study North American
Min. Max. Avg. Min. Max. Avg.
Nasofrontal 100 160 134 115 130 122.5%
Nasofacial 20 45 33.26 30 40 35%
Nasomental 112 142 128 120 132 126%
Mentocervical 75 120 99.88 80 95 87.5%

Lower Nasofacial angle shows the projection of nose in Himachali population is less than North Americans. Less prominent glabella is caused by higher mentocervical and nasofrontal angle as in the present study. Higher nasomental angle shows that chin has a bigger size which also well correlates with this study (Bigger lower face).

Ethnic and racial differences in the facial structure is a well accepted fact. The concept of aesthetics for a Roman nose may be quite different from that of a Chinese. Hence, it is imperative that effort is made to work out the aesthetics of Indian nose as a general feature with certain individual characetristics super- imposed.

Concluding all these facts we are now in a position to state that Himachali male has got, Smaller middle face ( N-SN= 44.63%), Bigger lower face (SN-MN= 55.37%), Less prominent glabella (Higher nasofacial 1600 & higher mentocervical angle 1200), Bigger chin ( Higher nasomental angle) & Depressed nasal bridge ( lower nasofacial angle 33.260 Average).

Acknowledgment:

Authors wish to acknowledge Mr. Balak Ram Photographer, Dr. R.P.G.M.C Kangra at Tanda for showing a great deal of enthusiasm in taking photographs, of subjects concerned. Mr. Amir Chand deserves special thanks for computerized typing of this manuscript.

References:

  1. Andrews J.T & Schoenrock L.D. Photodocumentation. In head and Neck surgery Otolaryngology. Byron. J. Bailey, 2ed, Philadelphia. Lippincott.-Raven; 1998,PP 247-255.
  2. Farkas LG, Hreczko TA, Kolar JC & Munro IR. Vertical and horizontal proportions of the face in young adult North American caucasians: revision of neoclassical canons. Plastic Reconstructive Surgery.1985; 7(3): 328-338.
  3. Larrabee WF. Facial analysis for rhinoplasty. Otolaryngology clinics North America.1987; 20 (4): 653-674.
  4. Peck H,& peck S. A concept of facial aesthetics. Angle orthodontics. 1970; 40 (4): 284-317.
  5. Powell N & Humphries B.Proportions of the Aesthetic face New york: Thieme-Stratton. 1984; 51-55 (cited by).
  6. Tweed CH.The frankfort-mandibular plane angle in othodontic diagnosis, classification, treatment planning and prognosis. American Journal of Orthodontics and oral surgery. 1946; 32: 175.
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