Skip to main content
Top
Published in: Aesthetic Plastic Surgery 1/2020

01-02-2020 | Face Lift | Original Article

Anthropometric Analysis of the Human Skull for Developmental Left-Sided Asymmetry, New Finding

Authors: Abbas Kazemi Ashtiani, Mahdokht Azarbakhsh, Farhad Hafezi, Bijan Naghibzadeh

Published in: Aesthetic Plastic Surgery | Issue 1/2020

Login to get access

Abstract

Background

Facial and cranial asymmetry is common in bilateral vertebrates, particularly human beings. Through years of injecting fillers and performing face-lift operation on patients, we began to observe that more fillers were required on the right side to reach symmetry and also more loose skin and soft tissue was observed on the right side in the majority of patients (Fig. 5). Here, we conducted an analytical study to comprehensively measure human skulls in order to observe and quantify this difference.

Methods

We collected forty-one natural skulls available from five medical schools of Tehran province in Iran. Standard photography was conducted from the front, lateral, and superior views. Measurements and statistics were completed using Image J software (National Institutes of Health) for exact comparison of fixed-point distances on the samples.

Results

Comparison of right and left dimensions on the skulls revealed several fixed asymmetries. The most significant differences were measurements around the orbit. The distance between the upper orbit point and zygion (zy), zygion to sub-nasal, and orbital areas were significantly larger on the left side. Measuring the anterior gonion–pogonion distance showed a wider mandibular body on the left side. We did not find any considerable differences between any other left-sided and right-sided skull dimensions.

Conclusions

Asymmetry of the face and body is a general rule in human anatomy, but correlation and consistency of this asymmetry between the left and right sides is a novel finding based on our measurements. Our findings showed that the orbit was significantly bigger in width, height, and surface area on the left side. We also quantified a narrower mandible on the right side. We hope these findings can be translated to aesthetic surgery practice to make the plastic surgeon and patient more familiar with the patient’s specific anatomy in order to better predict, plan, and successfully implement aesthetic procedures such as injecting fillers or doing peri-orbital procedures.

No Level Assigned

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 the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literature
1.
go back to reference Hafezi F, Javdani A, Naghibzadeh B, Ashtiani AK (2017) Laterality and left-sidedness in the nose, face, and body: a new finding. Plast Reconstr Surg Glob Open 5(12):e1590CrossRef Hafezi F, Javdani A, Naghibzadeh B, Ashtiani AK (2017) Laterality and left-sidedness in the nose, face, and body: a new finding. Plast Reconstr Surg Glob Open 5(12):e1590CrossRef
2.
go back to reference Hafezi F, Naghibzadeh B, Nouhi A, Yavari P (2010) Asymmetric facial growth and deviated nose: a new concept. Ann Plast Surg 64(1):47–51CrossRef Hafezi F, Naghibzadeh B, Nouhi A, Yavari P (2010) Asymmetric facial growth and deviated nose: a new concept. Ann Plast Surg 64(1):47–51CrossRef
3.
go back to reference Hafezi F, Naghibzadeh B, Ashtiani AK, Guyuron B, Nouhi AH, Naghibzadeh G (2014) Straight septum, crooked nose: an overlooked concept. Aesthet Plast Surg 38(1):32–40CrossRef Hafezi F, Naghibzadeh B, Ashtiani AK, Guyuron B, Nouhi AH, Naghibzadeh G (2014) Straight septum, crooked nose: an overlooked concept. Aesthet Plast Surg 38(1):32–40CrossRef
4.
go back to reference Blum M, Feistel K, Thumberger T, Schweickert A (2014) The evolution and conservation of left-right patterning mechanisms. Development 141(8):1603–1613CrossRef Blum M, Feistel K, Thumberger T, Schweickert A (2014) The evolution and conservation of left-right patterning mechanisms. Development 141(8):1603–1613CrossRef
5.
go back to reference Levin M (2004) The embryonic origins of left-right asymmetry. Crit Rev Oral Biol Med 15(4):197–206CrossRef Levin M (2004) The embryonic origins of left-right asymmetry. Crit Rev Oral Biol Med 15(4):197–206CrossRef
6.
go back to reference Rohrich RJ, Villanueva NL, Small KH, Pezeshk RA (2017) Implications of facial asymmetry in rhinoplasty. Plast Reconstr Surg 140(3):510–516CrossRef Rohrich RJ, Villanueva NL, Small KH, Pezeshk RA (2017) Implications of facial asymmetry in rhinoplasty. Plast Reconstr Surg 140(3):510–516CrossRef
7.
go back to reference Gawlikowska-Sroka A (2013) Analysis of variation of orbital openings in contemporary skulls. Ann Acad Med Stetin 59(1):76–80PubMed Gawlikowska-Sroka A (2013) Analysis of variation of orbital openings in contemporary skulls. Ann Acad Med Stetin 59(1):76–80PubMed
8.
go back to reference Ercan I, Ozdemir ST, Etoz A, Sigirli D, Tubbs RS, Loukas M, Guney I (2008) Facial asymmetry in young healthy subjects evaluated by statistical shape analysis. J Anat 213(6):663–669CrossRef Ercan I, Ozdemir ST, Etoz A, Sigirli D, Tubbs RS, Loukas M, Guney I (2008) Facial asymmetry in young healthy subjects evaluated by statistical shape analysis. J Anat 213(6):663–669CrossRef
9.
go back to reference Kim EJ, Palomo JM, Kim SS, Lim HJ, Lee KM, Hwang HS (2011) Maxillofacial characteristics affecting chin deviation between mandibular retrusion and prognathism patients. Angle Orthod 81(6):988–993CrossRef Kim EJ, Palomo JM, Kim SS, Lim HJ, Lee KM, Hwang HS (2011) Maxillofacial characteristics affecting chin deviation between mandibular retrusion and prognathism patients. Angle Orthod 81(6):988–993CrossRef
Metadata
Title
Anthropometric Analysis of the Human Skull for Developmental Left-Sided Asymmetry, New Finding
Authors
Abbas Kazemi Ashtiani
Mahdokht Azarbakhsh
Farhad Hafezi
Bijan Naghibzadeh
Publication date
01-02-2020
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 1/2020
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-019-01526-y

Other articles of this Issue 1/2020

Aesthetic Plastic Surgery 1/2020 Go to the issue