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Published in: European Journal of Plastic Surgery 4/2016

01-08-2016 | Original Paper

Computer-assisted analysis contour lines of aesthetic unit for the assessment of lip augmentation

Authors: Hassan Bagheri, Suzan Sirinturk, Figen Govsa, Yelda Pinar, Mehmet Asim Ozer

Published in: European Journal of Plastic Surgery | Issue 4/2016

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Abstract

Background

Lip augmentation and changing contour lines have become more popular ways of improving the appearance. However, validated measures of lip fullness for quantification of outcomes are needed; ethnic background and personal goals can optimise outcomes while tailoring lip enhancement treatment to each individual’s anatomy. The aim of this study is to analyse the morphological features of the lip in detail and to clarify the objective parameters in related with the subjective ones regarding the lip augmentation and lip reconstruction.

Methods

Standard photographs of the lips of 200 young Anatolian adults were calculated with linear and angular components. The features of the lower third of the face were analysed with the software program. Linear analyses (heights of the upper lip, the upper vermilion, the lower lip height, the lower vermillion and the chin height) and angular analyses (the upper lip, the lower lip, the apex and Cupid’s bow angles) were measured as reference points. The lip shape was classified into five groups: thin, very thin, medium, full and very full.

Results

The lower third of the face was divided into three segments (Sn–Sto, Sm–Me and Sto–Sm), and the largest portion of the lower face was occupied by the chin and the smallest by the lower lip height in both genders. The upper vermilion height was 8.07 ± 1.8 mm in males and 7.08 ± 1.5 mm in females. The lower vermilion height was 10.1 ± 2.4 mm in males and 9.7 ± 1.9 mm in females. The upper lip angle was calculated as 30.3 ± 9.6° in males and 24.2 ± 6.2°mm in females. The lower lip angle was calculated as 38.3 ± 9.7° in males and 36.5 ± 6.4° in females. Meanwhile, the angular measurements of Cupid’s bow (i.e., the apex and the central angle of Cupid’s bow) were smaller in men than in women. When the lip was analyzed, the medium and full types in upper and lower lips accounted for substantial fractions in men, whereas medium and thin types were predominant also in women.

Conclusions

With the help of certain software, this research has made possible to define the best cosmetical redesign solution of lip construction and augmentation with a natural appearance for the patient.
Level of Evidence: Level III, diagnostic study.
Literature
2.
go back to reference Carey J, Cohen M, Curry C, Devriendt K, Holmes L, Verloes A (2009) Elements of morphology: standard terminology for the lips, mouth, and oral region. Am J Med Genet 149A(1):77–92CrossRefPubMed Carey J, Cohen M, Curry C, Devriendt K, Holmes L, Verloes A (2009) Elements of morphology: standard terminology for the lips, mouth, and oral region. Am J Med Genet 149A(1):77–92CrossRefPubMed
3.
go back to reference Raphael P, Harris R, Harris S (2013) Analysis and classification of the upper lip aesthetic unit. Plast Reconstr Surg 132(3):543–551CrossRefPubMed Raphael P, Harris R, Harris S (2013) Analysis and classification of the upper lip aesthetic unit. Plast Reconstr Surg 132(3):543–551CrossRefPubMed
4.
go back to reference Alam M, Gladstone H, Kramer E et al (2008) ASDS Guidelines of Care: injectable fillers. Dermatol Surg 34(s1):S115–S148CrossRefPubMed Alam M, Gladstone H, Kramer E et al (2008) ASDS Guidelines of Care: injectable fillers. Dermatol Surg 34(s1):S115–S148CrossRefPubMed
5.
go back to reference Burstone C (1967) Lip posture and its significance in treatment planning. Am J Orthod 53(4):262–284CrossRefPubMed Burstone C (1967) Lip posture and its significance in treatment planning. Am J Orthod 53(4):262–284CrossRefPubMed
6.
go back to reference Clymer M (2007) Evolution in techniques: lip augmentation. Facial Plast Surg 23(1):021–026CrossRef Clymer M (2007) Evolution in techniques: lip augmentation. Facial Plast Surg 23(1):021–026CrossRef
8.
go back to reference Lemperle G, Anderson R, Knapp T (2010) An Index for quantitative assessment of lip augmentation. Aesthet Surg J 30(3):301–310CrossRefPubMed Lemperle G, Anderson R, Knapp T (2010) An Index for quantitative assessment of lip augmentation. Aesthet Surg J 30(3):301–310CrossRefPubMed
9.
go back to reference Anic-Milosevic S, Mestrovic S, Prlić A, Slaj M (2010) Proportions in the upper lip–lower lip–chin area of the lower face as determined by photogrammetric method. J Craniomaxillofac Surg 38(2):90–95CrossRefPubMed Anic-Milosevic S, Mestrovic S, Prlić A, Slaj M (2010) Proportions in the upper lip–lower lip–chin area of the lower face as determined by photogrammetric method. J Craniomaxillofac Surg 38(2):90–95CrossRefPubMed
10.
go back to reference Gunduz Arslan S, Genç C, Odabaş B, Devecioğlu KJ (2007) Comparison of facial proportions and anthropometric norms among Turkish young adults with different face types. Aesthetic Plast Surg 32(2):234–242CrossRef Gunduz Arslan S, Genç C, Odabaş B, Devecioğlu KJ (2007) Comparison of facial proportions and anthropometric norms among Turkish young adults with different face types. Aesthetic Plast Surg 32(2):234–242CrossRef
11.
go back to reference Farkas L, Katic M, Forrest C (2005) International anthropometric study of facial morphology in various ethnic groups/races. J Craniofac Surg 16(4):615–646CrossRefPubMed Farkas L, Katic M, Forrest C (2005) International anthropometric study of facial morphology in various ethnic groups/races. J Craniofac Surg 16(4):615–646CrossRefPubMed
12.
go back to reference Rhee S, Dhong E, Yoon E (2008) Photogrammetric facial analysis of attractive Korean entertainers. Aesthetic Plast Surg 33(2):167–174CrossRefPubMed Rhee S, Dhong E, Yoon E (2008) Photogrammetric facial analysis of attractive Korean entertainers. Aesthetic Plast Surg 33(2):167–174CrossRefPubMed
13.
go back to reference Wong W, Davis D, Camp M, Gupta S (2010) Contribution of lip proportions to facial aesthetics in different ethnicities: a three-dimensional analysis. J Plast Reconstr Aesthet Surg 63(12):2032–2039CrossRefPubMed Wong W, Davis D, Camp M, Gupta S (2010) Contribution of lip proportions to facial aesthetics in different ethnicities: a three-dimensional analysis. J Plast Reconstr Aesthet Surg 63(12):2032–2039CrossRefPubMed
14.
go back to reference Garcia de Mitchell C, Pessa J, Schaverien M, Rohrich R (2008) The Philtrum: anatomical observations from a new perspective. Plast Reconstr Surg 122(6):1756–1760CrossRefPubMed Garcia de Mitchell C, Pessa J, Schaverien M, Rohrich R (2008) The Philtrum: anatomical observations from a new perspective. Plast Reconstr Surg 122(6):1756–1760CrossRefPubMed
15.
go back to reference Jones L, Tatum S (2008) Pearls for aesthetic reconstruction of cleft lip and nose defects. Facial Plast Surg 24(1):146–151CrossRefPubMed Jones L, Tatum S (2008) Pearls for aesthetic reconstruction of cleft lip and nose defects. Facial Plast Surg 24(1):146–151CrossRefPubMed
16.
go back to reference Nakamura N, Suzuki A, Takahashi H, Honda Y, Sasaguri M, Ohishi M (2005) A longitudinal study on influence of primary facial deformities on maxillofacial growth in patients with cleft lip and palate. Cleft Palate Craniofac J 42(6):633–640CrossRefPubMed Nakamura N, Suzuki A, Takahashi H, Honda Y, Sasaguri M, Ohishi M (2005) A longitudinal study on influence of primary facial deformities on maxillofacial growth in patients with cleft lip and palate. Cleft Palate Craniofac J 42(6):633–640CrossRefPubMed
17.
go back to reference Schwenzer-Zimmerer K, Chaitidis D, Boerner I, et al (2008) Systematic contact-free 3D topometry of the soft tissue profile in cleft lips. Cleft Palate Craniofac J 45(6):607–613 Schwenzer-Zimmerer K, Chaitidis D, Boerner I, et al (2008) Systematic contact-free 3D topometry of the soft tissue profile in cleft lips. Cleft Palate Craniofac J 45(6):607–613
18.
go back to reference Schwenzer-Zimmerer K, Chaitidis D, Berg-Boerner I, et al (2008) Quantitative 3D soft tissue analysis of symmetry prior to and after unilateral cleft lip repair compared with non-cleft persons (performed in Cambodia). J Craniomaxillofac Surg 36(8):431–438 Schwenzer-Zimmerer K, Chaitidis D, Berg-Boerner I, et al (2008) Quantitative 3D soft tissue analysis of symmetry prior to and after unilateral cleft lip repair compared with non-cleft persons (performed in Cambodia). J Craniomaxillofac Surg 36(8):431–438
19.
go back to reference Wu D, Wang Y, Song T, et al (2014) Aesthetic reconstruction of the upper lip with novel split musculomucosal-pedicle cross-lip flap. Ann Plast Surg 73:S88–S91 Wu D, Wang Y, Song T, et al (2014) Aesthetic reconstruction of the upper lip with novel split musculomucosal-pedicle cross-lip flap. Ann Plast Surg 73:S88–S91
20.
go back to reference Pepper J, Baker S (2013) Local flaps: cheek and lip reconstruction. JAMA Facial Plast Surg 15(5):374CrossRefPubMed Pepper J, Baker S (2013) Local flaps: cheek and lip reconstruction. JAMA Facial Plast Surg 15(5):374CrossRefPubMed
21.
go back to reference Starmer H, Lyford-Pike S, Ishii L, Byrne P, Boahene K (2015) Quantifying labial strength and function in facial paralysis. JAMA Facial Plast Surg 17(4):274CrossRefPubMed Starmer H, Lyford-Pike S, Ishii L, Byrne P, Boahene K (2015) Quantifying labial strength and function in facial paralysis. JAMA Facial Plast Surg 17(4):274CrossRefPubMed
22.
go back to reference Kale-Varlk S (2008) Angular photogrammetric analysis of the soft tissue facial profile of Anatolian Turkish adults. J Craniofac Surg 19(6):1481–6 Kale-Varlk S (2008) Angular photogrammetric analysis of the soft tissue facial profile of Anatolian Turkish adults. J Craniofac Surg 19(6):1481–6
23.
go back to reference Mulliken J, Pensler J, Kozakewich H (1993) The anatomy of Cupidʼs bow in normal and cleft lip. Plast Reconstr Surg 92(3):404CrossRef Mulliken J, Pensler J, Kozakewich H (1993) The anatomy of Cupidʼs bow in normal and cleft lip. Plast Reconstr Surg 92(3):404CrossRef
24.
go back to reference Smith S, Lin X, Shamban A (2013) Small gel particle hyaluronic acid injection technique for lip augmentation. J Drugs Dermatol 12(7):764–9PubMed Smith S, Lin X, Shamban A (2013) Small gel particle hyaluronic acid injection technique for lip augmentation. J Drugs Dermatol 12(7):764–9PubMed
25.
go back to reference Wollina U. Perioral rejuvenation: restoration of attractiveness in aging females by minimally invasive procedures (2013). Clin Interv Aging 8:1149–1155. Wollina U. Perioral rejuvenation: restoration of attractiveness in aging females by minimally invasive procedures (2013). Clin Interv Aging 8:1149–1155.
26.
go back to reference Bo C, Ningbei Y (2014) Reconstruction of upper lip muscle system by anatomy, magnetic resonance imaging, and serial histological sections. J Craniofac Surg 25(1):48:54 Bo C, Ningbei Y (2014) Reconstruction of upper lip muscle system by anatomy, magnetic resonance imaging, and serial histological sections. J Craniofac Surg 25(1):48:54
27.
go back to reference Kishi N, Tanaka S, Iida S, Kogo M (2012) The morphological features and developmental changes of the philtral dimple: a guide to surgical intervention in cases of cleft lip. J Craniomaxillofac Surg 40(3):215–222CrossRefPubMed Kishi N, Tanaka S, Iida S, Kogo M (2012) The morphological features and developmental changes of the philtral dimple: a guide to surgical intervention in cases of cleft lip. J Craniomaxillofac Surg 40(3):215–222CrossRefPubMed
28.
go back to reference Bishara S, Jorgensen G, Jakobsen J (1995) Changes in facial dimensions assessed from lateral and frontal photographs. Part I-Methodology. Am J Orthod Dentofacial Orthop 108(4):389–393CrossRefPubMed Bishara S, Jorgensen G, Jakobsen J (1995) Changes in facial dimensions assessed from lateral and frontal photographs. Part I-Methodology. Am J Orthod Dentofacial Orthop 108(4):389–393CrossRefPubMed
29.
go back to reference Bishara S, Jorgensen G, Jakobsen J (1995) Changes in facial dimensions assessed from lateral and frontal photographs. Part II—results and conclusions. Am J Orthod Dentofacial Orthop 108(5):489–499CrossRefPubMed Bishara S, Jorgensen G, Jakobsen J (1995) Changes in facial dimensions assessed from lateral and frontal photographs. Part II—results and conclusions. Am J Orthod Dentofacial Orthop 108(5):489–499CrossRefPubMed
30.
go back to reference Onizuka T, Ichinose M, Hosaka Y, Usui Y, Jinnai T (1991) The contour lines of the upper lip and a revised method of cleft lip repair. Ann Plast Surg 27(3):238–252CrossRefPubMed Onizuka T, Ichinose M, Hosaka Y, Usui Y, Jinnai T (1991) The contour lines of the upper lip and a revised method of cleft lip repair. Ann Plast Surg 27(3):238–252CrossRefPubMed
31.
go back to reference Sepehr A, Mathew P, Pepper J, Karimi K, Devcic Z, Karam A (2012) The Persian woman’s face: a photogrammetric analysis. Aesthetic Plast Surg 36(3):687–691CrossRefPubMed Sepehr A, Mathew P, Pepper J, Karimi K, Devcic Z, Karam A (2012) The Persian woman’s face: a photogrammetric analysis. Aesthetic Plast Surg 36(3):687–691CrossRefPubMed
32.
go back to reference Anic-Milosevic S, Lapter Varga M, Slaj M (2008) Analysis of the soft tissue facial profile of Croatians using of linear measurements. J Craniofac Surg 19:251–258CrossRef Anic-Milosevic S, Lapter Varga M, Slaj M (2008) Analysis of the soft tissue facial profile of Croatians using of linear measurements. J Craniofac Surg 19:251–258CrossRef
33.
go back to reference Anic-Milosevic S, Lapter-Varga M, Slaj M (2008) Analysis of the soft tissue facial profile by means of angular measurements. Eur J Orthod 30(2):135–140CrossRefPubMed Anic-Milosevic S, Lapter-Varga M, Slaj M (2008) Analysis of the soft tissue facial profile by means of angular measurements. Eur J Orthod 30(2):135–140CrossRefPubMed
34.
35.
go back to reference Yamada T, Mori Y, Minami K, Mishima K, Sugahara T (2002) Three-dimensional facial morphology, following primary cleft lip repair using the triangular flap with or without rotation advancement. J Craniomaxillofac Surg 30(6):337–342CrossRefPubMed Yamada T, Mori Y, Minami K, Mishima K, Sugahara T (2002) Three-dimensional facial morphology, following primary cleft lip repair using the triangular flap with or without rotation advancement. J Craniomaxillofac Surg 30(6):337–342CrossRefPubMed
36.
go back to reference Choi H, Kim S, Han Y (2013) A new method for creating a definite philtrum by the flipping of an orbicularis oris muscle flap in a patient with an indistinct philtrum. Arch Plast Surg 40(1):62CrossRefPubMedPubMedCentral Choi H, Kim S, Han Y (2013) A new method for creating a definite philtrum by the flipping of an orbicularis oris muscle flap in a patient with an indistinct philtrum. Arch Plast Surg 40(1):62CrossRefPubMedPubMedCentral
37.
go back to reference Malkoc S, Demir A, Uysal T, Canbuldu N (2009) Angular photogrammetric analysis of the soft tissue facial profile of Turkish adults. Eur J Orthod 31(2):174–179CrossRefPubMed Malkoc S, Demir A, Uysal T, Canbuldu N (2009) Angular photogrammetric analysis of the soft tissue facial profile of Turkish adults. Eur J Orthod 31(2):174–179CrossRefPubMed
38.
go back to reference Ozdemir S, Sigirli D, Ercan I, Cankur N (2008) Photographic facial soft tissue analysis of healthy Turkish young adults: anthropometric measurements. Aesthetic Plast Surg 33(2):175–184CrossRefPubMed Ozdemir S, Sigirli D, Ercan I, Cankur N (2008) Photographic facial soft tissue analysis of healthy Turkish young adults: anthropometric measurements. Aesthetic Plast Surg 33(2):175–184CrossRefPubMed
39.
go back to reference Germec-Cakan D, Canter H, Nur B, Arun T (2010) Comparison of facial soft tissue measurements on three-dimensional images and models obtained with different methods. J Craniofac Surg 21(5):1393–1399CrossRefPubMed Germec-Cakan D, Canter H, Nur B, Arun T (2010) Comparison of facial soft tissue measurements on three-dimensional images and models obtained with different methods. J Craniofac Surg 21(5):1393–1399CrossRefPubMed
40.
go back to reference Hood C, Hosey M, Bock M, White J, Ray A, Ayoub A (2004) Facial characterization of infants with cleft lip and palate using a three-dimensional capture technique. Cleft Palate Craniofac J 41(1):27–35CrossRefPubMed Hood C, Hosey M, Bock M, White J, Ray A, Ayoub A (2004) Facial characterization of infants with cleft lip and palate using a three-dimensional capture technique. Cleft Palate Craniofac J 41(1):27–35CrossRefPubMed
Metadata
Title
Computer-assisted analysis contour lines of aesthetic unit for the assessment of lip augmentation
Authors
Hassan Bagheri
Suzan Sirinturk
Figen Govsa
Yelda Pinar
Mehmet Asim Ozer
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Plastic Surgery / Issue 4/2016
Print ISSN: 0930-343X
Electronic ISSN: 1435-0130
DOI
https://doi.org/10.1007/s00238-016-1190-x

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