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Aesthetic Plastic Surgery

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Open Access 01-02-2018 | Review

Art or Science? An Evidence-Based Approach to Human Facial Beauty a Quantitative Analysis Towards an Informed Clinical Aesthetic Practice

Authors: Harpal Harrar, Simon Myers, Ali M. Ghanem

Published in: Aesthetic Plastic Surgery | Issue 1/2018

Abstract

Background

Patients often seek guidance from the aesthetic practitioners regarding treatments to enhance their ‘beauty’. Is there a science behind the art of assessment and if so is it measurable? Through the centuries, this question has challenged scholars, artists and surgeons.

Aims and Objectives

This study aims to undertake a review of the evidence behind quantitative facial measurements in assessing beauty to help the practitioner in everyday aesthetic practice.

Methods

A Medline, Embase search for beauty, facial features and quantitative analysis was undertaken.

Selection Criteria

Inclusion criteria were studies on adults, and exclusions included studies undertaken for dental, cleft lip, oncology, burns or reconstructive surgeries. The abstracts and papers were appraised, and further studies excluded that were considered inappropriate. The data were extracted using a standardised table. The final dataset was appraised in accordance with the PRISMA checklist and Holland and Rees’ critique tools.

Results

Of the 1253 studies screened, 1139 were excluded from abstracts and a further 70 excluded from full text articles. The remaining 44 were assessed qualitatively and quantitatively. It became evident that the datasets were not comparable. Nevertheless, common themes were obvious, and these were summarised.

Conclusion

Despite measures of the beauty of individual components to the sum of all the parts, such as symmetry and the golden ratio, we are yet far from establishing what truly constitutes quantitative beauty. Perhaps beauty is truly in the ‘eyes of the beholder’ (and perhaps in the eyes of the subject too).

Level of Evidence V

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.

Marten T, Elyassnia D (2015) Fat grafting in facial rejuvenation. Clin Plast Surg 42(2):219–252CrossRefPubMed

American Society of Plastic Surgeons (2017) National Clearinghouse of plastic surgery statistics. 2010 report of the 2009 statistics. Accessed 10th July 2017

American Society of Plastic Surgeons (2017) National Clearinghouse of plastic surgery statistics. 2016 report of the 2016 statistics. Accessed 1st July 2017

Faure JC, Rieffe C, Maltha JC (2002) The influence of different facial components on facial aesthetics. Eur J Orthod 24:1–7CrossRefPubMed

Baldwin DC (1980) Appearance and aesthetics in oral health. Community Dent Oral Epidemiol 8:244–256CrossRefPubMed

Barker DJ, Barker MJ (2002) The body as art. J Cosmet Dermatol 1:88–93CrossRefPubMed

Bashour M (2006) History and current concepts in the analysis of facial attractiveness. Plast Reconstr Surg 118:741–756CrossRefPubMed

Adamson PA, Zavod MB (2006) Changing perceptions of beauty: a surgeon’s perspective. Fac Plast Surg 22:188–193CrossRef

Larrabee WF (1997) Facial beauty Myth or reality? Arch Otolaryngol Head Neck Surg 123(6):571–572CrossRefPubMed

10.

Foo P, Sampson W, Roberts R, Jamieson L, David D (2013) Facial aesthetics and perceived need for further treatment among adults with repaired cleft as assessed by cleft team professionals and laypersons. The Eur J Orthod 35(3):341–346CrossRefPubMed

11.

Huang X, Lin J, Demner-Fushman D (2006) Evaluation of PICO as a knowledge representation for clinical questions. AMIA Ann Symp Proc 2006:359–363

12.

Liu S, Fan YY, Guo Z, Samal A, Ali A (2017) A landmark-based data-driven approach on 2.5D facial attractiveness computation. Neurocomputing 238:168–178CrossRef

13.

Heidekrueger P, Juran S, Szpalski C, Larcher L, Ng R et al (2017) The current preferred female lip ratio. J Cranio-Maxillofac Surg 45(5):655–660CrossRef

14.

Koidou VP, Rosenstiel SF, Rashid RG (2017) Celebrity smile esthetics assessment: smile angulation. J Prosthet Dent 117(5):636–641. https://doi.org/10.1016/j.prosdent.2016.08.008 CrossRefPubMed

15.

Popenko NA, Tripathi PB, Devcic Z, Karimi K, Osann K, Wong BJF (2017) A quantitative approach to determining the ideal female lip aesthetic and its effect on facial attractiveness. JAMA Fac Plast Surg 19(4):261–267. https://doi.org/10.1001/jamafacial.2016.2049 CrossRef

16.

Benslimane F, van Harpen L, Myers SR, Ingallina F, Ghanem AM (2017) The Benslimane’s artistic model for females’ gaze beauty: an original assessment tool. Aesthetic Plast Surg 41(1):81–89CrossRefPubMed

17.

Melo AR, Conti ACCF, Almeida-Pedrin RR, Didier V, Valarelli DP, Capelozza Filho L (2017) Evaluation of facial attractiveness in black people according to the subjective facial analysis criteria. Dent Press J Orthod 22(1):75–81. https://doi.org/10.1590/2177-6709.22.1.075-081.oar CrossRef

18.

Kaipainen A, Sieber R, Nada R, Maal T, Katsaros C, Fudalej P (2016) Regional facial asymmetries and attractiveness of the face. Eur J Orthod 38(6):602–608CrossRefPubMed

19.

Hwang K, Hong JU, Park SJ, Hwang SW (2015) Eyes of beautiful women and femme fatales depicted in western portraits. J Cranio Surg 26(3):937–939CrossRef

20.

Galantucci LM, Di Gioia E, Lavecchia F, Percoco G (2014) Is principal component analysis an effective tool to predict face attractiveness? A contribution based on real 3D faces of highly selected attractive women, scanned with stereophotogrammetry. Med Biol Eng Comput 52(5):475–489. https://doi.org/10.1007/s11517-014-1148-8 CrossRefPubMed

21.

Murakami T, Kataoka T, Tagawa J, Yamashiro T, Kamioka H (2016) Antero-posterior and vertical facial type variations influence the aesthetic preference of the antero-posterior lip positions. The Eur J Orthod 38(4):414–421. https://doi.org/10.1093/ejo/cjv073 CrossRefPubMed

22.

Tauk A, Bassil-Nassif N, Mouhanna-Fattal C, Bouserhal J (2016) The importance of using the entire face to assess facial profile attractiveness. Int Orthod 14(1):65–79. https://doi.org/10.1016/j.ortho.2015.12.007 PubMed

23.

Gibelli D, Codari M, Rosati R, Dolci C, Tartaglia GM, Cattaneo C, Sforza C (2015) A quantitative analysis of lip aesthetics: the influence of gender and aging, Aesthetic Plast Surg 39(5):771–776. doi: 10.1007/s00266-015-0495-7. Epub 2015 May 7. Erratum in: Aesthetic Plast Surg. 2015 Oct; 39(5):777

24.

Penna V, Fricke A, Iblher N, Eisenhardt SU, Stark GB (2015) The attractive lip: a photomorphometric analysis. J Plast Reconstr Aesthet Surg 68(7):920–929CrossRefPubMed

25.

Wu F, Li J, He H, Huang N, Tang Y, Wang Y (2015) Soft-tissue facial characteristics of attractive Chinese men compared to normal men. Int J Clin Exp Med 8(5):7977–7982PubMedPubMedCentral

26.

Farrera A, Villanueva M, Quinto-Sánchez M, González-José R (2015) The relationship between facial shape asymmetry and attractiveness in Mexican students. Am J Hum Biol 27(3):387–396. https://doi.org/10.1002/ajhb.22657 CrossRefPubMed

27.

Hwang K, Heo WY, Jeong JM, Hwang SW (2014) Anthropometric comparison of the idealized youth and hideous old man of Leonardo’s profile drawings. J Craniofac Surg 25(6):2223–2226PubMed

28.

Park HS, Rhee SC, Kang SR, Lee JH (2004) Harmonized profiloplasty using balanced angular profile analysis. Aesthet Plast Surg 28(2):89–97. https://doi.org/10.1007/s00266-004-3125-3 CrossRef

29.

Fortes HNDR, Guimarães TC, Belo IML, Matta ENRD (2014) Photometric analysis of esthetically pleasant and unpleasant facial profile. Dent Press J Orthod 19(2):66–75CrossRef

30.

Rossetti A, De Menezes M, Rosati R, Ferrario VF, Sforza C (2013) The role of the golden proportion in the evaluation of facial esthetics. Angle Orthod 83(5):801–808CrossRefPubMed

31.

Wong BJF, Karimi K, Devcic Z, McLaren CE, Chen W-P (2008) Evolving attractive faces using morphing technology and a genetic algorithm: a new approach to determining ideal facial aesthetics. The Laryngoscope 118(6):962–974. https://doi.org/10.1097/MLG.0b013e31816bf545 CrossRefPubMedPubMedCentral

32.

Pancherz H (2010) Divine proportions in attractive and nonattractive faces. World J Orthod 11(1):27PubMed

33.

Pallett PM, Link S, Lee K (2010) New “golden” ratios for facial beauty. Vis Res 50(2):149–154CrossRefPubMed

34.

Komori M, Kawamura S, Ishihara S (2009) Averageness or symmetry: Which is more important for facial attractiveness? Acta Psychol 131(2):136–142. https://doi.org/10.1016/j.actpsy.2009.03.008 CrossRef

35.

Jahanbin A (2008) The effects of upper lip height on smile esthetics perception in normal occlusion and nonextraction, orthodontically treated females. Indian J Dent Res 19:204CrossRefPubMed

36.

Holland E (2008) Marquardt’s phi mask: pitfalls of relying on fashion models and the golden ratio to describe a beautiful face. Aesthet Plast Surg 32(2):200–208CrossRef

37.

Medici Filho E, Martins MV, dos Santos da Silva MA, de M Castilho JC, de Moraes LC, de A Gil CTL (2007) Divine proportions and facial esthetics after manipulation of frontal photographs. World J Orthod 8(2):103–108PubMed

38.

Kim Y-H (2007) Easy facial analysis using the facial golden mask. The J Craniofac Surg 18(3):643–649. https://doi.org/10.1097/scs.0b013e3180305304 CrossRefPubMed

39.

Costa M, Corazza L (2006) Aesthetic phenomena as supernormal stimuli: the case of eye, lip, and lower-face size and roundness in artistic portraits. Perception 35(2):229–246CrossRefPubMed

40.

Milutinovic J, Zelic K, Nedeljkovic N (2014) Evaluation of facial beauty using anthropometric proportions. The Sci World J 2014:1–8. https://doi.org/10.1155/2014/428250 CrossRef

41.

Bronfman CN, Janson G, Pinzan A, Rocha TL (2015) Cephalometric norms and esthetic profile preference for the Japanese: a systematic review. Dent Press J Orthod 20(6):43–51CrossRef

42.

Gillen MM (2015) Associations between positive body image and indicators of men’s and women’s mental and physi- cal health. Body Image 13:67–74CrossRefPubMed

43.

Strub B, Mende K, Meuli-Simmen C, Bessler S (2015) The frontal view of the nose: lighting effects and photographic bias. Aesthet Surg J 35(5):524–532CrossRefPubMed

44.

Smith S, Lin X, Shamban A (2013) Small gel particle hyaluronic acid injection technique for lip augmentation. J Drugs Dermatol 12(7):764–769PubMed

45.

AlamM Gladstone H, Kramer E et al (2008) ASDS guidelines of care: injectable fillers. Dermatol Surg 34(s1):S115–S1485CrossRef

46.

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

47.

Grundl M, Klein S, Horczakiwskyj R et al (2008) The jaguar’s eye as a new beauty trend? Age related effects in judging the attractiveness of the oblique eye axis. Aesthet Plast Surg 32:915–919CrossRef

48.

Johnston VS, Franklin M (1993) Is beauty in the eye of the beholder? Ethol Sociobiol 14(3):183–199. https://doi.org/10.1016/0162-3095(93)90005-3 CrossRef

49.

Danel D, Pawlowski B (2007) Eye-mouth-eye angle as a good indicator of face masculinization, asymmetry, and attractiveness (Homo sapiens). J Comp Psychol 121(2):221–225CrossRefPubMed

50.

Rhodes G, Sumich A, Byatt G (1999) Are average facial configurations attractive only because of their symmetry? Psychol Sci 10(1):52–58. https://doi.org/10.1111/1467-9280.00106 CrossRef

51.

Mealey L, Bridgstock R, Townsend GC (1999) Symmetry and perceived facial attractiveness: a monozygotic co-twin comparison. J Personal Soc Psychol, 76(1):151–8. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9972560

52.

Hönn M, Göz G (2007) The ideal of facial beauty: a review. J Orofac Orthop Fortschr Der Kieferorthopädie 68(1):6–16. https://doi.org/10.1007/s00056-007-0604-6 CrossRef

53.

Prokopakis EP, Vlastos IM, Picavet VA, Nolst Trenite G, Thomas R, Cingi C, Hellings PW (2013) The golden ratio in facial symmetry. Rhinology 51(1):18–21. https://doi.org/10.4193/Rhino12.111 PubMed

54.

Gan J, Li L, Zhai Y, Liu Y (2014) Deep self-taught learning for facial beauty prediction. Neurocomputing 144:295–303. https://doi.org/10.1016/j.neucom.2014.05.028 CrossRef

55.

Xie D, Liang L, Jin L, Xu J, Li M (2015) SCUT-FBP: a benchmark dataset for facial beauty perception. In: 2015 IEEE international conference on systems, man, and cybernetics IEEE, pp. 1821–1826. http://doi.org/10.1109/SMC.2015.319

56.

Shlens J (2014) A tutorial on principal component analysis. Retrieved from http://arxiv.org/abs/1404.1100

57.

Ras F, Habets LL, van Ginkel FC, Prahl-Andersen B (1996) Quantification of facial morphology using stereophoto- grammetry–demonstration of a new concept. J Dent 24(5):369–374CrossRefPubMed

58.

Rossetti A, De Menezes M, Rosati R, Ferrario VF, Sforza C (2013) The role of the golden proportion in the evaluation of facial esthetics. The Angle Orthod 83(5):801–808CrossRefPubMed

59.

Rosati R, Rossetti A, De Menezes M, Ferrario VF, Sforza C (2012) The occlusal plane in the facial context: inter-operator repeatability of a new three-dimensional method. Int J Oral Sci 4:34–37CrossRefPubMedPubMedCentral

60.

Alam MK, Mohd Noor NF, Basri R, Yew TF, Wen TH (2015) Multiracial facial golden ratio and evaluation of facial appearance. PLoS ONE 10(11):e0142914CrossRefPubMedPubMedCentral

61.

Jang KS, Bayome M, Park JH, Park K-H, Moon H-B, Kook Y-A (2017) A three-dimensional photogrammetric analysis of the facial esthetics of the Miss Korea pageant contestants. Korean J Orthod 47(2):87–99CrossRefPubMedPubMedCentral

62.

Bagheri H, Sirinturk S, Govsa F, Pinar Y, Ozer MA (2017) Digitalized analysis of philtral anatomy for planning individual treatment. Surg Radiol Anat 39(11):1183–1189CrossRefPubMed

Title: Art or Science? An Evidence-Based Approach to Human Facial Beauty a Quantitative Analysis Towards an Informed Clinical Aesthetic Practice
Authors: Harpal Harrar
Simon Myers
Ali M. Ghanem
Publication date: 01-02-2018
Publisher: Springer US
Published in: Aesthetic Plastic Surgery / Issue 1/2018
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI: https://doi.org/10.1007/s00266-017-1032-7

ACC 2024 Congress

Springer Medicine

Art or Science? An Evidence-Based Approach to Human Facial Beauty a Quantitative Analysis Towards an Informed Clinical Aesthetic Practice

Abstract

Background

Aims and Objectives

Methods

Selection Criteria

Results

Conclusion

Level of Evidence V

ACC 2024 Congress

Springer Medicine

Abstract

Background

Aims and Objectives

Methods

Selection Criteria

Results

Conclusion

Level of Evidence V

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