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PreoperativeEvaluationoftheAestheticPatient
NIEYUNFEIFacialAnalysisFacialAnalysisFace:General(Shape)FacialBeauty“[You]can’tdefineit,butyouknowitwhenitwalksintotheroom〞--AaronSpellingGreekPolycleitus450-420B.C.firsttoquantifysymmetriesandproportions–theCanonLeonardoDaVinci(1452-1519)Durer(1471-1528)Joseph(1865-1934)fatherofrhinoplastyBroadbent(1894-1977)radiographiccephalometricsRicketts-thegoldenproportion(1:1.618)Farkas-revisedtheclassiccannonwithhundredsofmeasurementsonlivingsubjectsDoryphorusFacialBeautyFewpeople,whetherCaucasionorethnic,fittheNeoclassicalcanonoffixedproportionsandratios(Farkas,Porter,Teck,Milgrim)Attractivenessconsistentacrossculturalgroups.(Cunningham,Thakerar,Buss,Perrett)Symmetry,“averageness〞associatedwithbeautyExtremebeautyseemstobeassociatedwithmagnificationordiminutionofatleastonefeature(Perrett,Rhodes)“thereisnoexcellentbeautythathathnotsomestrangenessintheproportion〞–FrancisBaconBeautyLifeiseasierwhenyou’rebeautifulhighergrades(scoreequallyonstandardizedtests)moreoftenjudgedkind,decentandhonestgivenmorepersonalspacemorelikelytomarrymorelikelytobepromotedatwork(rankinthearmedforces)waitshorteramountoftimeforservicesbadbehaviormorelikelytobeforgivenlesslikelytobereported,caught,orpunishedformajororminorcrimeeasiertoprocurehelpintimesofneedFacialAnalysis--TermsTrichion-frontalhairlineGlabella-mostprominentpointofmidsagittalforeheadRadix-rootofnoseNasion-depressionatrootofnoseRhinion-junctionofbonyandcartilaginousnasaldorsumTip-definingpoint-anteriormostprojectionofnasaltipAlarcrease-lateralaspectofnasalalaSubnasale-junctionofcolumellaandupperlipatbaseofnoseStomion-wherelipsmeetPogonion-mostanterioraspectofchinMenton-lowerborderofcontourofchinGnathion-pointatjunctionoftangentstomentonandpogonionCervicalpoint-pointatjunctionoftangentstomentonandanteriorborderofneckFacialAnalysisFace:GeneralDividedin1/3’strichiontoNFANFAtosubnasalesubnasaletomentonFacialAnalysisFace:GeneralDividedin1/3’strichiontoNFANFAtosubnasalesubnasaletomentonFacialAnalysisVerticaldivisions1/5’seachequaltooneeyewidthFacialAnalysisVerticaldivisions1/5’seachequaltooneeyewidthLipsoralcommissureatmediallimbusNasalalalateralaspectatmedialcanthusFacialAnalysisLipsoralcommissureatmediallimbussmallermouthpreferredinAsia(Chinese)NasalalalateralaspectatmedialcanthusmaybewiderinAsianandAfrican-AmericanpatientsFacialAnalysis-TheNoseNosenasofrontalangleapproximately120degreesnasolabialangle90-105inmen100-120inwomencolumnellarshow2-4mmFacialAnalysis-TheNoseTipheightGoode’sRatio:(alargroovetotip)dividedby(nasiontotip)=0.55-0.60Baum’sRatio:(nasiontotip)dividedby(subnasaletotip)=2.8FacialAnalysis-TheNoseNosenasofrontalangleapproximately110degreesnasolabialangle90-105inmen90-110inwomenFacialAnalysis-TheNoseSubmentalvertexview:equilateraltrianglelateralalaatmedialcanthusmaybewiderinasian,africannosesFacialAnalysis-TheNoseTipheightGoode’sRatio:(alargroovetotip)dividedby(nasiontotip)=0.55-0.60Baum’sRatio:(nasiontotip)dividedby(subnasaletotip)=2.8Submentalvertexview:equilateraltrianglelateralalaatmedialcanthusmaybewiderinasian,africannosesFacialAnalysisChinprojectionBurstone’sAngleSNtopogoniontocervicomentalangleisapproximately100degreesVerticallinefromsubnasale:3mmformales5mmforfemalesFacialAnalysis-TheNoseChinprojectionBurstone’sAngleSNtopogoniontocervicomentalangleisapproximately100degreesVerticallinefromsubnasale:3mmformales5mmforfemalesFacialAnalysis-OcclusionOcclusionClassIClassIIClassIIIRetrognathia:poorchinprojectionplusClassIIocclusionMicrognathia:poorprojectionClassIFacialAnalysis-TheNeckNeckDedoclassificationhyoidpositionskinpositionfataccumulationmuscularpositioncervicomentalangle90to110degreesFacialAnalysis-TheNeckNeckDedoclassificationhyoidpositionskinpositionfataccumulationmuscularpositioncervicomentalangle90to110degreesFacialAnalysis:CheeksFacialAnalysis-ForeheadBrowpositionmales:atrimfemalesslightlyaboverim,maximumlaterallimbusEyeslateralhoodingFacialAnalysis-ForeheadHairlineBrowpositionmales:atrimfemalesslightlyaboverim,maximumarchatlaterallimbusFacialAnalysis
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