The use of facial anthropometrics in aesthetic assessment.

OBJECTIVE

To identify a valid method for scoring facial aesthetics, correlating clinicians' assessments with measurements taken from 3D facial photographs.

DESIGN

Album assessment of facial images, using a visual analog scale of attractiveness and the scores ranked. Facial ratios, obtained following digitization of the images compared with control group mean data, obtained from the Farkas growth study and the differences from the matched mean calculated. Ranked scores compared according to the inclusion of surface as well as caliper (shortest distance) measurements and whether the ranked scores, representing difference to the mean, were weighted.

PATIENTS, PARTICIPANTS: Eleven facial images were presented. Seven clinicians provided clinical judgment.

MAIN OUTCOME MEASURES

Correlation coefficients between mean attractiveness rankings and summed differences between patients' facial proportions and matched control data from the Farkas growth study.

RESULTS

The highest correlation was obtained with the use of the difference accommodating the mean of the Farkas proportion index (r = -.76, p = .006), followed by standard deviation (r = -.65, p = .032), using data in which the difference is weighted according to the magnitude of the linear measurement involved. Repeatability of the clinicians' assessments and operator digitization were validated.

CONCLUSIONS

There appears to be potential in the use of the mean as aesthetic ideal as a principle in aesthetic assessment and perhaps as an objective means of outcome assessment after facial surgery. The most appropriate scoring method would seem to include use of both surface and caliper measurements and incorporate weighting.