Anatomical Points and Aesthetic Anatomical Areas in the Aesthetic Evaluation of the Face
The perception of an attractive face is affected by the balance and harmony of facial features. Therefore, changing the existing harmony of the face and creating a new face may cause a different aesthetic perception. Percent skeletal bone structure, muscles and soft tissue analysis as a tool has always been used to determine facial aesthetic and treatment goals.
Soft tissue analysis is primarily done through clinical examinations but indirect measurements.
For this purpose, facial features are analyzed on radiographic and photographic images. Anthropometric methods are used by making numerical measurements as cephalometry and photogrammetry. Thus, the balance and aesthetic ratios of the face are evaluated. However, these assessments are not the best method for evaluating facial soft tissues. In addition to concerns about the patient’s exposure to radiation during this assessment, the soft tissue structures of the face can only measure in the lateral profile of the face. With these negatives, measurements were started only with photographs without X-rays.
Recently, various studies have published data on normal values of soft tissue measurements in different populations.
Today, soft tissue measurements of the face have gained popularity with computer software products.
In the evaluation of the patient, the face should be without make-up. Photo measurements are made today.
Anatomical points in the Aesthetic Evaluation of the Face Aesthetic anatomical areas
Anatomical aesthetic points of the face and their determination;
Trichion (Tri), the midpoint of the forehead at the hairline border; Due to hair loss and regression of the frontal hairline, the origin of the slightly upper part of the frontal muscle should be taken rather than the origin of the hair in the determination of the Trichion.
Glabella (G), the most anterior point of the middle of the eyebrow on the forehead
Nasion ( N ) is the middle point on the root of the nose
Pronasal (PRN); the most anterior point of the tip of the nose
Midnasal (Mn); Midpoint on the outer circumference of the nose between PRN and N
Columella(Cm); profiled lowest and anterior point of the columella separating the nostrils
Subnasal (Sn), the point where the upper lip meets the columella.
Upper lip (Ls), mucocutaneous border of the upper lip
Upper Stomion (Sts); the lowest point where the upper lip meets the lower lip
Lower Stomion (Sti), the highest point where the lower lip meets the upper lip
Lower lip (Li) mucocutaneous border of the lower lip
Supramental (Sm); the deepest point of the concavity extending from the lower lip to the chin
Pogonion (Pg), anterior point of the chin,
Menton (Me), the lowest point of the lower edge of the chin
Cervical ( C ), the point that connects the neck and jaw lines
Tragus (Trg) the most posterior point of the tragus in the ear
TH; line parallel to the horizontal ground plane passes through the tragus
TV; the vertical line passes through the nasion.
Cover; The intersection of TH and TV.
Anatomical areas of the Face and Neck
1. Forehead area-Forehead
2. Temporal area-Temporal
3. Cheekbone – Zygomatic arch
4. Cheek area – Malar
5. Eye and surrounding area – Orbital
6. Under-eye area – Infraorbital
7. Nose area – Nasal
8. Ear – External ear
9. Parotid gland, Masseter chewing muscle area – Parotid-masseteric
10. Cheek area – Buccal
11. Oral area – Oral
12. Jaw area – Chin
13. Mandibular border area – Mandibular border
14. Mandibular corner area – Mandibular
15. Suprahyoid cartilage area – Suprahyoid
16. Al chin area – Submandibular
17. Triangular area where the carotid neck vein is located – Carotid triangle
18. Area behind the corner of the mandible – Retromandibular fossa
19. Anterior neck – Median cervical
These anatomical areas on the face are divided into some sub-areas for better evaluation. These are shown in the picture below.
1- Forehead area; 1a the middle part of the forehead, the side part of the forehead, 1c the eyebrow part
2. Eye and eyelids area; 3a lower eyelid area, 3b upper eyelid area, 3c outer corner area, 3d inner corner area
4- Cheek area; 4a mid cheek area, 4b zygomatic area, 4c cheek area, 4d buccal area
5- Upper lip area; 5a philtrum, 5b upper lip lateral area, 5c vermilion area
6- Lower lip area; 6a lower lip central area, 6b vermilion area
These subunits are not only important in facial assessment. In addition, these areas have differences in terms of thickness, color, structure and underlying support tissues of the skin. In facial aesthetic applications, applications should be made by considering these areas. In addition, the transition boundaries of these areas are also important. In surgical applications or aesthetic interventions, the risk of scarring after wound healing is higher in these borders.
There are also skin tension lines on the face. These are the lines of change of skin elasticity angles. Surgical procedures should be performed in parallel with them.