Zonal Analysis of Facial Asymmetry and Its Clinical Significance in Facial Plastic Surgery

Dhir, Karan; Lawson, William; Binder, William J.

doi:10.1001/2013.jamafacial.65

Cited by 8 publications

(6 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Facial subunit descent is not easily differentiated from the innate facial asymmetry that may be present in up to 90% of individuals. 7 The manner in which preexisting skeletal and soft-tissue asymmetries influence the expression of facial aging is unclear. These commonly seen differences may obscure or, alternatively, accentuate signs of age-related involution.…”

Section: Discussionmentioning

confidence: 99%

“…An expert observer who subjectively ascertained differences in vertical position of facial subunits including the eyebrow, malar fat pad, nasolabial crease and fold, and jowl determined differences in facial ptosis in this study. Facial subunit descent is not easily differentiated from the innate facial asymmetry that may be present in up to 90% of individuals . The manner in which preexisting skeletal and soft‐tissue asymmetries influence the expression of facial aging is unclear.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Sleep Position on Perceived Facial Aging

Kotlus

2013

Dermatologic Surgery

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of Sleep Position on Perceived Facial Aging

Kotlus

2013

Dermatologic Surgery

View full text Add to dashboard Cite

show abstract

“…7 Other studies have used measurement techniques from photographs. 14,[21][22][23] Photos can be imperfect in representing a patient's face. 24 In addition, the authors felt that it was somewhat difficult to judge the position of the ears in standard frontal preoperative photographs.…”

Section: Discussionmentioning

confidence: 99%

“…Facial asymmetry has been extensively studied previously, and thought to be relatively common among the general population; though to the authors' knowledge no prior study has specifically noted a relationship between eyebrow position and the position of other facial structures in the same region of the face, such as the ear. 3,4,13,14 A recent article by Dhir et al noted that brow position was variable and did not Keywords ► facial asymmetry ► brow ptosis ► blepharoplasty ► brow asymmetry…”

mentioning

confidence: 99%

Facial Asymmetry: Brow and Ear Position

Perumal

Meyer

2018

Facial plast Surg

View full text Add to dashboard Cite

The purpose of the current study was to analyze brow and ear position, and examine the relationship between these structures in patients presenting for blepharoplasty evaluation. A retrospective chart review was performed, which included all patients presenting to one oculoplastic physician for a blepharoplasty evaluation from November, 2012 to March, 2014. The prevalence of brow ptosis and brow and ear asymmetry was calculated; the proportional distribution was determined, and chi-square analysis and the z-test of proportions were used to calculate the significance. Institutional Review Board approval was obtained for this study. A total of 133 patients met the inclusion criteria. Some degree of brow ptosis was noted in 83% of patients. Brow asymmetry was found in 88% of patients, and ear asymmetry in 77%. Of those patients who had asymmetry, 61% had the right brow lower and 75% had the right ear lower; 73% of all patients had the brow and ear lower on the same side ( < 0.001). In this study, brow ptosis and asymmetry were quite common. In addition, the side of the lower brow correlated strongly with the side of the lower ear, and the right side structures were lower more often than the left. Patients presenting for blepharoplasty evaluation may have an element of generalized facial asymmetry which includes the brows and ears. These observations can be important for preoperative planning and patient counseling.

show abstract

“…First, landmarks were only chosen if they were easily visible on a front-facing photograph. Many sources referenced use the point of highest cheek projection 10,20,21 or angle of the jaw 10,21 as a landmark, but these were felt to be too arbitrary with poor interrater reliability and thus omitted. Second, a global measure of the hemifacial area is a natural measurement for facial asymmetry, but a challenge arose when it came to the hairline, as this obscures the lateral outline to be traced.…”

Section: Evaluation Of Measurementsmentioning

confidence: 99%

Facial Asymmetry in Children With Unilateral Congenital Ptosis

Tenzel

Brown

Zhou

et al. 2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Purpose:To analyze facial asymmetry in children with unilateral congenital ptosis.Methods: This is a retrospective review of pediatric patients undergoing ptosis repair between January 1, 2017, and December 31, 2020. Charts were reviewed to ensure a diagnosis of idiopathic unilateral congenital ptosis. Sex, age, laterality, margin to reflex distance 1, levator function, and surgical intervention were collected. Clear preoperative photos without head turn were included. Using the ImageJ software (nih.gov), landmarks of the periorbital region, midface, and lower face were marked, and measurements between these landmarks were taken. Two-tailed Student t tests were used to compare measurements between the ptotic and non-ptotic sides. Relationships between different measurements on the same side of the face were analyzed using paired-variable regressions.Results: Forty-four patients with unilateral congenital ptosis were included. The surgical management consisted of Mullerectomy in 9 of 44 (20%), levator resection in 15 of 44 (34%), and frontalis suspension in 20 of 44 (46%) patients. The side of the face with blepharoptosis was found to more often have smaller margin to reflex distance 1 (p < 0.001), smaller margin to reflex distance 2 (p < 0.005), smaller horizontal palpebral fissure (p < 0.05), shorter midface height (p < 0.001), and a more inferiorly displaced lateral canthus (canthal angle, p < 0.001) relative to the non-ptotic side of the face. The mean head tilt of patients with right sided ptosis (1.37° right tilt) was statistically significantly different from those with left sided ptosis (0.85° left tilt; p = 0.04).Conclusions: In children with unilateral congenital ptosis, the ptotic side of the face was found to be the nondominant side of the face. Patients were also found to have ipsilateral head tilt.

show abstract

Zonal Analysis of Facial Asymmetry and Its Clinical Significance in Facial Plastic Surgery

Cited by 8 publications

References 24 publications

Effect of Sleep Position on Perceived Facial Aging

Effect of Sleep Position on Perceived Facial Aging

Facial Asymmetry: Brow and Ear Position

Facial Asymmetry in Children With Unilateral Congenital Ptosis

Contact Info

Product

Resources

About