CHAPTER 8
8
The ultimate absolute shape is symmetry. Good healthy colour of skin, exuberant healthy hair, and symmetry are conditions which suggest health of a human being and this anticipates the capability of Michelangelo acknowledged the Roman architect
from the first century b.c. Vitruvius to be his “teach- er”. And it was Vitruvius who said: “Symmetria forma absoluta est.”
Symmetry of the Face
Dimitrije E. Panfilov
Fig. 8.1 a–e. High-grade asymmetry of a male patient who only wanted to sym- metrize the nose. His “left face” seems to be 10 years older than his “right face”. a Right half. b Preoperative face.
c Left half. d Right half doubled. e Left half doubled. This “left face” looks 10 years older than the “right face”
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generating healthy descendants. Symmetric-looking persons seem subconsciously more attractive to the opposite sex because of the suggested ability to pro- duce healthy children.
There is another interesting fact. All top sports- men are somehow good-looking. This is due to the fact that facial symmetry correlates with the corporal symmetry and this is a prerequisite of the optimal physical performance which an individual is able to
Fig. 8.2. Symmetrizing of the nose – reduction of left nostril and elevation of left lip commissure
Fig. 8.3. Additionally left side unilat- eral facelift and microlipofilling of the left temple was performed.
a preoperative b postoperative view
31 8 Symmetry of the Face
deliver. Somebody who has one leg shorter than the other or asymmetric muscles in both extremities will not be able to achieve better results than somebody who has symmetric and almost perfect corporal con- ditions. And featural asymmetry is often accompa- nied by corporal asymmetry.
On the other hand, there is no face and no body in the world which is absolutely symmetrical. A slight unevenness of eyebrows, of eyelids, or mouth angles and different sizes and positions of cheeks and ears are present in almost every face. Science has discov- ered that women’s earlobes achieve most symmetry during the fertile period of the menstrual cycle. Na- ture helps women to become symmetric, that means more attractive, just to increase the chances of be- coming pregnant! It is interesting that most patients
coming to our consulting rooms do not feel conscious of their even obvious asymmetries. Sometimes they are astonished when we analyze their en face pictures.
They say they did not realize it before.
As the key to facial symmetry, the nose itself often deviates, not only the septum, but sometimes the whole pyramid (ridge) or the tip, or the whole nose might be more or less asymmetric. In planning our surgeries we should pay attention to this point espe- cially if the patients themselves ask for it. If they do not notice these irregularities, we are obliged to ask them if they would like them to be corrected if an op- eration has to be done. If they agree, we can try to harmonize these mosaic stones in the face, to make it more attractive. For instance, when one side of the face sags more than the other one, the less flaccid side
Fig. 8.4. a Right half. b Postopera- tive face. c Left half. d Postoperative right half doubled. e Postoperative left half doubled surgically changed.
f Preoperative left half doubled for comparison (still unchanged)
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can be lifted less than the opposite side, or if one eye- brow is lower than the other one, it should be lifted more to achieve postoperative symmetry, etc. All these elements can be taken into account when the aim is surgical beautification. Some photographic ex- amples of these changes document this.
Bibliography
Please see the general bibliography at the end of this book.
Fig. 8.5. a The nose is the key to facial harmony – middle third of verti- cal length of the face and the middle structure of the facial symmetry divid- ing the face into left and right halves;
here the deviation is to the left. b Same patient 3 months postoperatively. c As a piano player she wore glasses for no ophtalmological reason, just to distract attention from the shape of her nose.
d No need for glasses after correction
