The Morphological Changes of Asian Face Depending on Posture

Background: During the facial operation, it is important to predict the postoperative results in the upright position, while doing the operation in the spine position. Most of the plastic surgeons change their preoperative design for individuals based on experience and not in actual measurement or detailed plan. It is well known that the facial soft tissue changes with posture and there may be a difference based on the patient's sex and age. This study was performed to clarify the morphological changes of facial soft tissue in Asian face depending on posture.

Methods: A total of 100 healthy volunteers were divided into four groups based on age and sex. The four groups were young men, young women, old men, and old women. For all subjects, 18 measuring points were marked on the skin with ink and 18 paired linear measurements and angle were measured by using the digital slinding caliper and angle meter in the upright position and the supine position(Figure.1).

Results: In all the four subject groups, intercanthal width (en-en), binocular width (ex-ex), length of the eye fissure (en-ex), length of the nasal bridge (n-prn), width of the nose (al-al), height of the lower face (sn-gn), vermilion height of the lower lip (sto-li), height of the lower lip (sto-sl), width of the philtrum (cphi-cphi), width of the mouth (ch-ch) and nasolabial angle (NLA) were significantly larger in the spine position than in the upright position. The amount of increase was different in depending on age and sex. There was no much difference in amount of increase between young men and young women. The amount of increase was larger in old men compared to old women

Conclusions: The facial configuration is composed of skin, fat, mimic muscles, retaining ligament and facial skeleton. These components change their forms by the external force and aging. The Asian face tends to age principally due to the gravitational descent because of the thicker skin, heavier malar fat pad, and weaker skeletal support which all contribute to considerable facial sagging. Men don't makeup and don't have skincare as everyday habit. These fact cause men's face more exposure to ultraviolet-light, more dryness of the skin, getting damage by the shaving, compare to women's face. These long years of damage to the facial skin results in more facial sagging in men's face compared to women's. During the Asian facial operation the plastic surgeons should change their preoperative design depending on the part of the face and patient's age and sex.

Figure 1. The schematic drawing of the face showing the surface landmarks in relation to the underlying craniofacial skeleton.