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Facial Plast Surg 2022; 38(02): 193-200
DOI: 10.1055/s-0041-1729910
Original Research

Morphological Changes in Faces Depending on Posture

Hiroshi Nishioka 
1   Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Nagano, Japan
,
Miki Hishikawa
2   Department of Plastic and Reconstructive Surgery, Osaka City University School of Medicine, Osaka, Japan
,
Fumio Nagai
1   Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Nagano, Japan
,
Shunsuke Yuzuriha
1   Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Nagano, Japan
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Abstract

Facial surgeries are usually performed with the patient in the supine position; however, it is crucial to predict postoperative results in the upright position. This study aimed to clarify the posture-related morphological changes in the facial soft tissue regarding age and sex, using physical measurements to obtain results in specific linear metric measurements of standard facial features. One hundred healthy volunteers were divided into four groups based on age and sex (25 young men, 25 young women, 25 old men, 25 old women). For all participants, 18 measuring points were marked on the skin along with 18 paired linear measurements, and the angle was measured using a digital sliding caliper and angle meter in both upright and supine positions. In all four groups, the 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 supine position than in the upright position. The increase was larger in the older age groups than in the younger age groups. Moreover, the increase was larger in old men than in old women. During facial surgery involving these areas, surgeons should consider the patient's age and sex and understand what facial figuration change would occur depending on posture and change their preoperative design or make minor adjustments during operation in the supine position to increase patient satisfaction.

Keywords

facial surgery - morphological change - supine position - upright position

Note

Patients provided written consent for the use of their photographs. This work is based on the work presented at Plastic Surgery—The Meeting in 2018.




Publication History

Article published online:
01 June 2021

© 2021. Thieme. All rights reserved.

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  • References

  • 1 Ozsoy U, Sekerci R, Ogut E. Effect of sitting, standing, and supine body positions on facial soft tissue: detailed 3D analysis. Int J Oral Maxillofac Surg 2015; 44 (10) 1309-1316
    CrossrefPubMedGoogle Scholar
  • 2 Bulut O, Jessica Liu CY, Koca F, Wilkinson C. Comparison of three-dimensional facial morphology between upright and supine positions employing three-dimensional scanner from live subjects. Leg Med (Tokyo) 2017; 27: 32-37
    CrossrefPubMedGoogle Scholar
  • 3 De Greef S, Claes P, Mollemans W. et al. Semi-automated ultrasound facial soft tissue depth registration: method and validation. J Forensic Sci 2005; 50 (06) 1282-1288
    CrossrefPubMedGoogle Scholar
  • 4 O'Boyle KH, Gallagher FD, O'Sullivan M, McDevitt WE. The effect of posture change on the position of the skin marks for the transverse horizontal axis. J Prosthet Dent 1996; 75 (05) 545-551
    CrossrefPubMedGoogle Scholar
  • 5 Iblher N, Gladilin E, Stark BG. Soft-tissue mobility of the lower face depending on positional changes and age: a three-dimensional morphometric surface analysis. Plast Reconstr Surg 2013; 131 (02) 372-381
    CrossrefPubMedGoogle Scholar
  • 6 See MS, Roberts C, Nduka C. Age- and gravity-related changes in facial morphology: 3-dimensional analysis of facial morphology in mother-daughter pairs. J Oral Maxillofac Surg 2008; 66 (07) 1410-1416
    CrossrefPubMedGoogle Scholar
  • 7 Mally P, Czyz CN, Wulc AE. The role of gravity in periorbital and midfacial aging. Aesthet Surg J 2014; 34 (06) 809-822
    CrossrefPubMedGoogle Scholar
  • 8 Yamamoto S, Miyachi H, Watanabe S, Hujii H, Simozato K. Analysis of facial soft tissue by using three-dimensional optical scanner depending on postural change. Jpn J Jaw Deformities 2016; 26: 18-25
    CrossrefPubMedGoogle Scholar
  • 9 Hirai H, Ozawa S, Yoshioka F. et al. Determination of the effect of human posture on the deformation of facial contours by using a 3D data acquisition system. Maxillofacial Prosthetics 2012; 35: 46-52
    PubMedGoogle Scholar
  • 10 Munn L, Stephan CN. Changes in face topography from supine-to-upright position-and soft tissue correction values for craniofacial identification. Forensic Sci Int 2018; 289: 40-50
    CrossrefPubMedGoogle Scholar
  • 11 Martin R, Saller K. Lehrbuch der Anthropologie in systematischer Darstellung. Stuttgart: Fischer; 1957
    Google Scholar
  • 12 Farkas LG, Katic MJ, Hreczko TA, Deutsch C, Munro IR. Anthropometric proportions in the upper lip-lower lip-chin area of the lower face in young white adults. Am J Orthod 1984; 86 (01) 52-60
    CrossrefPubMedGoogle Scholar
  • 13 Farkas LG. Anthropometry of the Head and Face in Medicine. New York: Elsevier; 1981
    Google Scholar
  • 14 Farkas LG, Ross RB, Posnick JC, Indech GD. Orbital measurements in 63 hyperteloric patients. Differences between the anthropometric and cephalometric findings. J Craniomaxillofac Surg 1989; 17 (06) 249-254
    CrossrefPubMedGoogle Scholar
  • 15 Daniel RK, Farkas LG. Rhinoplasty: image and reality. Clin Plast Surg 1988; 15 (01) 1-10
    CrossrefPubMedGoogle Scholar
  • 16 Farkas LG. Anthropometry of the Head and Face. New York: Raven Press; 1994
    Google Scholar
  • 17 Munro IR, Das SK. Improving results in orbital hypertelorism correction. Ann Plast Surg 1979; 2 (06) 499-507
    CrossrefPubMedGoogle Scholar
  • 18 Farkas LG, Hreczko TA, Deutsch CK. Objective assessment of standard nostril types—a morphometric study. Ann Plast Surg 1983; 11 (05) 381-389
    CrossrefPubMedGoogle Scholar
  • 19 Kang H, Takahashi Y, Nakano T, Asamoto K, Ikeda H, Kakizaki H. Medial canthal support structures: the medial retinaculum: a review. Ann Plast Surg 2015; 74 (04) 508-514
    CrossrefPubMedGoogle Scholar
  • 20 Kang H, Takahashi Y, Ichinose A. et al. Lateral canthal anatomy: a review. Orbit 2012; 31 (04) 279-285
    CrossrefPubMedGoogle Scholar
  • 21 Lee Y, Hwang K. Skin thickness of Korean adults. Surg Radiol Anat 2002; 24 (3-4): 183-189
    CrossrefPubMedGoogle Scholar
  • 22 McCurdy Jr JA. Cosmetic Surgery of the Asian Face. New York: Thieme Medical Publishers; 1990
    Google Scholar
  • 23 Gierloff M, Stöhring C, Buder T, Gassling V, Açil Y, Wiltfang J. Aging changes of the midfacial fat compartments: a computed tomographic study. Plast Reconstr Surg 2012; 129 (01) 263-273
    CrossrefPubMedGoogle Scholar
  • 24 Rohrich RJ, Pessa JE, Ristow B. The youthful cheek and the deep medial fat compartment. Plast Reconstr Surg 2008; 121 (06) 2107-2112
    CrossrefPubMedGoogle Scholar
  • 25 Pessa JE. An algorithm of facial aging: verification of Lambros's theory by three-dimensional stereolithography, with reference to the pathogenesis of midfacial aging, scleral show, and the lateral suborbital trough deformity. Plast Reconstr Surg 2000; 106 (02) 479-488 , discussion 489–490
    CrossrefPubMedGoogle Scholar
  • 26 Lam SM, Kim YK. Augmentation rhinoplasty of the Asian nose with the “bird” silicone implant. Ann Plast Surg 2003; 51 (03) 249-256
    CrossrefPubMedGoogle Scholar
  • 27 Giunta SX. Augmentation mentoplasty in Asian men and women. Facial Plast Surg Clin North Am 1996; 4: 117-128
    PubMedGoogle Scholar
  • 28 Berardesca E, de Rigal J, Leveque JL, Maibach HI. In vivo biophysical characterization of skin physiological differences in races. Dermatologica 1991; 182 (02) 89-93
    CrossrefPubMedGoogle Scholar
  • 29 Shirakabe Y, Suzuki Y, Lam SM. A new paradigm for the aging Asian face. Aesthetic Plast Surg 2003; 27 (05) 397-402
    CrossrefPubMedGoogle Scholar
  • 30 Stephan CN, Preisler R, Bulut O, Bennett M. Turning the tables of sex distinction in craniofacial identification: why females possess thicker facial soft tissues than males, not vice versa. Am J Phys Anthropol 2016; 161 (02) 283-295
    CrossrefPubMedGoogle Scholar