Facial Analysis

On this page

Facial Analysis: Introduction & Proportions - Face Value Fundamentals

  • Goal: Objective evaluation for diagnosis, surgical planning & outcome assessment.
  • Vertical Thirds: (📌 Mnemonic: Tall Giraffes Seldom Meet for landmarks Tr-G-Sn-Me)
    • Upper: Trichion (Tr) to Glabella (G)
    • Middle: Glabella (G) to Subnasale (Sn)
    • Lower: Subnasale (Sn) to Menton (Me)
    • Ideal ratio: 1:1:1.
    • Lower third division: Upper lip (Sn-Stomion) $1/3$, Lower lip-chin (Stomion-Me) $2/3$.
  • Horizontal Fifths:
    • Face divided into 5 equal segments.
    • Each segment = width of one eye (intercanthal distance).
    • Intercanthal distance ≈ Alar width.
  • Frankfort Horizontal Plane: Porion (Po) to Orbitale (Or). Basis for cephalometric analysis.
  • Angle of Facial Convexity: Glabella (G) - Subnasale (Sn) - Pogonion (Pog). Ideal: ~12° (Range 8-16°).

⭐ The Rule of Thirds and Fifths provides a fundamental framework for assessing facial symmetry and proportion.

Facial thirds and fifths with landmarks for analysis

Facial Analysis: Key Facial Angles & Lines - Geometry of Glamour

  • Nasofrontal Angle (NFrA): Glabella-Nasion to Nasion-Tip. Ideal: 115-130°.
  • Nasofacial Angle (NFA): Facial plane (Glabella-Pogonion) to Nasion-Tip. Ideal: 30-40°.
  • Nasolabial Angle (NLA): Columella-Subnasale-Upper Lip. ♂: 90-95°, ♀: 95-110°.
  • Mentocervical Angle (MCA): Submental line to anterior neck line. Ideal: 80-95°.
  • Facial Convexity Angle (Legan): Glabella-Subnasale-Pogonion. Ideal: 8-12°.
  • Ricketts' E-line: Pronasale to soft tissue Pogonion.
    • Upper lip: 4mm posterior.
    • Lower lip: 2mm posterior.
  • Holdaway's H-line: Soft tissue Pogonion to Upper lip. Nose tip on/anterior.
  • Zero Meridian Line (Gonzalez-Ulloa): Vertical from Frankfort horizontal via Nasion. Pogonion on/posterior.

Facial Profile Convexity Angles Diagram

Ricketts' E-line: Ideal lip position: upper lip 4mm posterior, lower lip 2mm posterior to Pronasale-Pogonion line.

Facial Analysis: Regional Analysis Highlights - Zone In On Features

  • Forehead/Brow:
    • Brow position: Female ~1cm above supraorbital rim (SOR), arched; Male at SOR, flatter.
    • Brow peak: Aligns with lateral limbus.
  • Eyes/Periorbital:
    • Intercanthal distance (ICD): 30-34 mm (≈ alar width).
    • Palpebral fissure height: 8-12 mm.
    • Tarsal platform show (TPS): 4-6 mm.
    • Canthal tilt: Positive (lateral canthus 1-2 mm > medial).
  • Nose: (Integrate with overall facial harmony)
    • Alar width ≈ ICD.
    • Tip-defining points: Bilateral, symmetric.
  • Lips/Perioral:
    • Upper lip length (subnasale-stomion): 18-22 mm.
    • Maxillary incisor show (at rest): 1-4 mm.
    • Vermilion height ratio (Upper:Lower): Approx. $1:1.6$.
    • Commissure orientation: Neutral to slightly upward.
  • Chin/Mandible:
    • Chin projection: Assessed with reference lines (e.g., Riedel's, Goode's).
    • Labiomental angle: 120-130°.
    • Mandibular angle: Clearly defined.

⭐ The Frankfort horizontal plane (infraorbital rim to superior auditory meatus) is a crucial reference for assessing facial proportions, particularly chin projection.

Facial Analysis: Assessment & Variations - Diverse Faces, Dynamic Changes

  • Systematic Assessment:
    • Global (overall harmony), Regional (e.g., periorbital), Local (e.g., ala).
    • Standardized photography: Frankfort horizontal plane parallel to floor.
    • Anthropometry: Key to surgical planning.
  • Facial Proportions & Angles:
    • Vertical Thirds: Upper (trichion-glabella), Middle (glabella-subnasale), Lower (subnasale-menton) - ideally equal.
    • Horizontal Fifths: Each fifth ≈ intercanthal distance.
    • Nasofrontal angle: 115-130°.
    • Nasolabial angle: M: 90-95°, F: 95-110°.
    • Mentocervical angle: 80-95°.
  • Key Variations:
    • Age: ↓ elasticity, volume changes, bony resorption.
    • Ethnicity: Diverse skeletal & soft tissue profiles.
    • Gender: Distinct masculine/feminine ideals.
  • Dynamic Evaluation: Assess facial muscle function & symmetry during animation. image

⭐ The Frankfort Horizontal Plane (infraorbital rim to superior auditory meatus) is crucial for standardized facial assessment.

High‑Yield Points - ⚡ Biggest Takeaways

  • Facial thirds (upper, middle, lower) should be equal for ideal harmony.
  • Facial fifths: Intercanthal distance equals eye width and alar width.
  • Ideal nasofrontal angle is 115-130°.
  • Nasolabial angle: 90-95° (males), 95-105° (females).
  • Mentocervical angle should be 80-95°.
  • Frankfort horizontal plane (porion to orbitale) is a crucial reference.
  • Ricketts' E-line: Lips 2-4 mm posterior to line from pronasale to pogonion.

Practice Questions: Facial Analysis

Test your understanding with these related questions

Which index is used to evaluate palatal height?

1 of 5

Flashcards: Facial Analysis

1/4

In a _____ nose, there is depressed nasal dorsum.

TAP TO REVEAL ANSWER

In a _____ nose, there is depressed nasal dorsum.

saddle

browseSpaceflip

Enjoying this lesson?

Get full access to all lessons, practice questions, and more.

Start Your Free Trial