Facial Aesthetic Ideals: A Literature Summary of Supporting Evidence.

Abstract

The challenge of objectively defining the parameters of beauty dates back centuries. As aesthetic physicians and plastic surgeons, our responsibility is to enhance the natural beauty of our patients' faces, whether it is for aesthetic enhancement or reconstructive purposes. To achieve this goal, it is crucial for us to have a deep understanding of the aesthetic ideals that we strive to achieve. While numerous aesthetic criteria have been proposed over the years, there is a lack of empirical analysis supporting many of these standards. This literature review represents the first exploration of the empirical evidence concerning the aesthetic ideals of the face in the existing literature. A comprehensive search in MEDLINE, EMBASE, SCOPUS and CENTRAL databases was conducted for primary clinical studies reporting on the classification of the facial aesthetic units as per Gonzales-Ulloa facial aesthetic unit Classification from January 1962 to November 2022. A total of 35 articles were included in the final review. There were 12 case series, 13 cohort studies, and 10 comparative studies. We identified 6 studies that described the aesthetic ideals of the forehead with a mean level of evidence of 3.33. We identified 9 studies that described the aesthetic ideals of the nose with a mean level of evidence of 3.6. We identified 6 studies that described the aesthetic ideals of the orbit with a mean level of evidence of 3. We identified 4 studies that described the aesthetic ideals of the cheek with a mean level of evidence of 4.07. We identified 6 studies that described the aesthetic ideals of the lips with a mean level of evidence of 3.33. We identified 4 studies that described the aesthetic ideals of the chin with a mean level of evidence of 3.75. We identified 1 study that described the aesthetic ideals of the ear with a level of evidence of 4. The units that were most extensively studied were the nose, forehead, and lip units, and they also had a relatively higher impact factor than other subunits. Conversely, the chin and ear subunits had the fewest studies conducted on them and had a relatively lower impact factor. In order to provide a useful resource for readers, we believe it would be prudent to identify and discuss influential papers for each subunit.