Abstract
BackgroundThree-dimensional surface imaging is established in many disciplines for objective facial acquisition regarding anthropometry. Former studies addressed the validation of landmark-based measurements for single race. In order to distinguish racial difference, the reproducibility of the landmark measurements must first be validated.ObjectivesOur purpose is to validate the reproducibility of 46 facial soft-tissue landmarks on x, y, z axes to prove their reliability as 3D reference points.MethodsThe study included 80 European Caucasian and 80 Chinese volunteers. Standardized 3D surface imaging was performed using Vectra 3D system. Two raters identified and defined 46 landmarks (138 coordinates), then repeatedly 3D-imaged volunteers' facial region in separate sessions. Coordinates' reproducibility of landmarks is divided into three categories (< 0.5 mm, < 1 mm, and >1 mm) for intra- and inter-rater reproducibility assessments.ResultsCoordinates' reproducibility of 160 samples was distributed as follows: Intra-rater: < 0.5 mm (45%), < 1 mm (42%), >1 mm (13%); inter-rater: < 0.5 mm (31.2%), < 1 mm (42%), > 1 mm (26.8%). The reproducibility of landmarks in nasal tip region differs slightly between Caucasians and Asians. Compared to females, males typically have higher landmark reproducibility in lip and chin region. However, there were no differences in the reproducibility ranking of landmarks by gender.ConclusionThe majority of the 46 landmarks in the 3D plane are reproducible to 1 mm, which is clinically acceptable. All selected landmarks showed strong consistency across race and gender, suggesting their potential use as reference points in prospective clinical practice.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Highlights
Three-dimensional surface imaging (3DSI) is an established means of facial analysis for infant facial development and congenital conditions such as cleft lip and palate or alterations of the skull, in facial reconstructive surgery, and for aesthetic facial plastic surgery consultation [1,2,3]
Landmarks located at different positions on the face have broad variation in reproducible levels; the landmarks placed on clear features and boundaries area have higher reproducibility than those placed on flat or a gently curved plane
This may be related to gender and ethnic differences in facial morphology, leading to variations in the reproducibility of certain landmarks
Summary
Three-dimensional surface imaging (3DSI) is an established means of facial analysis for infant facial development and congenital conditions such as cleft lip and palate or alterations of the skull, in facial reconstructive surgery, and for aesthetic facial plastic surgery consultation [1,2,3]. There are numerous devices for three-dimensional (3D) acquisition, the basis of anthropometric surveying is often a landmark-based approach. Facial surface landmarks are critical to the accuracy of 3D facial morphology measurement and analysis [4, 5]. Three-dimensional surface imaging is established in many disciplines for objective facial acquisition regarding anthropometry. Former studies addressed the validation of landmark-based measurements for single race. In order to distinguish racial difference, the reproducibility of the landmark measurements must first be validated
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