The impact of facial pattern on esthetic evaluation of cheek size

Abstract

This research evaluate the facial esthetic related to cheek size changes in vertical facial patterns. The sample included 18 images of three female models with brachyfacial, mesofacial and dolichofacial patterns. Frontal facial photographs were taken at rest and smiling, and modified simulating bichectomy or cheek augmentation. A total of 76 evaluators were invited, including laypersons (LP) (n=25), professionals with experience in facial harmonization (HOFp) (n=25) and orthodontists (n=26), to judge the attractiveness of the face according to the Likert scale. The Kruskal-Wallis test for the evaluators and the Friedman test for the cheeks changes at a significance level (p<0.05) were used. In the brachyfacial pattern, resting photography with bichectomy simulation was preferred by HOFp and LP. According to LP, there is a tendency to assign higher grades to the brachyfacial smile photo, regardless of the alteration. In the mesofacial pattern, cheek augmentation, original and reduction, at rest and smiling, were similarly evaluated by the 3 groups. In the dolichofacial pattern, LP gave higher scores than orthodontists for all cheek changes in smile photographs. It is concluded that facial esthetic in relation to cheek size in the different vertical facial patterns was assessed differently by orthodontists, HOFp and LP. However, it was not possible to identify a preferred size (original, -6mm or +6mm) for each facial pattern. The clinical relevance of this study is related to the orientation of patients in making decisions about the treatment plan, including aesthetics and multidisciplinarity, considering the facial pattern and the patient's opinion.