Facial Balance (Nose & Chin)
What is the mystery surrounding facial beauty? Is it in the eye of the beholder and only skin deep or are there some absolutes? It may not be able to always be defined but it is always recognized. Facial beauty is a matter of balance and proportion.
These is a universal recognition of pleasant proportion. We can tell if a face is too long or too short. We notice when balance is upset because the human mind perceives some forms as beautiful and others less so. Even across cultures there is a common understanding of who is attractive.
The whole is greater than the sum of the parts.
In accessing the problems of the face it is best to consider the total face as an aesthetic unit. It is possible that there may only be a nasal issue or a chin issue. However, many times there are constellations of issues - small chin, flat cheeks, big nose, that create the disharmony of unhappiness when it comes to the face.
The explanation that it may be many small parts of the puzzle that need rearranging rather than one central item may be a hard sell to the patient and family. However, the minimalist approach may be many small adjustments for balance rather than one large compensatory procedure. Refine the nose, augment the chin and the cheeks to create balance and harmony rather than a very large nasal reductions.
Here is where computer imaging can be very helpful. When you look in the mirror you see the opposite view - the mirror image of what others see. Also you cannot see in all dimensions. The computer makes it possible for the patient and physician to look at the same image. The ability to adjust multiple features brings to light the issues of facial imbalance and the vision of the plastic surgeon.
The Nose
"It's as plain as the nose on your face". "It fits your face". Both of these comments are the subliminal recognition for balance and harmony. When a nose is out of balance it can disrupt the entire beauty of the face. It is a central singular feature that divides the face. It is seen in multiple views and therefore judged more critically than perhaps other facial features. Comments like Pinocchio for a long nose, or a piggy nose for one that is too short, set the stage for the appreciation and observation of the importance of the nose as it relates to the face. The image connoted by a nose can define a face. A nose that is out of balance can be too wide, too long, too short, too anything. Most importantly it cannot be hidden or camouflaged. Therefore it is often the largest concerns of young teens when it comes to their face.
The Chin
When evaluating the chin there must be attention paid to dental issues - are the teeth straight. is there an overbite? Is the problem purely correctable by dental care or is surgery necessary - or both? In any event, a chin that is out of balance with the rest of the face creates an unappealing disharmony.
The Cheeks
Youth and beauty are accented by those full "rosy cheeks". Teens without full cheeks (mid faces) look older and more drawn that they really are. Their faces are flat. Many times the angst of the teen regarding their nose is a focus of unhappiness from unrecognized facial imbalance. It is here that the artistic, mathematical, philosophical, and psychological skills of the adolescent surgeon come into play.
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