Limits...
Vertical Localization of the Malar Prominence.

Kaptein YE, Kaptein JS, Markarian A - Plast Reconstr Surg Glob Open (2015)

Bottom Line: We assessed the vertical location of the malar prominence relative to other facial landmarks, determined consistency among individuals, and compared this with values used in artistry.No difference was found between gender and age groups or between whites and Hispanics.Our population's value is not different from the value of 0.809 used in artistry, which is based on the Golden Ratio φ.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology - Head & Neck Surgery, Keck School of Medicine, Los Angeles, Calif. Currently, University of Illinois College of Medicine, Chicago, Ill.; Southern California Permanente Medical Group, Los Angeles, Calif.; and Department of Otolaryngology - Head & Neck Surgery, University of Southern California, Los Angeles, Calif.

ABSTRACT

Background: During reconstruction or augmentation, it is important to localize the malar complex in a symmetrical and aesthetically pleasing position. Few studies have determined the location of this feature and none related the location to gender, age, or ethnicity. Some of these have attempted to relate the position to the aesthetically pleasing Golden Ratio φ.

Methods: We assessed the vertical location of the malar prominence relative to other facial landmarks, determined consistency among individuals, and compared this with values used in artistry. Study population consisted of a convenience sample of 67 patients taken from an otolaryngology practice at a large urban medical center. Coordinates of the malar prominence were referenced to distinct facial landmarks from which the ratio of chin-to-malar prominence to chin-to-eye canthus was determined.

Results: Average chin-to-malar prominence distance was 0.793 ± 0.023 (SD) of the chin-to-eye canthus distance. Variability due to the specific image chosen [coefficient of variation (CV) = 1.19%] and combined inter/intrareader variability (CV = 1.71%) validate the methodology. Variability among individuals (CV = 2.84%) indicates population consistency. No difference was found between gender and age groups or between whites and Hispanics. Individuals of other/unknown ethnicities were within the range common to whites and Hispanics. Our population's value is not different from the value of 0.809 used in artistry, which is based on the Golden Ratio φ.

Conclusions: The vertical position of the malar prominence is consistent among individuals, is clinically well-approximated by the value based on the Golden Ratio, and may be useful as a reference for surgical reconstruction or augmentation.

No MeSH data available.


Related in: MedlinePlus

Calculating cheek height to canthus height ratio. Points represent facial landmarks. Lines through canthi and commissures converge at a vanishing point (not shown). Lines are drawn from this point to chin and malar prominence. We define height ratio of malar prominence as ratio of vertical distances a to b. Calculations for the individual are shown as follows: Origin of the coordinate system is at top left. (x,y) coordinates of the right eye canthus are (4.261, 5.039) and of the left eye canthus (6.009, 4.933), right mouth commissure (4.651, 6.616), left mouth commissure (5.430, 6.593), base of chin (5.182, 7.548), and malar prominence at the edge of the face (4.036, 5.538). Thus, the line running through the eye canthi is defined by: y = (4.933 − 5.039)/(6.009 − 4.261) × (x − 4.261) + 5.039. This can be simplified to y = −0.061 × x + 5.297. Specifically, at the x-coordinate of the malar prominence (4.036), the y-coordinate (ie, top of arrow “b”) is found to be 5.053. The y-coordinate of the top of arrow “a” is directly observed to be at 5.538. Similarly, the line running through the commissures of the mouth is defined by: y = (6.593 − 6.616)/(5.430 − 4.651) × (x − 4.651) + 6.616, which can be simplified to y = −0.030 × x + 6.753. The lines through the eye canthi and the mouth commissures meet at a vanishing point (far to the left in the diagram). At this point, the x and y coordinates satisfy the definition for each of these lines. Thus, y = −0.061 × x + 5.297 = −0.030 × x + 6.753. x is solved to be −46.780 and y is 8.135. The coordinates of the vanishing point thus allow definition of the line joining the vanishing point to the chin as: y = (7.548 − 8.135)/(5.182 + 46.780) × (x + 46.780) + 8.135, which simplifies to y = −0.011 × x + 7.607. Specifically, at the x-coordinate of the malar complex (4.036), the y-coordinate (ie, bottom of arrows “a” and “b”) is found to be 7.516. The relative height of the malar complex as the ratio of “a” to “b” is thus (7.516 − 5.538)/(7.516 − 5.053) = 0.807, which is almost exactly the value shown in Figure 1, generated using (φ + 0.5)/(φ + 1.0) ≈ 0.809. It should be noted that this individual was not one of the subjects presented in this study.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4494481&req=5

Figure 2: Calculating cheek height to canthus height ratio. Points represent facial landmarks. Lines through canthi and commissures converge at a vanishing point (not shown). Lines are drawn from this point to chin and malar prominence. We define height ratio of malar prominence as ratio of vertical distances a to b. Calculations for the individual are shown as follows: Origin of the coordinate system is at top left. (x,y) coordinates of the right eye canthus are (4.261, 5.039) and of the left eye canthus (6.009, 4.933), right mouth commissure (4.651, 6.616), left mouth commissure (5.430, 6.593), base of chin (5.182, 7.548), and malar prominence at the edge of the face (4.036, 5.538). Thus, the line running through the eye canthi is defined by: y = (4.933 − 5.039)/(6.009 − 4.261) × (x − 4.261) + 5.039. This can be simplified to y = −0.061 × x + 5.297. Specifically, at the x-coordinate of the malar prominence (4.036), the y-coordinate (ie, top of arrow “b”) is found to be 5.053. The y-coordinate of the top of arrow “a” is directly observed to be at 5.538. Similarly, the line running through the commissures of the mouth is defined by: y = (6.593 − 6.616)/(5.430 − 4.651) × (x − 4.651) + 6.616, which can be simplified to y = −0.030 × x + 6.753. The lines through the eye canthi and the mouth commissures meet at a vanishing point (far to the left in the diagram). At this point, the x and y coordinates satisfy the definition for each of these lines. Thus, y = −0.061 × x + 5.297 = −0.030 × x + 6.753. x is solved to be −46.780 and y is 8.135. The coordinates of the vanishing point thus allow definition of the line joining the vanishing point to the chin as: y = (7.548 − 8.135)/(5.182 + 46.780) × (x + 46.780) + 8.135, which simplifies to y = −0.011 × x + 7.607. Specifically, at the x-coordinate of the malar complex (4.036), the y-coordinate (ie, bottom of arrows “a” and “b”) is found to be 7.516. The relative height of the malar complex as the ratio of “a” to “b” is thus (7.516 − 5.538)/(7.516 − 5.053) = 0.807, which is almost exactly the value shown in Figure 1, generated using (φ + 0.5)/(φ + 1.0) ≈ 0.809. It should be noted that this individual was not one of the subjects presented in this study.

Mentions: Coordinates of pupil centers, lateral canthi, commissures of the mouth, the menton (base of the chin), and the malar prominence were recorded (Fig. 2). Three independent readers determined the (x,y) coordinates of the most prominent part of the cheek on the far side of the face (Fig. 2).


Vertical Localization of the Malar Prominence.

Kaptein YE, Kaptein JS, Markarian A - Plast Reconstr Surg Glob Open (2015)

Calculating cheek height to canthus height ratio. Points represent facial landmarks. Lines through canthi and commissures converge at a vanishing point (not shown). Lines are drawn from this point to chin and malar prominence. We define height ratio of malar prominence as ratio of vertical distances a to b. Calculations for the individual are shown as follows: Origin of the coordinate system is at top left. (x,y) coordinates of the right eye canthus are (4.261, 5.039) and of the left eye canthus (6.009, 4.933), right mouth commissure (4.651, 6.616), left mouth commissure (5.430, 6.593), base of chin (5.182, 7.548), and malar prominence at the edge of the face (4.036, 5.538). Thus, the line running through the eye canthi is defined by: y = (4.933 − 5.039)/(6.009 − 4.261) × (x − 4.261) + 5.039. This can be simplified to y = −0.061 × x + 5.297. Specifically, at the x-coordinate of the malar prominence (4.036), the y-coordinate (ie, top of arrow “b”) is found to be 5.053. The y-coordinate of the top of arrow “a” is directly observed to be at 5.538. Similarly, the line running through the commissures of the mouth is defined by: y = (6.593 − 6.616)/(5.430 − 4.651) × (x − 4.651) + 6.616, which can be simplified to y = −0.030 × x + 6.753. The lines through the eye canthi and the mouth commissures meet at a vanishing point (far to the left in the diagram). At this point, the x and y coordinates satisfy the definition for each of these lines. Thus, y = −0.061 × x + 5.297 = −0.030 × x + 6.753. x is solved to be −46.780 and y is 8.135. The coordinates of the vanishing point thus allow definition of the line joining the vanishing point to the chin as: y = (7.548 − 8.135)/(5.182 + 46.780) × (x + 46.780) + 8.135, which simplifies to y = −0.011 × x + 7.607. Specifically, at the x-coordinate of the malar complex (4.036), the y-coordinate (ie, bottom of arrows “a” and “b”) is found to be 7.516. The relative height of the malar complex as the ratio of “a” to “b” is thus (7.516 − 5.538)/(7.516 − 5.053) = 0.807, which is almost exactly the value shown in Figure 1, generated using (φ + 0.5)/(φ + 1.0) ≈ 0.809. It should be noted that this individual was not one of the subjects presented in this study.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4494481&req=5

Figure 2: Calculating cheek height to canthus height ratio. Points represent facial landmarks. Lines through canthi and commissures converge at a vanishing point (not shown). Lines are drawn from this point to chin and malar prominence. We define height ratio of malar prominence as ratio of vertical distances a to b. Calculations for the individual are shown as follows: Origin of the coordinate system is at top left. (x,y) coordinates of the right eye canthus are (4.261, 5.039) and of the left eye canthus (6.009, 4.933), right mouth commissure (4.651, 6.616), left mouth commissure (5.430, 6.593), base of chin (5.182, 7.548), and malar prominence at the edge of the face (4.036, 5.538). Thus, the line running through the eye canthi is defined by: y = (4.933 − 5.039)/(6.009 − 4.261) × (x − 4.261) + 5.039. This can be simplified to y = −0.061 × x + 5.297. Specifically, at the x-coordinate of the malar prominence (4.036), the y-coordinate (ie, top of arrow “b”) is found to be 5.053. The y-coordinate of the top of arrow “a” is directly observed to be at 5.538. Similarly, the line running through the commissures of the mouth is defined by: y = (6.593 − 6.616)/(5.430 − 4.651) × (x − 4.651) + 6.616, which can be simplified to y = −0.030 × x + 6.753. The lines through the eye canthi and the mouth commissures meet at a vanishing point (far to the left in the diagram). At this point, the x and y coordinates satisfy the definition for each of these lines. Thus, y = −0.061 × x + 5.297 = −0.030 × x + 6.753. x is solved to be −46.780 and y is 8.135. The coordinates of the vanishing point thus allow definition of the line joining the vanishing point to the chin as: y = (7.548 − 8.135)/(5.182 + 46.780) × (x + 46.780) + 8.135, which simplifies to y = −0.011 × x + 7.607. Specifically, at the x-coordinate of the malar complex (4.036), the y-coordinate (ie, bottom of arrows “a” and “b”) is found to be 7.516. The relative height of the malar complex as the ratio of “a” to “b” is thus (7.516 − 5.538)/(7.516 − 5.053) = 0.807, which is almost exactly the value shown in Figure 1, generated using (φ + 0.5)/(φ + 1.0) ≈ 0.809. It should be noted that this individual was not one of the subjects presented in this study.
Mentions: Coordinates of pupil centers, lateral canthi, commissures of the mouth, the menton (base of the chin), and the malar prominence were recorded (Fig. 2). Three independent readers determined the (x,y) coordinates of the most prominent part of the cheek on the far side of the face (Fig. 2).

Bottom Line: We assessed the vertical location of the malar prominence relative to other facial landmarks, determined consistency among individuals, and compared this with values used in artistry.No difference was found between gender and age groups or between whites and Hispanics.Our population's value is not different from the value of 0.809 used in artistry, which is based on the Golden Ratio φ.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology - Head & Neck Surgery, Keck School of Medicine, Los Angeles, Calif. Currently, University of Illinois College of Medicine, Chicago, Ill.; Southern California Permanente Medical Group, Los Angeles, Calif.; and Department of Otolaryngology - Head & Neck Surgery, University of Southern California, Los Angeles, Calif.

ABSTRACT

Background: During reconstruction or augmentation, it is important to localize the malar complex in a symmetrical and aesthetically pleasing position. Few studies have determined the location of this feature and none related the location to gender, age, or ethnicity. Some of these have attempted to relate the position to the aesthetically pleasing Golden Ratio φ.

Methods: We assessed the vertical location of the malar prominence relative to other facial landmarks, determined consistency among individuals, and compared this with values used in artistry. Study population consisted of a convenience sample of 67 patients taken from an otolaryngology practice at a large urban medical center. Coordinates of the malar prominence were referenced to distinct facial landmarks from which the ratio of chin-to-malar prominence to chin-to-eye canthus was determined.

Results: Average chin-to-malar prominence distance was 0.793 ± 0.023 (SD) of the chin-to-eye canthus distance. Variability due to the specific image chosen [coefficient of variation (CV) = 1.19%] and combined inter/intrareader variability (CV = 1.71%) validate the methodology. Variability among individuals (CV = 2.84%) indicates population consistency. No difference was found between gender and age groups or between whites and Hispanics. Individuals of other/unknown ethnicities were within the range common to whites and Hispanics. Our population's value is not different from the value of 0.809 used in artistry, which is based on the Golden Ratio φ.

Conclusions: The vertical position of the malar prominence is consistent among individuals, is clinically well-approximated by the value based on the Golden Ratio, and may be useful as a reference for surgical reconstruction or augmentation.

No MeSH data available.


Related in: MedlinePlus