Correction of Facial Proportions

Proportion is a vital concept in plastic surgery. Every surgeon who performs nasal reshaping should keep in mind the “Golden Section” principle developed in the 15th century concerning women’s facial proportions. Leonardo DaVinci was the inventor of charts used by surgeons around the world. In his works, DaVinci described the ideal proportions of a woman’s face that help us to understand why we consider one face beautiful and another less so.

The ideal nasal length is based on the equality of sections a, b and c (fig. 1) The distance between the hairline and eyebrows should be equal to that between the eyebrows and a line drawn beneath the nose; and also equal to the distance between the line beneath the nose and the chin line. The width of the mouth from edge to edge should equal the distance between the eye pupils. The width of the mouth should be about 1.5 times wider than the nose. The distance between the eyes should be equal to the length of one eye from edge to edge; and the edges of the nose should not reach out beyond the lines running through the internal corners of the eyes.

In cases where the nose is too large and the eyes are set too closely, the appropriate solution is to rebalance the proportions by rhinoplastic surgery. By narrowing a large nasal tip, the nose will look smaller and the eyes farther apart. Chin shape correction can improve the facial oval proportions. The ideal facial oval has a width equal to two thirds of its height.

Facial implants (fig.2) are used for augmenting the volume in specific areas in order to add or restore the ideal contours of facial proportions. This enhancing effect changes not only one’s appearance but also one’s quality of life. For instance, a small, ‘weak’ chin often causes a psychological discomfort.

Pic.3. Before and after: chin grafting augmentation and rhinoseptoplasty. 
By Intra oral, submental silicone implant placement, the chin’s lateral projection was reduced, and nasal bridge elevated. A septal spreader graft was also inserted

Among the many facial grafting materials, silicone implants are the most popular with surgeons. They have proved to be the safest, most neutral ones that can remain inside the body without causing side effects.

Pic.4. Submental liposuction
Llipoaspiration of lower chin area.
Chin augmentation by grafting
Silicone implant placed by intra-oral method (incison)

Implants are placed through intra-oral incisions (fig 4). The implant placement procedure can be performed in combination with other aesthetic surgeries like rhinoplasty, eyebrow lifting, etc. for a fuller rejuvenating effect.
The angle formed by the line running along the nasal dorsum and intersecting with the forehead line should be between 30 and 40 degrees.

A larger angle will emphasize a high nasal dorsum, and a smaller one is also far from ideal. Moreover, a very low dorsum makes the face look flat.

Pic.6. Genioplasty(intra oral chin reduction using electro-borer).Open rhinoseptoplasty(nasal tip shape was improved as well as nasal respiratory function. Incision made along columella and inside nostrils).

Pic.9. Ideal facial profile