Facial analysis is an integral part of the surgical planning process. Clinical photography has long been an invaluable tool in the surgeon’s practice not only for accurate facial analysis but also for enhancing communication between the patient and surgeon, for evaluating postoperative results, for medicolegal documentation, and for educational and teaching opportunities. From 35-mm slide film to the digital technology of today, clinical photography has benefited greatly from technological advances. With the development of computer imaging software, objective facial analysis becomes easier to perform and less time consuming. Thus, while the original purpose of facial analysis remains the same, the process becomes much more efficient and allows for some objectivity. Although clinical judgment and artistry of technique is never compromised, the ability to perform objective facial photograph analysis using imaging software may become the standard in facial plastic surgery practices in the future.
Accurate facial analysis is one of the key components to proper surgical planning in facial plastic surgery. Consistent photographic technique and documentation is the cornerstone of critical preoperative analysis of the patient’s facial features. The gold standard of photography has long been known to be the use of a single-lens reflex (SLR) 35-mm camera. However, with advances in technology, digital photography has become an integral part of the facial plastic surgeon’s practice. Technological advances have allowed digital images to be archived and morphed with computer imaging software, which has led to the advanced capability for performing objective facial photograph analysis using imaging software.
Historical perspective
Proper facial analysis has always been a key component of the surgeon’s preoperative assessment. Such is the case in any surgical specialty in which a balanced harmony of facial features is important to the final aesthetic outcome. Holly Broadbent described one of the earliest standardized techniques for facial analysis. He detailed a method for taking consistent radiographs to obtain craniofacial measurements, known as cephalometry. Skeletal landmarks, measurements, and relationships were defined. Skeletal and soft tissue cephalometric analysis is still a useful tool for presurgical planning in orthodontic and orthognathic treatment.
Another approach to facial analysis was described by Bahman Guyuron, who used life-size photographs for soft tissue cephalometric analysis. During patient photography, he placed a removable marker on the patient to allow for a precise, full-scale, life-size photograph enlargement. Using drafting film overlying the photographs, Guyuron described a series of steps of drawn lines, measurements, and angles to critically analyze the patient’s frontal and lateral views for surgical planning of a rhinoplasty. By using soft tissue landmarks on the life-size photographs, he added that surgeons, who were not so artistically inclined nor had a keen eye for aesthetics, would be able to carefully analyze and predictably obtain optimal aesthetic outcomes.
Thus, whether using radiographs or photographs, guidelines were established for the ideal aesthetic facial proportions, which facilitated accurate facial analysis. Surgeons were then able to strike a balance between their artistry and their technical skill by objectively measured data points or analyses.
Related posts:
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
