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Circles of Prominence
A New Theory on Facial Aesthetics
Philip A. Young, MD;
Uttam Sinha, MD;
Dale H. Rice, MD;
Fred Stucker, MD
Arch Facial Plast Surg. 2006;8:263-267.
Objective To elucidate key elements of facial aesthetics through a new hypothesis called the circles of prominence.
Design In this subjective survey, 32 persons in the medical field rated frontal-view photographs of 20 subjects in 5 categories on a 0-to-100 scale, 0 representing the most unaesthetic rating, 100, the most aesthetically pleasing. The study was conducted in an academic setting, and the subject photographs were of 9 women (aged 27-65 years) from a clinical setting and 11 women whose pictures appeared in entertainment magazines. Each subject’s eyes, nose, mouth, and chin were subjectively rated for their aesthetic quality. A general rating was also given for the subject's face as a whole. The subject’s faces were then analyzed and measured based on the circles of prominence theory. A total of 52 measurements were chosen for the analysis. All raters' numbers for each anatomic unit and the face in general for each subject were averaged. The theoretical measurements were also averaged for each unit. The percentage of the ideal for the face in general was calculated based on weighted averages of the measurements from the individual units of each subject. The Wilcoxon signed-rank test was used to determine whether a significant difference existed between the raters' averages and the averages measured based on the facial analysis. Spearman rank coefficient correlation was used to determine if a significant correlation existed between those means.
Results We set statistical significance at P .05 and found that the mean ratings of 11 of the 20 raters for the face in general were not significantly different from the measured means based on the the circles of prominence theory. There was a significant correlation between the raters' means and the measured percentages of the ideal for all units and the face in general based on the Spearman rank test.
Conclusions Although the statistical analysis showed that many of the raters' subjective averages were significantly different from the averages calculated on the circles of prominence theory, the trends for those averages showed that the theory has meaningful validity in assessing facial aesthetics. The measured average ratings based on the theoretical calculations were higher than the subjectively rated averages. This was especially true for the photographs of clinical subjects and might be the cumulative result of multiple measured deviations from what is most aesthetically pleasing, thus creating an impact greater than the sum of its parts on the observer's subjective interpretation. The possible synergistic effects of multiple deviations for each anatomic unit or the face in general might have resulted in the much poorer subjective ratings than what the equally weighted, linearly determined measurements could analyze.
Author Affiliations: Department of Otolaryngology, University of Southern California, Los Angeles (Drs Young, Sinha, and Rice); and Department of Otolaryngology, Louisiana State University Health Sciences, Shreveport (Dr Stucker).
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