Facial Aesthetics

Concepts and Clinical Diagnosis

Farhad B. Naini

• Publisher: Wiley-Blackwell
• Year: 2011
• ISBN:
  9781444391039
• Edition: 1
• Topic: Medicine
• Subtopic: Dentistry

Facial Aesthetics: Concepts and Clinical Diagnosis is a unique new illustrated resource for facial aesthetic surgery and dentistry, providing the comprehensive clinical textbook on the art and science of facial aesthetics for clinicians involved in the management of facial deformities, including orthodontists, oral and maxillofacial surgeons, plastic and reconstructive surgeons and aesthetic dentists. It aims to provide readers with a comprehensive examination of facial aesthetics in the context of dentofacial and craniofacial diagnosis and treatment planning. This aim is achieved through coupling meticulous research and practical clinical advice with beautifully drawn supporting illustrations and diagrams.

Structured over 24 logically arranged and easy-to-follow chapters, Part I of Facial Aesthetics covers the historical evidence for facial aesthetic canons and concepts in depth. It incorporates all aspects relevant to the work of the clinician, including the philosophical and scientific theories of facial beauty, facial attractiveness research, facial expression and the psychosocial ramifications of facial deformities. Part II of the book then goes on to examine clinical evaluation and diagnosis in considerable detail under four sections, from the initial consultation interview and acquisition of diagnostic records (section 1), complete clinical examination and analysis of the craniofacial complex (section 2), in depth analysis of each individual facial region using a top-down approach (section 3) and finally focussing on smile and dentogingival aesthetic evaluation (section 4).

An in-depth, thoughtful, practical and absorbing reference, Facial Aesthetics will find an enthusiastic reception among facial aesthetic surgeons and aesthetic dentists with an interest in refining their understanding and appreciation of the human face and applying practical protocols to their clinical diagnosis and treatment planning.

Key features:

• Examines facial aesthetics in a clinical context
• Promotes an interdisciplinary approach to facial aesthetic analysis
• Detailed description of the systematic clinical evaluation of the facial soft tissues and craniodentoskeletal complex
• Detailed, step-by-step aesthetic analysis of each facial region
• In-depth analysis of 2D and 3D clinical diagnostic records
• Evidence-based approach, from antiquity to contemporary scientific evidence, to the guidelines employed in planning the correction of facial deformities
• Treatment planning from first principles highlighted
• Clinical notes are highlighted throughout
• Clearly organized and practical format
• Highly illustrated in full colour throughout

Part I: CONCEPTS

Chapter 1

Facial Beauty

‘Beauty itself doth of itself persuade

The eyes of men without an orator.’

William Shakespeare (1564–1616), The Rape of Lucrece (1594)¹

Definition of Beauty and Aesthetics

‘Beauty as we feel it is something indescribable:

what it is or what it means can never be said.’

George Santayana (1863–1952), The Sense of Beauty (1896)²

It is almost impossible to clearly and accurately define beauty. Definitions often do not and cannot elucidate the full significance of the concept of beauty. Beauty may be defined as ‘a combination of qualities that give pleasure to the senses or to the mind’.³ The Oxford English Dictionary defines beauty as:

‘A combination of qualities, such as shape, colour, or form, which pleases the aesthetic senses, especially the sight.’

The Renaissance artist and thinker Leon Battista Alberti (1404–72) defined beauty as:

‘The summation of the parts working together in such a way that nothing needs to be added, taken away or altered.’⁴

The various definitions of beauty and facial beauty all essentially describe the assemblage of graceful features that please the eye and mind of an observer, yet the definitions are philosophical, debatable and non-specific. Three variables exist in the definitions of beauty:

• The graceful features: The human face is comprised of a number of ‘features’, e.g. the eyes, nose, lips, etc., with a wide array of shapes, sizes, relative positions and colours.
• Their assemblage: Which components of which features and in which combinations result in a beautiful face?
• The observer: Does each observer see and sense the same beauty?

The number of variables makes it clear that the concept of beauty is difficult to explain with complete clarity. In Dreams of a Final Theory: The Search for the Fundamental Laws of Nature (1993), the Nobel prize-winning theoretical physicist Steven Weinberg eloquently writes:

‘I will not try to define beauty, any more than I would try to define love or fear. You do not define these things; you know them when you feel them.’⁵

Aesthetics is the study of beauty and, to a lesser extent, its opposite, the ugly. The eighteenth-century German philosopher Alexander Baumgarten (1714–62) established aesthetics as a distinct field of philosophy with the publication of his treatise Aesthetica (c. 1750) (Figure 1.1).⁶ Baumgarten re-coined the term ‘aesthetics’ to mean ‘taste’ or ‘sense’ of beauty, thereby inventing its modern usage; the term ‘aesthetics’ is derived from the Greek word for sensory perception (aisth

tikos). Baumgarten defined aesthetics as ‘the science of sensual cognition’.⁶ In effect, Baumgarten separated the concept of beauty from its ancient link related to ‘goodness’. Baumgarten defined ‘taste’ as the ability to judge according to the senses, instead of according to the intellect; such a judgement of taste is based on feelings of pleasure or displeasure.

Figure 1.1 Alexander Gottlieb Baumgarten established aesthetics as a distinct field of philosophy with the publication of his treatise Aesthetica (c. 1750).

Is Beauty ‘in the Eye of the Beholder’?

‘Look in mine eye-balls, there thy beauty lies.’

William Shakespeare (1564–1616), Venus and Adonis (1593)⁷

A longstanding debate revolves round the question of the subjectivity-objectivity of beauty. Beauty may be considered a mystifying quality that some faces have, or may be ‘in the eye of the beholder’. Does a face, which one person finds ‘beautiful’, appeal to another person in the same way? Is the ‘beauty’ of a face due to some objective quality inherent in the face or is it subjectively determined by each individual with their sensory enjoyment depending on their own ideas, feelings and judgements, which themselves have a direct relation to sensory enjoyment?

The idea that one individual’s aesthetic sensibilities may differ from another’s has a long tradition. Plato (428–348 BC) alluded to this concept in his Symposium, where he described ‘Beholding beauty with the eye of the mind.’⁸ In the third century BC, the Greek poet Theocritus wrote: ‘Beauty is not judged objectively, but according to the beholder’s estimation’ (The Idylls).⁹ Shakespeare (Figure 1.2) reiterated this view in Love’s Labour’s Lost (1595), saying, ‘Beauty is bought by judgement of the eye’.¹⁰ In his Essays, Literary, Moral and Political (1742) the Scottish philosopher David Hume wrote: ‘Beauty, properly speaking, lies … in the sentiment or taste of the reader.’¹¹ In Jane Eyre (1847) Charlotte Brontë wrote: ‘Most true is it that ‘beauty is in the eye of the gazer’.¹² Yet the idea that beauty is according to the observer’s estimation became an adage when the writer Margaret Wolfe Hungerford in Molly Bawn (1878) famously coined the expression: ‘Beauty is in the eye of the beholder.’¹³ In The Prince of India (1893), the novelist Lew Wallace repeated the adage as: ‘Beauty is altogether in the eye of the beholder.’¹⁴

Figure 1.2 William Shakespeare – this copper-engraved image from the title page of the First Folio (1623) was made by the young English engraver Martin Droeshout probably from another drawing or painting now lost; it is the only reasonably authentic portrait of the Great Bard of Avon.

The question to consider is one that remains difficult to answer: Is the origin of the human perception of facial beauty dependent on each individual’s own sense perception, or is this ‘sense’ common to all men and women? The above quotations, and their respective philosophical ideology, assume that the ‘sense’ is subjective to each individual. However, the eighteenth-century philosopher Francis Hutcheson (1694–1746) (Figure 1.3) said:

‘Aesthetic judgements are perceptual and take their authority from a sense that is common to all who make them,’¹⁵

Figure 1.3 Francis Hutcheson.

and he went on to say that

‘The origin of our perceptions of beauty and harmony is justly called a “sense” because it involves no intellectual element, no reflection on principles and causes.’¹⁵

Therefore, if a beautiful face ‘pleases universally’ then some part of our ‘sense’ perception must be common to all men and women. After all, when we describe a face as beautiful, we do not merely mean that it pleases us. We are describing the face, not our judgement. We will often point to features of the face to back up our statement. A paradox therefore emerges. Obviously one cannot make a judgement regarding the beauty of a face one has never encountered. Therefore, facial beauty is related to some quality of the observed face, which may be ‘universally’ accepted. However, each individual’s own ideas and feelings, like a conditioned response, also have a direct relationship to their judgement, hence the difference in the extent of rating a face as beautiful depending on the ‘eye of the beholder’.³

It is important to bear in mind that any theory that cannot be directly and physically tested remains a philosophy, not a science. Therefore, the answer to the objectivity-subjectivity debate of facial beauty remains unanswered. Perhaps beauty as a concept can be perceived but not fully explained. This debate will no doubt continue.

Note

There is a plethora of evidence in the psychology literature which negates the statement that ‘beauty is in the eye of the beholder’ and supports the view that judgements of attractiveness are universal.¹⁶ Yet, most individuals will still admit that judgements of attractiveness differ. There is perhaps an explanation that may have been overlooked: different individuals will find different types of face ‘very attractive’, e.g. one individual may find a certain actor to be extremely beautiful whereas another may find them rather ‘average’. The point is that neither will find the actor ‘deformed’. It is only with faces within normal limits that arguments occur as to the level of attractiveness, and such judgements may often also be affected by factors other than beauty, e.g. the actor’s talent or charisma. In other words, for faces with features that are ‘within normal limits’, beauty may be, to some extent, ‘in the eye of the beholder’. Yet, if a patient with a facial deformity is observed, almost all individuals will agree that the face is deformed and not physically beautiful, i.e. where deformity is concerned, beauty is no longer in the eye of the beholder.

The Enigma of Facial Beauty

Why Is One Face Seen As Beautiful and Another As Unattractive?

What Guides and Validates Our Judgement?

‘Some day, I doubt not, we shall arrive at an understanding of the evolution of the aesthetic faculty; but all the understanding in the world will neither increase nor diminish the force of the intuition that this is beautiful and that is ugly.’ [emphasis added]

Thomas Henry Huxley (1825–95) E...

Table of contents

• Cover
• Half title page
• Prologue
• Title page
• Copyright page
• Dedication
• Dedication
• Preface
• Dedication
• Acknowledgements
• Part I: CONCEPTS
• Part II: CLINICAL DIAGNOSIS
• Index