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The Orbital Oval Balance Principle: A Morphometric Clinical Analysis

Gülbitti, Haydar A. M.D.; Bouman, Theo K. Ph.D.; Marten, Timothy J. M.D.; van der Lei, Berend M.D., Ph.D.

Plastic and Reconstructive Surgery: October 2018 - Volume 142 - Issue 4 - p 451e-461e
doi: 10.1097/PRS.0000000000004805
Cosmetic: Original Articles

Background: The aim of this study was to test the validity of the “orbital oval balance principle,” a system of analysis and guideline that is used among aestheticians, artists, and makeup artists to create and design aesthetically pleasing eyebrows for optimal upper facial appearance. According to this principle, a face is optimally attractive when the eye is centered in an “oval” defined by the lid-cheek junction and the eyebrow.

Methods: One hundred participants were asked to rank digital morphed images of four female models with four different periorbital proportions: higher or lower lid-cheek junction versus higher or lower eyebrow position. In addition, the participants were asked to quantify seven emotions on these morphed images.

Results: A higher lid-cheek junction was rated as significantly more attractive with a lower eyebrow position, and a lower lid-cheek junction was regarded far more attractive in combination with a higher eyebrow position. Moreover, a higher lid-cheek junction was rated as more attractive than a lower lid-cheek junction, and elevation of the lid-cheek junction improved the perception of emotions such as tiredness and sadness.

Conclusions: This study lends support to the orbital oval balance principle that can provide important insight into facial attractiveness to surgeons undertaking procedures intended to improve and rejuvenate facial appearance. Moreover, this study has also shown not only that a high(er) lid-cheek junction is regarded as more youthful and attractive, but that it also may reduce the appearance of tiredness and sadness.

Groningen, Zwolle, and Heerenveen, The Netherlands; and San Francisco, Calif.

From the Department of Plastic Surgery, University and University Medical Centre of Groningen; the Department of Clinical Psychology, University of Groningen; Bergman Clinics; and Marten Clinic & Plastic Surgery, San Francisco, Calif.

Received for publication August 4, 2017; accepted April 10, 2018.

Disclosure:The authors have no financial interest to declare in relation to the content of this article. No funding was received.

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Berend van der Lei, M.D., Ph.D., Department of Plastic Surgery, University and University Medical School of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands,

Copyright © 2018 by the American Society of Plastic Surgeons