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OBJECTIVE: Fetal face measurements in prenatal ultrasound can aid in identifying craniofacial abnormalities in the developing fetus. However, the accuracy and reliability of ultrasound measurements can be affected by factors such as fetal position, image quality, and the sonographer's expertise. This study assesses the accuracy and reliability of fetal facial measurements in prenatal ultrasound. Additionally, the temporal evolution of measurements is studied, comparing prenatal and postnatal measurements. METHODS: Three different experts located up to 23 facial landmarks in 49 prenatal 3D ultrasound scans from normal Caucasian fetuses at weeks 20, 26, and 35 of gestation. Intra- and inter-observer variability was obtained. Postnatal facial measurements were also obtained at 15 days and 1 month postpartum. RESULTS: Most facial landmarks exhibited low errors, with overall intra- and inter-observer errors of 1.01 mm and 1.60 mm, respectively. Landmarks on the nose were found to be the most reliable, while the most challenging ones were those located on the ears and eyes. Overall, scans obtained at 26 weeks of gestation presented the best trade-off between observer variability and landmark visibility. The temporal evolution of the measurements revealed that the lower face area had the highest rate of growth throughout the latest stages of pregnancy. CONCLUSIONS: Craniofacial landmarks can be evaluated using 3D fetal ultrasound, especially those located on the nose, mouth, and chin. Despite its limitations, this study provides valuable insights into prenatal and postnatal biometric changes over time, which could aid in developing predictive models for postnatal measurements based on prenatal data.

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Background: The utilization of three-dimensional (3D) surface imaging for facial anthropometry is a significant asset for patients undergoing maxillofacial surgery. Notably, there have been recent advancements in smartphone technology that enable 3D surface imaging.In this study, anthropometric assessments of the face were performed using a smartphone and a sophisticated 3D surface imaging system. Methods: 30 healthy volunteers (15 females and 15 males) were included in the study. An iPhone 14 Pro (Apple Inc., USA) using the application 3D Scanner App (Laan Consulting Corp., USA) and the Vectra M5 (Canfield Scientific, USA) were employed to create 3D surface models. For each participant, 19 anthropometric measurements were conducted on the 3D surface models. Subsequently, the anthropometric measurements generated by the two approaches were compared. The statistical techniques employed included the paired t-test, paired Wilcoxon signed-rank test, Bland-Altman analysis, and calculation of the intraclass correlation coefficient (ICC). Results: All measurements showed excellent agreement between smartphone-based and Vectra M5-based measurements (ICC between 0.85 and 0.97). Statistical analysis revealed no statistically significant differences in the central tendencies for 17 of the 19 linear measurements. Despite the excellent agreement found, Bland-Altman analysis revealed that the 95% limits of agreement between the two methods exceeded ±3 mm for the majority of measurements. Conclusion: Digital facial anthropometry using smartphones can serve as a valuable supplementary tool for surgeons, enhancing their communication with patients. However, the proposed data suggest that digital facial anthropometry using smartphones may not yet be suitable for certain diagnostic purposes that require high accuracy.

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Three-dimensional (3D) body scanning technology has applications for obtaining anthropometric data in human-centered and product development fields. The reliability of 3D measurements gathered from 3D scans must be assessed to understand the degree to which this technology is appropriate for use in place of manual anthropometric methods. The intra- and inter-rater reliabilities of 3D facial measurements were assessed among four novice raters using 3D landmarking. Intraclass correlation coefficient (ICC) statistics were calculated for the 3D measurement data collected in three phases to assess baseline reliabilities and improvements in reliabilities as the result of additional training and experience. Based on the results of this study, the researchers found that the collection of 3D measurement data, by multiple raters and using 3D landmarking methods, yielded a high percentage of ICC statistics in the good to excellent (>0.75 ICC) reliability range. Rater training and experience were important considerations in improving intra- and inter-rater reliabilities.

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Purpose: To identify the facial anthropometric parameters that predict the difficulty during femtosecond (FS) laser. Methods: This was a: single-center observational study was conducted on participants between the ages 18 and 30 years who were planned for FS-LASIK (femtosecond laser-assisted laser in situ keratomileusis) or SMILE (small incision lenticule extraction) at Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India. The front and side-facing images of the participants were analyzed using Image J software to measure different anthropometric parameters. The nasal bridge index, facial convexity, and other parameters were measured. The difficulty faced by the surgeon during docking was recorded for each subject. The data were analyzed on Stata 14. Results: A total of 97 subjects were included. The mean age was 24 (±7) years. Twenty-three (23.71%) subjects were females while the rest were males. Difficulty in docking was seen in 1 (4.34%) female and 14 (19%) males. The mean nasal bridge index was 92.58 (±4.01) in subjects with deep-set eyes and 89.72 (±4.30) in normal subjects. The mean total facial convexity was 129.28 (±4.24) in deep-set eyes, and 140.23 (±4.74) in normal subjects. Conclusion: Total facial convexity appeared as the most important feature, with the value being less than 133° in most subjects with unfavorable facial anthropometry.

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The diagnosis of aging based on the morphogeometric changes experienced by the face, measured by the application of facial stratigraphic semiology by thirds, could become a novel approach that guarantees an efficient replacement of aged tissues through minimally invasive aesthetic medicine strategies. Facial aging should be analyzed by thirds, because not all thirds grow old at the same time. Owing to this is necessary go giving solve the aging problems each one of them, by means of therapies of the facial restructuring into sequential treatment appointments, with the purpose of being go giving time to the tissues rearrangement of the face, so that it is perceived as a subtle progressive reversal of aging and so generate a comfortable social acceptance of the resulting changes of said facial rejuvenation. This article intends to present the practical approach of the concepts and guidelines illustrated in the routine aesthetic diagnosis, the anatomical changes in the various tissue layers that are externally appreciated, but detailing them under a regional approach (upper, middle, and lower thirds). Our paradigm seeks that as professionals of aesthetic and regenerative medicine we identify facial aging not only as the obvious wrinkles and other changes in the skin, but that we diagnose according to the proposed parameters, so that when considering the rejuvenation treatment, we identify which are facial tissues that have changed due to aging and must therefore be restored to harmonize the face according to the ideal forms and proportions that must prevail (morphometry).

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Background: Facial anthropometric measurements in relation to self-esteem and self-perception have become a very popular topic, not only in anthropological and psychological research, but also in plastic reconstructive surgery.Aim: To compare the interrelations between facial perception, self-esteem and psychosocial well-being in patients after nasal surgery due to trauma, cancer and aesthetic needs.Subjects and methods: In total, ninety patients after nasal surgery (due to trauma, cancer and aesthetic reasons), and thirty control persons underwent facial anthropometry and answered questions related to facial perception (FP), self-esteem (SE) and psychosocial well-being (PW). Cluster analysis was performed.Results: Facial measurements were not related to the perception of the whole face in all investigated persons. The whole face and nasal perception were interrelated in the majority of male groups and in the control female group. SE in females from the control and cancer groups was not related to real facial parameters or FP, however, in females after aesthetic surgery it was related to nasal tip protrusion. SE in females after nasal surgery due to trauma was strongly related to FP. SE in almost all groups of males was related to real facial parameters, and in males after aesthetic surgery it was related to FP. PW was mostly linked to SE in males and females after aesthetic surgery, in other groups it was related to FP.Conclusions: FP was most frequently not related to real facial measurements; however, it was related to PW. Patients after aesthetic nasal surgery had specific relations between FP, SE and PW.

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BACKGROUND: Stature or body height is one of the most important and useful anthropometric parameters which determines the physical identity of an individual. As craniofacial structures have the advantage of being composed largely of hard tissue which is relatively indestructible, the careful study of these can enable reliable determination of stature of the person in life. Studies pertaining to stature estimation from facial measurements are limited in an Indian population. The present investigation attempts to estimate stature from anthropometric dimensions of face. MATERIALS AND METHODS: The material for the present study comprises 361 Indian students (151 males and 210 females) in the age range of 21-45 years. Stature and six facial measurements were taken on each participant following standard methods and techniques. Karl Pearson's correlation coefficient and linear regression were done to estimate stature. RESULTS: The results indicate that facial measurements are strongly and positively correlated (P < 0.001) with stature. The accuracy of the computed equations was further tested on 50 randomly selected study participants of each group, which shows close approximation of actual and estimated stature. CONCLUSION: Within the limits of this study, we conclude that facial dimensions can be used as a supplementary approach for the estimation of stature but with caution, as these are population-specific approach.

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RESUMEN: Introducción: Antropometría facial es la medición de distancias del rostro. Un método indirecto es a través de fotografías estandarizadas, conocido como fotogrametría. Este trabajo busca estandarizar una técnica fotográfica y estudiar la fiabilidad de la fotogrametría facial, comparando mediciones antropométricas directas y fotogramétricas con tres objetivos fotográficos distintos. Objetivo: Estandarizar parámetros de la cámara fotográfica y encuadre de la imagen para fotogrametría facial. Materiales y métodos: A una muestra de 50 sujetos se les midieron directa e indirectamente seis distancias faciales. Para las fotografías se utilizaron objetivos fotográficos fijos de 35mm, 50mm y 100mm. Se tomaron seis fotografías a cada uno de los voluntarios; tres de frente y tres de perfil, una con cada lente. La distancia entre la cámara y el sujeto fue variable, siempre con un encuadre de 30cm. Se compararon las diferencias estadísticamente. Resultados: Con el lente de 100mm fue el único con el que todas las distancias medidas en fotografías fueron iguales y sin diferencia estadística respecto a las medidas obtenidas directamente. Conclusión: De los tres objetivos fotográficos utilizados uno de 100mm es el que permite la fotografía más fiel a la realidad, con una diferencia promedio de 0,5mm con las medidas directas.

ABSTRACT: Introduction: Facial anthropometry is the measurement of distances of the face. It can be performed directly in the subject present or indirectly. Among the indirect methods is photogrammetry: measuring facial distances in photographs. In order to perform the facial photographic registration, a standardized photographic technique is required, that is, the parameters of the camera, the photographic set and the parameters of the subject must be previously established. This work aims to standardize a photographic technique and to study the reliability of facial photogrammetry, comparing direct anthropometric measurements and photogrammetry with three different photographic lenses, in order to determine which one has the highest fidelity. Objective: To standardize camera parameters and image framing for facial photogrammetry. Materials and Methods: Six facial distances were measured directly and indirectly on a sample of 50 subjects. The indirect measurements were taken on photographs of the subjects using fixed photographic lenses of 35mm, 50mm and 100mm. Six photographs were taken from each volunteer; three of front and three of profile, one with each lens. The distances between the camera and the subjects was variable, so that the image frame was always 30 cm. The differences were statistically compared. Results: With a 35mm lens, only one of the six distances measured in photographs was equal to the measurement obtained directly. With a 50mm lens, three of the six distances obtained were equal to the direct measurements. With a 100mm lens, all distances measured in photographs were equal and without statistical difference in relation to the measurements obtained directly. Conclusion: Of the three photographic lenses, the 100mm lens is the one that allows the photograph more faithful to the reality, where the photogrammetric measures of the face have a difference of 0,5mm or less with the direct measurements.

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RESUMEN: Objetivo: El objetivo de este estudio fue determinar si existe equivalencia entre las medidas faciales obtenidas mediante antropometría facial directa y antropometría facial indirecta utilizando sistema de imagen digital en tres dimensiones en adultos jóvenes. Materiales y métodos: Estudio transversal descriptivo. La muestra consistió en 81 voluntarios (19-29 años). A cada uno se le realizó mediciones de 6 distancias faciales con el método antropométrico directo y 5 distancias faciales con el método fotogramétrico 3D. Se utilizaron los programas Excel 2013 y Stata14®. Se aplicó el test de Shapiro-Wilk, para establecer el tipo de distribución de los datos. Para los que presentaron distribución normal se aplicó t-Test; para aquellos con distribución no normal, se aplicó test de Mann-Whitney. Se comparó las mediciones obtenidas con ambos métodos. Resultados: Se compararon las 5 distancias faciales medidas con el método antropométrico directo con las 5 registradas mediante fotogrametría 3D y se determinó que no existe diferencia estadísticamente significativa entre los métodos utilizados. Hubo una medición que no pudo ser registrada con el método fotogramétrico 3D. Conclusión: La antropometría facial indirecta medida en imágenes 3D, entrega mediciones equivalentes a la antropometría facial directa.

ABSTRACT: Objective: The aim of this study was to determine if there is equivalence between facial measurements obtained through direct facial anthropometry and indirect facial anthropometry using a three-dimensional digital imaging system in young adults. Materials and methods: Descriptive cross-sectional study. The sample consisted of 81 volunteers (19-29 years). Each was measured with 6 facial distances with the direct anthropometric method and 5 facial distances with the 3D photogrammetric method. The programs Excel 2013 and Stata14® were used. The Shapiro-Wilk test was applied to establish the type of distribution of the data. For those with normal distribution, t-Test was applied; for those with non-normal distribution, a Mann-Whitney test was applied. The measurements obtained with both methods were compared. Results: We compared the 5 facial distances measured with the direct anthropometric method with the 5 recorded by 3D photogrammetry and it was determined that there is no statistically significant difference between the methods used. There was a measurement that could not be recorded with the 3D photogrammetric method. Conclusion: The indirect facial anthropometry measured in 3D images, provides measurements equivalent to direct facial anthropometry.

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OBJECTIVE: Craniometry is a subset of anthropometry, which measures the anatomical sizes of the head and face (craniofacial indicators). These dimensions are used in designing devices applied in the facial area, including respirators. This study was conducted to measure craniofacial dimensions of Iranian male workers required for face protective equipment design. METHODS: In this study, facial anthropometric dimensions of 50 randomly selected Iranian male workers were measured by photographic method and Digimizer version 4.1.1.0. Ten facial dimensions were extracted from photographs and measured by Digimizer version 4.1.1.0. Mean, standard deviation and 5th, 50th and 95th percentiles for each dimension were determined and the relevant data bank was established. RESULTS: The anthropometric data bank for the 10 dimensions required for respirator design was provided for the target group with photo-anthropometric methods. The results showed that Iranian face dimensions were different from those of other nations and ethnicities. CONCLUSIONS: In this pilot study, anthropometric dimensions required for half-mask respirator design for Iranian male workers were measured by Digimizer version 4.1.1.0. The obtained anthropometric tables could be useful for the design of personal face protective equipment.

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Fetal alcohol spectrum disorders (FASD) comprise a range of physical differences and neurologic deficits from prenatal alcohol exposure. Previous studies suggest that relative maxillary growth deficiency can accompany FASD. Using the Fetal Alcohol Syndrome Epidemiologic Research (FASER) database, we investigated how maxillary and mandibular arcs and the ratio between them differ between FASD and non-FASD individuals. First, we established normative values for maxillary and mandibular arcs and maxillary-to-mandibular arc ratio. In our control group (545 males, 436 females), mean maxillary and mandibular arcs for males/females were 24.98/24.52 cm and 25.91/25.35 cm, respectively. The ratio was 0.9643 and 0.9676 for males and females, respectively. We then evaluated the effect of microcephaly, short stature, and low weight (<10th centile), individually on arcs in controls. Generally, arcs were reduced significantly but the ratio did not differ. We compared our controls to 138 male and 135 female FASD cases. We noted a significant difference in arcs in male and female groups, but not the ratio. We compared non-FAS controls with reduced growth parameters to similar cases with FASD. We did not find a significant difference in arc or ratio measurements. Therefore, we conclude the effect of prenatal alcohol exposure on maxillary and mandibular arc measurements is primarily on overall facial growth and less on asymmetric growth of the maxilla relative to the mandible, at least using this technique. © 2016 Wiley Periodicals, Inc.

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OBJECTIVE: Rhinoplasty is a constant challenge for the surgeon, where the correct evaluation of facial aesthetic parameters allows harmonic changes appropriate for each patient. The aim of this study was to compare the preoperative and postoperative results of nasofacial analysis, performed by Rhinobase® software (indirect anthropometry) compared with direct anthropometry (caliper), in patients undergoing aesthetic rhinoplasty. METHODS: The authors assessed the reliability of using Rhinobase® software for measuring nasofacial characteristics in 20 individuals (18 F, 2 M). In each patient, the nasofacial analysis was performed before and after surgery. Two raters performed indirect anthropometry on each image on two separate occasions. RESULTS: Intrarater and interrater reliability for most indirect anthropometric measurements had intraclass correlation coefficients greater than 0.8. Regarding intermethod reliability, Pearson correlation coefficients ranged from 0.6 to 0.9 for most measurements. The highest correlation was found in interalar width, chin vertical, and lower facial height. The Cronbach's α coefficient calculated for all measurements was 0.8. CONCLUSIONS: The Rhinobase® software is an easy and safe method for facial analysis. This study provides evidence of high reliability for several nasofacial measurements. The nasofacial analysis allows an accurate preoperative evaluation, surgical planning, and analysis of outcomes in rhinoplasty and may be a useful tool for both novice and experienced surgeons. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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INTRODUCTION: Facial clefts involve complex abnormalities. The therapy is elaborate, and a critical evaluation of therapeutic outcome is required. Our study analyzed the lip and nose deformities associated with unilateral clefts in a prospective longitudinal study. MATERIAL AND METHODS: A total of 33 patients with a cleft lip or cleft lip and alveolus (UCL) and 46 with a cleft lip and palate (UCLP) were treated using a similar concept. Standardized photographs were taken preoperatively (age 0.4-0.52 years) and again aged 4.04-4.59 years. Anthropometric analyses were performed and compared with age-matched normal values. RESULTS: Nostril width (UCL = 1.01, UCLP = 1.03) and nostril floor width (UCL = 1.02, UCLP = 1.04) were almost symmetric. Nasal tip angles were normalized by surgery. Upper labial height improved, but remained slightly reduced (-4% to -6%). Upper vermillion length was increased (15-17%), and vermillion width was reduced (-12% to -13%) postoperatively. A significantly flatter nostril axis inclination persisted, especially on the affected side (UCL: 37.5°; UCLP: 38.5°), when compared with normal values (53.8°). CONCLUSION: Most cleft irregularities were almost eliminated by therapy; however, the outcome is still not satisfactory for some parameters. The rehabilitation of patients with clefts remains a considerable surgical challenge. Facial anthropometric assessment must play an important role in order to detect and overcome therapeutic shortcomings.

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La estética y armonía facial se relacionan de forma directa con la percepción y autoestima de los individuos; muchas veces se generan deseos de cambios estéticos por medio de cirugías para obtener una valoración positiva de sí mismo. El objetivo de este estudio fue investigar la relación entre la percepción, autoestima y deseo de cambio estético; y puntos antropométricos, cefalométricos y maloclusiones de un grupo de mujeres. Se escogieron 29 mujeres chilenas, entre 20 y 25 años de edad, en las cuales se realizó una encuesta sobre la autoestima, autopercepción de normalidad facial, deseo de cambio estético y cambio de autoestima posterior a una cirugía, éstas se asociaron a través de un análisis de chi2, regresión logística de multivariado y ANOVA, con las distancias entre puntoantropométricos objetivos basados en estudios de Farkas y entre puntos cefalométricos basados en Epker y Fish; y entre ellas a través de un análisis. La normalidad facial se ve afectada principalmente por clases caninas derecha (p=0,02) e izquierda (p=0,015) y molares derecha (p=0,015) e izquierda (p=0,04); y además el apiñamiento dentario (p=0,012). Mientras el aumento en la distancia de exocantios (p=0,04), bases alares (p=0,03), proporción glabela subnasal y subnasal mentón (p=0,02) se asocian a una percepción de anormalidad. La autoestima puede variar de forma positiva posterior a un cambio estético, a través de cirugía o tratamiento de ortodoncia. Los parámetros dentomaxilares y craneofaciales son determinantes en la percepción de normalidad estética de estas mujeres, siendo los relacionados con nariz y altura facial los de mayor influencia en este estudio. Son necesarios futuros estudios para evaluar autoestima, autopercepción de normalidad facial y proporciones estéticas.

Aesthetics and facial harmony are directly related to self-esteem and perception individuals have of themselves. There is often a desire to make overall aesthetic changes through surgery in order to get a positive assessment of oneself. The aim of this study was to research the relationship between perception, self-esteem and desire for change; and points aesthetic anthropometric and cephalometric points, as well as malocclusions in a group of women. Twenty nine (29)Chilean women between 20 and 25 years of age were chosen, taking part in a survey on self-esteem, self-perception of facial normalcy, the desire for aesthetic change, and changes of self-esteem following surgery. These were subsequently associated through Chi2 analysis, logistic multi variant regression and ANOVA, with distances between objective anthropometric marks based on Farkas research, and between cephalometric points based in Epker and Fish study. Facial normalcy seems mainly affected by right canine class (p=0.02), and left (p=0.015); right molar class (p=0.015) and left (p=0.04), as well as dental crowding (p=0.012). While greater exocanthion distance (p=0.04), alar base (p=0.03), subnasal glabella and subnasal menton ratios (p=0.02), are related to a perception of abnormality. Self esteem perception can vary in positive ways following an aesthetic change through surgery or orthodontic treatment. Dental, maxillary and craniofacial parameters are determinants of the aesthetic normalcy perception of these women, with nose and facial height having the most influence in this study. Further research is necessary to evaluate self- esteem and self perception of facial normalcy, as well as aesthetic ratios.

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