Perceptions in facial ageing
Reviewed by Bilal Gani Taib

A determinant of a youthful face is based on how facial aesthetic units flow together. Facial ageing results in surface and subsurface structural changes. These factors contribute to the position of bony landmarks, formation of wrinkles and lines and variability of skin pigmentation. These together are deemed the facial aesthetic unit. In this study seven female volunteers between 18 and 57 years old were recruited from a tertiary care plastic and reconstructive surgery clinic. One aesthetic unit was focussed upon the periorbital region. Once all photos were cropped they were then modified to add or remove skin and soft tissue characteristics that separated the aesthetic unit. This yielded seven original and seven modified photographs [three were modified to add facial aesthetic unit separation (Group A) and four were modified to remove these (Group B)]. Then 16 men and eight women between 20 and 91 years old were asked to judge the photographic pairs (A vs B or B vs A). A preference score was calculated based on the proportion of people that chose the more youthful face. The mean preference score for Group A was 0.33 whilst for Group B it was 0.66. Furthermore, when directly comparing a photograph from Group A to Group B participants indicated that Group B was the younger 95% of the time. The results of this investigation support the hypothesis that separation of facial aesthetic units has a direct effect on the perception of facial age.

The aesthetic unit principle of facial ageing.
Tan SL, Brandt MG, Yeung JC, Doyle PC, Moore CC.
JAMA FACIAL PLASTIC SURGERY
2015;17(1):33-8.