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The Asian Eye: Anthropometric Eye Measurements of Attractiveness in Young East Asian Women

BACKGROUND
Due to the high volume of Asian eyelid surgeries performed and the complexity of the Asian eye, there is a need to define exactly what anthropometric measurements determine attractiveness.


METHODS
Eye photographs of young East Asian women were collected from publicly available sources online. Photographs were evaluated on Likert scale of 1-5 for attractiveness. Thirty-seven anthropometric measurements were collected using ImageJ from the most attractive and least attractive eyes to discover which features play the most important role in attractiveness.


RESULTS
A total of 322 right eye photographs were evaluated for attractiveness. Sixty-six eyes received a median score of ≥4.0 and were included in the attractive cohort. Forty-three eyes received a score of ≤ 2.0 and were included in the unattractive cohort. The superior brow peak was more lateralized compared to the upper lid crease and upper lash line peaks in attractive eyes. A greater palpebral aperture height to upper lid show ratio was found to be more associated with attractive eyes than unattractive. At the mid-pupillary line, the ratio was on average 1.58 ± (0.32) in attractive eyes vs 1.22 ± (0.43) in unattractive, p<0.001. Eyes with convergence of the upper lid crease with the upper lash line were more likely to be deemed unattractive (p<0.001).


CONCLUSION
East Asian eyes have specific anthropometric measurements that are more associated with attractiveness. These ideal measurements are different from those in Caucasians suggesting ethnic variability in features defining attractiveness and a need to tailor surgical care appropriately.


METHODS:
A cadaver dissection was performed to revise the local anatomy and the viability of this kind of dissection. The surgery was conducted in steps: Step 1-The nippleareola complex (NAC) was marked, and the Schwartzman maneuver was done. The breast tissue was incised medially and laterally until the pectoralis fascia; Step 2-Breast tissue was incised beginning 5 cm below the inferior part of the NAC to create the superior pedicle. Glandular resection is done centrally in an amount sufficient to make the NAC free to ascend and for an adequate implant accommodation, leaving a thin superior based dermoglandular flap; Step 3-Pectoralis muscle was dissected inferiorly, until the inframammary fold, as a "shirt pocket." The superior margin of the pocket was sutured to the breast tissue at the level of the inferior projection of the NAC.
Step 4-The NAC was placed on its new position and the extremities of the superiorly based dermoglandular flap were inferiorly and deeply sutured to the inframammary fold as an additional cover; Step 5-Superior corners of the skin flaps were closed, and the inferior edges of these flaps were sutured in the inframammary fold, overlapping the dermoglandular flap.

RESULTS:
The technique was performed on four patients, as described above. In two of them, the procedures done were secondary to a previous augmentation mammaplasty, and in the other two, the procedure done was primary surgery. The mean follow-up period was 15 months. There were no complications related to the anesthetic or surgical procedure during the postoperative period.

CONCLUSIONS:
The anatomic review showed that the "shirt pocket" is safe. The technique was shown to be feasible and seems to be effective as being another alternative to perform augmentation mammaplasty.

RESULTS:
A set of 322 young Asian eye photographs were evaluated for attractiveness. Eyes that received a majority rating of 3 4 from 10 evaluators were designated as attractive, while those £ 2 as unattractive. These thresholds were set to find only the most significant differences between the attractive and unattractive cohorts. A total of 66 attractive eyes and 43 unattractive eyes were compared. The angle of the superior brow peak was more lateral than that of the upper lid crease peak and upper lash line peak from the pupil center in attractive eyes [65.38 ± (7.76)], compared with unattractive eyes [72.08 ± (9.98)] (P < 0.001). The upper lid crease and upper lash line peaks were approximately 8-9 degrees more medial than the superior brow peak in attractive eyes compared with ~6 degrees lateral in unattractive eyes (P = 0.01). The upper lid show at the punctum, medial limbus, mid-pupillary line, lateral limbus, and lateral canthus were all significantly smaller in attractive eyes. When comparing the ratios of the aperture heights to upper lid show along the punctum, medial limbus, midpupillary line, and lateral limbus, attractive eyes had greater ratios than unattractive eyes. For example, at the mid-pupillary line, the palpebral height to upper lid show ratio was ~3:2 for attractive eyes compared with ~1:1 for unattractive eyes, P ≤ 0.001.

CONCLUSIONS:
In young Asian eyes, a lateralized superior brow peak position to the peak points of the upper lid and upper lash line is more attractive. Furthermore, in Asian eyes, the ratio of palpebral heights to upper lid show seems to be more important than the ratio of upper lid to pretarsal show. An understanding of these proportions can help guide double-eyelid surgery, brow lifts, and filler injections.

PURPOSE:
The objective of this study was to understand which anthropometric measurements and angles determine attractiveness in young black female eyes to help guide surgical technique.

METHODS:
Frontal facial photographs of young black women were collected from publicly available sources. Photographs with excessive makeup distorting anatomy, non-neutral expressions, ptosis, or a negative intercanthal tilt were excluded. The periorbital region of each eye was cropped, and all left eyes were reflected about a vertical axis to gather a collection of only right eye images. These images were evaluated by eight people of varying ethnicities, age, and occupation, on a likert scale of 1-5 to determine attractiveness. Images were subsequently standardized by iris diameter and analyzed using ImageJ software. Thirty-seven measurements relating various eye anatomy were collected from each attractive and unattractive eye.

RESULTS:
A total of 318 images were rated by eight evaluators. Eyes with an average rating of ≥4.0 were included in the attractive cohort, while those ≤2.0 were included in the unattractive. These thresholds were set to find only the most significant differences between the attractive and unattractive cohorts. Fifty-five attractive and 48 unattractive eyes were compared. Attractive eyes had greater intercanthal angles (9.12 degrees ± (2.77) versus 6.71 degrees ± (3.09), P < 0.001) and intercanthal heights (4.42 mm ± (1.39) versus 3.27 mm ± (1.61), P < 0.001), but lower endocanthion angles (42.8 mm ± (10.09) versus 50.49 mm ± (14.03), P = 0.002) compared with unattractive eyes. The superior brow, upper lid crease, and upper lash line peaks were more lateralized in attractive eyes when compared with unattractive. The upper lid fold show, pretarsal show, and palpebral aperture heights at the punctum, medial limbus, mid-pupillary line, lateral limbus, and lateral canthus trended to be lower in attractive versus unattractive eyes.

CONCLUSIONS:
In black young women, a lateralized superior brow peak, upper lid crease peak, and upper lash line peak coincide with attractiveness. Procedures such as brow lifts, filler injections, or upper blepharoplasties can be utilized to achieve these angles. Smaller endocanthion and larger intercanthal angles are also seen in attractive eyes. Lateral canthopexies may help lengthen the intercanthal height and angle. Although greater palpebral aperture heights are commonly associated with more attractive eyes in Whites and Asians, this may not hold true in young black female eyes. Rather the distances of the upper lid show, pretarsal show, and palpebral aperture heights all tend to be less in attractive eyes. This suggests that there may be racial and ethnic differences in what constitutes attractiveness. Aesthetic surgery should therefore take into account these differences and tailor the surgical approach accordingly.