Introduction: Facial Analysis – Why, When, and How . . . . . . . . . . . xv
1 Approaching the Patient for Direct and Photographic
Facial Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1 The Single Room Concept . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1.1 The Interview Area. . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1.2 The Clinical Examination Area . . . . . . . . . . . . . . . . 2
1.1.3 The Clinical Photography Area . . . . . . . . . . . . . . . . 3
1.2 The First Consultation Approach . . . . . . . . . . . . . . . . . . . . . . 3
1.2.1 The First Ten Minutes . . . . . . . . . . . . . . . . . . . . . . . 3
1.2.2 The Entrance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
1.2.3 The Interview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
1.2.4 The Direct Clinical Examination . . . . . . . . . . . . . . . 6
1.2.5 The Clinical Photographic Documentation . . . . . . . 6
1.2.6 Final Communications and Remarks . . . . . . . . . . . . 6
1.3 The Time Spent in Organizing the Next Consultation . . . . . . 6
1.4 The Second (and Successive) Consultation Approach . . . . . 7
1.5 How to Enhance Patient/Physician Communication . . . . . . . 7
1.6 The Single Operator Concept . . . . . . . . . . . . . . . . . . . . . . . . . 8
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2 Lighting Techniques for Clinical Facial Photography . . . . . . . . 9
2.1 Lighting Techniques for Clinical Facial Photography . . . . . . 9
2.2 Equipment and Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
2.3 Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.3.1 Point, Line, and Plane . . . . . . . . . . . . . . . . . . . . . . . 13
2.3.2 A “Natural” Option . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.3.3 Problems with Two or More Lights . . . . . . . . . . . . . 13
2.3.4 Avoid a False Asymmetric Face . . . . . . . . . . . . . . . . 14
2.3.5 The Importance of Soft Box Size . . . . . . . . . . . . . . . 14
2.3.6 Avoid Shadows on the Background Panel . . . . . . . . 14
2.3.7 Advantages of Ceiling-Mounted Equipment . . . . . . 14
2.4 The Seven Rules of Multiple Shots . . . . . . . . . . . . . . . . . . . . 15
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
viii Contents
3 Views of Clinical Facial Photography . . . . . . . . . . . . . . . . . . . . . 17
3.1 Natural Head Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
3.2 How to Obtain Life-Size Photographs . . . . . . . . . . . . . . . . . . 18
3.3 The Poster “Views of Clinical Facial Photography” . . . . . . . 18
3.4 The Shooting of a Complete Set of Clinical
Facial Photographs (Step-by-Step Description) . . . . . . . . . . . 19
3.4.1 Accompanying the Patient in the Photo Area . . . . . 19
3.4.2 The Eleven Basic Views . . . . . . . . . . . . . . . . . . . . . . 19
3.4.3 The Five Nasal Views . . . . . . . . . . . . . . . . . . . . . . . . 21
3.4.4 The Five Orthognathic/Orthodontic Views . . . . . . . 24
3.4.5 The Seven Eye Views . . . . . . . . . . . . . . . . . . . . . . . . 25
3.4.6 The Four Ear Views . . . . . . . . . . . . . . . . . . . . . . . . . 25
3.5 Final Remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
4 The “Facial Points of Interest” . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
4.1 Eye Movements and Visual Perception . . . . . . . . . . . . . . . . . 29
4.2 From the Regions of Interest
to the Facial Points of Interest . . . . . . . . . . . . . . . . . . . . . . . . 30
4.3 A Different – Visual – Approach
to Facial Deformities and Aging . . . . . . . . . . . . . . . . . . . . . . 32
4.4 Adding Lines to the Facial Points of Interest . . . . . . . . . . . . . 33
4.5 Illusion in Clinical Facial Analysis . . . . . . . . . . . . . . . . . . . . 37
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
5 Basic Facial Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
5.1 Regions of the Face and Neck . . . . . . . . . . . . . . . . . . . . . . . . 41
5.2 Basic Qualitative Facial Analysis (Without Measurements) . 42
5.2.1 Frontal View Analysis . . . . . . . . . . . . . . . . . . . . . . . 42
5.2.2 Basal View Analysis. . . . . . . . . . . . . . . . . . . . . . . . . 43
5.2.3 Oblique Views Analysis . . . . . . . . . . . . . . . . . . . . . . 43
5.2.4 Profi le View Analysis . . . . . . . . . . . . . . . . . . . . . . . . 47
5.3 The Facial Angles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
5.4 The Supporting Skeleton Assessment . . . . . . . . . . . . . . . . . . 48
5.5 Facial Soft Tissue Envelope
Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
5.6 Facial Soft Tissue Analysis Checklist . . . . . . . . . . . . . . . . . . 51
5.7 The Overweight Patient, Facial Analysis,
and Surgical Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
5.8 From Specifi c to General: A Reversed
Approach to Basic Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . 54
5.9 Basic Analysis: Preferred Terms . . . . . . . . . . . . . . . . . . . . . . 55
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
6 Forehead, Eyebrows, and Eyes . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
6.1 Forehead Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
6.2 Eyebrow, Eye, and Lids Analysis . . . . . . . . . . . . . . . . . . . . . 60
6.2.1 The Female Attractive Eye . . . . . . . . . . . . . . . . . . . . 62
Contents ix
6.3 Upper Lid Crease Malposition . . . . . . . . . . . . . . . . . . . . . . . . 63
6.4 A Closer Look at the Upper Lateral Orbital Quadrant . . . . . 64
6.5 Eyebrow Malposition and Inappropriate Expressions . . . . . . 64
6.6 Suspect and Search for the Early Signs
of Aging in the Upper Third of the Face . . . . . . . . . . . . . . . . 67
6.7 Forehead, Eyebrows, and Eyes Analysis Checklist . . . . . . . . 67
6.8 Forehead, Eyebrows, and Eyes:
Preferred Terms Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
7 Nasal Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
7.1 Points, Lines, and Subunits of the External Nose . . . . . . . . . 73
7.2 Direct and Photographic Clinical Analysis
for Nasal Deformities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
7.2.1 General Considerations . . . . . . . . . . . . . . . . . . . . . . 75
7.2.2 Nasal Upper Third Assessment . . . . . . . . . . . . . . . . 83
7.2.3 Nasal Middle Third Assessment . . . . . . . . . . . . . . . 83
7.2.4 Nasal Lower Third Assessment . . . . . . . . . . . . . . . . 88
7.3 The Close Relationship Between
the Nose and the Upper Lip . . . . . . . . . . . . . . . . . . . . . . . . . . 92
7.4 Nasal Analysis Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
7.4.1 Nasal Analysis Checklist:
General Considerations . . . . . . . . . . . . . . . . . . . . . . 92
7.4.2 Nasal Analysis Checklist:
Upper Third of the Nose . . . . . . . . . . . . . . . . . . . . . 96
7.4.3 Nasal Analysis Checklist:
Middle Third of the Nose . . . . . . . . . . . . . . . . . . . . . 96
7.4.4 Nasal Analysis Checklist:
Lower Third of the Nose . . . . . . . . . . . . . . . . . . . . . 100
7.5 The Nasal Analysis Sheets . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
7.6 Cephalometric Nasal Analysis . . . . . . . . . . . . . . . . . . . . . . . . 101
7.6.1 The Method of Byrd and Hobar . . . . . . . . . . . . . . . . 101
7.7 Nasal Airway Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
7.8 Nasal Analysis: Preferred Terms . . . . . . . . . . . . . . . . . . . . . . 104
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
8 Lips, Teeth, Chin, and Smile Analysis . . . . . . . . . . . . . . . . . . . . . 107
8.1 Dental Occlusion: Basic Assessment . . . . . . . . . . . . . . . . . . . 107
8.2 Upper Frontal Teeth Assessment . . . . . . . . . . . . . . . . . . . . . . 110
8.3 Lips Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
8.3.1 The Attractive Female Lips . . . . . . . . . . . . . . . . . . . 111
8.4 Smile Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
8.4.1 The Attractive Female Smile . . . . . . . . . . . . . . . . . . 117
8.4.2 The “No-Smile Patient” . . . . . . . . . . . . . . . . . . . . . . 117
8.5 Chin Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
8.6 Lips, Teeth, Chin, and Smile Analysis Checklists . . . . . . . . . 119
8.6.1 Dental Occlusion Analysis Checklist . . . . . . . . . . . . 119
8.6.2 Upper Frontal Teeth Analysis Checklist . . . . . . . . . 121
x Contents
8.6.3 Lips Analysis Checklist . . . . . . . . . . . . . . . . . . . . . . 121
8.6.4 Posed Smile Analysis Checklist . . . . . . . . . . . . . . . . 122
8.6.5 Chin Analysis Checklist . . . . . . . . . . . . . . . . . . . . . . 122
8.7 Lips, Teeth, Chin, and Smile Analysis:
Preferred Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
9 Dentofacial Deformities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
9.1 The Basic Components of Dentofacial Deformities . . . . . . . 125
9.1.1 Anterior Vertical Excess . . . . . . . . . . . . . . . . . . . . . . 126
9.1.2 Anterior Vertical Defi ciency . . . . . . . . . . . . . . . . . . 126
9.1.3 Class III Sagittal Discrepancy . . . . . . . . . . . . . . . . . 129
9.1.4 Class II Sagittal Discrepancy . . . . . . . . . . . . . . . . . . 129
9.1.5 Transverse Discrepancies
and Asymmetry of the Jaws . . . . . . . . . . . . . . . . . . . 131
9.1.6 The Immense Number of Combinations
of Different Types and Grades of the
Basic Components of Facial Deformities . . . . . . . . 132
9.2 Direct and Photographic Clinical Analysis
for Dentofacial Deformities . . . . . . . . . . . . . . . . . . . . . . . . . . 132
9.3 The Youthful Neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
9.4 Intraoral and Dental Cast Analysis . . . . . . . . . . . . . . . . . . . . 141
9.5 Cephalometric Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
9.5.1 A Personal View on
Radiographic Cephalometry. . . . . . . . . . . . . . . . . . . 142
9.5.2 Essential Radiographic Cephalometry . . . . . . . . . . . 142
9.6 Dental Cephalometric Analysis . . . . . . . . . . . . . . . . . . . . . . . 142
9.6.1 Interincisal Angle . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
9.6.2 Angle Between the Upper Central
Incisors and the Maxillary Plane . . . . . . . . . . . . . . . 143
9.6.3 Angle Between the Lower Incisors
and the Mandibular Plane . . . . . . . . . . . . . . . . . . . . . 143
9.6.4 Protrusion of Maxillary Incisors . . . . . . . . . . . . . . . 143
9.7 Skeletal Cephalometric Analysis . . . . . . . . . . . . . . . . . . . . . . 144
9.7.1 Maxilla to Cranial Base
Anteroposterior Assessment. . . . . . . . . . . . . . . . . . . 144
9.7.2 Mandible to Cranial Base
Anteroposterior Assessment. . . . . . . . . . . . . . . . . . . 144
9.7.3 Mandible to Maxilla Assessment . . . . . . . . . . . . . . . 144
9.8 Soft Tissue Cephalometric Analysis . . . . . . . . . . . . . . . . . . . 145
9.8.1 Vertical Proportions . . . . . . . . . . . . . . . . . . . . . . . . . 146
9.8.2 Nasofacial Angle . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
9.8.3 Nasomental Angle . . . . . . . . . . . . . . . . . . . . . . . . . . 146
9.8.4 Mentocervical Angle . . . . . . . . . . . . . . . . . . . . . . . . 146
9.8.5 Submental–Neck Angle . . . . . . . . . . . . . . . . . . . . . . 146
9.8.6 Subnasal Vertical . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
9.8.7 Nasolabial Angle . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
9.9 The Points, Lines, and Angles Diffi cult to Trace . . . . . . . . . . 147
9.10 The Maxillomandibular Complex Concept . . . . . . . . . . . . . . 147
Contents xi
9.11 The Role of Dentofacial Deformities
in Premature Aging Appearance . . . . . . . . . . . . . . . . . . . . . . 149
9.12 Dentofacial Analysis Checklist . . . . . . . . . . . . . . . . . . . . . . . 149
9.13 Dentofacial Deformities: Preferred Terms . . . . . . . . . . . . . . . 152
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
10 The Aging Face . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
10.1 Structural Factors of Aging . . . . . . . . . . . . . . . . . . . . . . . . . . 158
10.2 Soft Tissue Quality and Aging . . . . . . . . . . . . . . . . . . . . . . . . 158
10.3 Soft Tissue Quantity and Aging . . . . . . . . . . . . . . . . . . . . . . . 161
10.4 Soft Tissue Dynamics and Aging . . . . . . . . . . . . . . . . . . . . . . 161
10.5 Skeletal Supporting Framework and Aging . . . . . . . . . . . . . . 161
10.6 Recognizing Aging in the Face . . . . . . . . . . . . . . . . . . . . . . . 161
10.6.1 General Considerations . . . . . . . . . . . . . . . . . . . . . . 161
10.7 Recognizing the Signs of Facial Aging . . . . . . . . . . . . . . . . . 161
10.7.1 Forehead Transverse Furrows . . . . . . . . . . . . . . . . . 161
10.7.2 Frown Lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
10.7.3 Temporal Depression . . . . . . . . . . . . . . . . . . . . . . . . 162
10.7.4 Eyebrow Ptosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
10.7.5 Upper Eyelid Hooding . . . . . . . . . . . . . . . . . . . . . . . 164
10.7.6 Crow’s Feet and Eyelid Wrinkles. . . . . . . . . . . . . . . 164
10.7.7 Lateral Canthal Bowing . . . . . . . . . . . . . . . . . . . . . . 164
10.7.8 Scleral Show . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164
10.7.9 Baggy Lower Eyelid. . . . . . . . . . . . . . . . . . . . . . . . . 164
10.7.10 Tear Trough Deformity (Palpebrojugal Fold)
and Palpebral Malar Groove . . . . . . . . . . . . . . . . . . 165
10.7.11 Malar Bags (Festoons, “Cheek Bags”) . . . . . . . . . . 165
10.7.12 Nasolabial Fold . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
10.7.13 Preauricular Lines . . . . . . . . . . . . . . . . . . . . . . . . . . 166
10.7.14 Lip Lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
10.7.15 Horizontal Upper Lip Line . . . . . . . . . . . . . . . . . . . . 166
10.7.16 Vertical Lengthening of the Upper Lip
and Ptosis of the Lip Commissures . . . . . . . . . . . . . 166
10.7.17 Corner of the Mouth Lines
(Commissural Lines) and “Marionette” Lines . . . . . 167
10.7.18 Jowls and Prejowl Depression . . . . . . . . . . . . . . . . . 167
10.7.19 Witch’s Chin Deformity (Ptotic Chin) . . . . . . . . . . . 167
10.7.20 Platysma Bands and Loss
of Cervicomental Angle . . . . . . . . . . . . . . . . . . . . . . 167
10.7.21 Horizontal Neck Lines . . . . . . . . . . . . . . . . . . . . . . . 167
10.7.22 Ptotic Submandibular Gland . . . . . . . . . . . . . . . . . . 168
10.8 Recognizing Nasal Aging . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
10.9 Recognizing Aging in the Oral Frame . . . . . . . . . . . . . . . . . . 168
10.10 The Aging Face Analysis Checklist . . . . . . . . . . . . . . . . . . . . 168
10.11 The Aging Face: Preferred Terms . . . . . . . . . . . . . . . . . . . . . 171
10.11.1 Wrinkles, Mimetic Lines, Mimetic
Furrows, and Folds . . . . . . . . . . . . . . . . . . . . . . . . . . 171
10.11.2 Other Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
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11 Continuing Facial Analysis Utilizing
Four Images by Man Ray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
11.1 Man Ray’s Unconventional Oblique Views . . . . . . . . . . . . . . 175
11.2 Man Ray’s Asymmetrical Face . . . . . . . . . . . . . . . . . . . . . . . 176
12 Continuing Facial Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
12.1 Meet the Patient the Day Before the Operation . . . . . . . . . . . 179
12.2 Continuing Facial Analysis in the Operating Room . . . . . . . 180
12.2.1 The Basic Preoperative Documents
Are Hanging up in the Operating Room . . . . . . . . . 180
12.2.2 Problems Related to General Anesthesia
and Patient Positioning During Facial Surgery . . . . 180
12.3 The Intraoperative and Postoperative
Procedure Documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
12.4 The Continuing Facial Analysis
in the Early Postoperative Phase . . . . . . . . . . . . . . . . . . . . . . 181
12.5 The Continuing Facial Analysis
in the Late Postoperative Phase . . . . . . . . . . . . . . . . . . . . . . . 181
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
13 Aesthetic Facial Surgery: First Consultation Notes, Essential
Medical History, and Clinical Diary . . . . . . . . . . . . . . . . . . . . . . 183
13.1 General Characteristics of AFS Folder . . . . . . . . . . . . . . . . . 186
13.2 Front and Back Covers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
13.2.1 Frontal, Oblique, Profi le, and Basal
Full Face View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
13.2.2 Nasal Area Images . . . . . . . . . . . . . . . . . . . . . . . . . . 187
13.2.3 Facial Aging and Facelift Incision
Line Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
13.2.4 Eyebrow and Eyelid Area Images . . . . . . . . . . . . . . 189
13.2.5 Lip and Smile Area Images . . . . . . . . . . . . . . . . . . . 189
13.2.6 Ear Area Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
13.3 Left-Hand Side of Inside Page of the AFS Folder . . . . . . . . . 190
13.4 The Right-Hand Internal Page of the AFS Folder . . . . . . . . . 200
14 Exercises in Clinical Photography and Analysis . . . . . . . . . . . . 201
14.1 Exercise 1: Orientate the Face
in the Natural Head Position . . . . . . . . . . . . . . . . . . . . . . . . . 201
14.2 Exercise 2: Perform a Complete
Session of Clinical Facial Photography . . . . . . . . . . . . . . . . . 202
14.3 Exercise 3: Find and Compare
the Facial Points of Interest in Two Different Subjects . . . . . 202
14.4 Exercise 4: Perform a Systematic,
Step-by-Step Facial Analysis . . . . . . . . . . . . . . . . . . . . . . . . . 202
15 Suggested Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
15.1 Errors in Patient Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
15.2 Enhance Preoperative, Intraoperative,
and Postoperative Patient Care . . . . . . . . . . . . . . . . . . . . . . . . 204
15.3 The Normal-Average Face and the Beautiful Face . . . . . . . . 204
Contents xiii
15.4 Forehead Aesthetics and Preoperative Assessment . . . . . . . . 204
15.5 Eyelid Aesthetics and Preoperative Assessment . . . . . . . . . . 204
15.6 Understanding the Nasal Airway . . . . . . . . . . . . . . . . . . . . . . 204
15.7 Planning Rhinoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
15.8 From Nasal Analysis to Nasal Surgery . . . . . . . . . . . . . . . . . 205
15.9 The Six Keys to Optimal Dental Occlusion . . . . . . . . . . . . . . 205
15.10 The Smile Analysis: An Orthodontic Point of View . . . . . . . 205
15.11 Clinical Cephalometric Analysis . . . . . . . . . . . . . . . . . . . . . . 205
15.12 Clinical Analysis of Dentofacial Deformities . . . . . . . . . . . . 205
15.13 Proportion and Disproportion in Dentofacial Deformity . . . . 205
15.14 How the Skin Ages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206
15.15 How the Face Ages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206
16 Surround Yourself with Experts
(and Other Important Advice for a Constructive
and Creative Surgical Practice) . . . . . . . . . . . . . . . . . . . . . . . . . . 207
16.1 Surround Yourself with Experts . . . . . . . . . . . . . . . . . . . . . . . 207
16.2 The Cost of Complexity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208
16.3 John F. Kennedy on Myth . . . . . . . . . . . . . . . . . . . . . . . . . . . 208
16.4 Jack Sheen: “A Psychiatrist Once Told Me…” . . . . . . . . . . . 208
16.5 The 20 Rules of Surgical Planning
(or the “Think in Terms of…” Planning Series) . . . . . . . . . . 208
16.6 David Sarver on “Diagnosis by Procedure” . . . . . . . . . . . . . . 208
16.7 The Three Most Powerful Treatments . . . . . . . . . . . . . . . . . . 209
16.8 The Priority List and the 80/20 Rule (Pareto’s Law) . . . . . . . 209
16.9 Professional Success Is a Consequence of Interest,
Joy, and the Desire for Future Happiness . . . . . . . . . . . . . . . 209
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
17 Beauty Is Composite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Beauty Is Composite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
It Is Built, but It Destructs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217