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From a health perspective, forward growth is very easy to understand. The more the face grows forward, the more space is available for the teeth, airway, and tongue. Visualizing forward growth however, especially its esthetic value, is a different story.
Looking at ideal examples of faces with forward growth doesn’t always yield easy to identify differences. Sure such faces look good, but that could be due to the selection process. To the contrary, forward growth seems to suggest a face that’s over stretched in the sagittal plane.
Sideways growth, in the transverse plane, comes to mind instead when thinking about improving facial dimensions. Wide faces are greatly appreciated, perhaps because most social interactions are naturally carried in a forward facing perspective. Start turning the face sideways, however, and the effects of forward growth, or lack of, emerge. The best way to visualize this is by looking at profile pictures.
Going through such pictures, the difference becomes evident. Forward faces tend to have positive under eye support, upturned nose, matching lips, and a chin that extends to the lips. More importantly, they always have the upper and lower jaws extend well beyond the nasion.
In a previous post we learned that the face is mainly comprised of the maxilla and mandible. They cover the area from under the eyes down to the bottom of the chin reaching to the neck, but what’s the nasion?
That’s the point on the top of the nose and bottom of the forehead where the skull and face meet. Drawing an imaginary line straight down from that point reveals the extent of facial growth. The further the face is forward of that line the more the face is forward grown.
How to Measure Forward Growth?
This method, called the Facial Plane in Photometric Analysis, makes testing and appreciating forward growth very easy. Nonetheless, as simple and clear as this measurement is, it does not provide any figures to work with and is significantly prone to error because it requires the head to be completely level.
Since forward head posture has become pandemic, most people subconsciously tilt their heads’ backward. This moves the upper part of the head backward and the bottom forward, making the test results incorrect.
Hence, a person with a recessed face and forward head posture will appear to have a forward grown face with this test. Due to muscle imbalances, correcting this before taking a picture is very difficult. With enough information however, it’s possible to correct it after, by tilting the picture to level the head. Nonetheless, the results will look awkward.
To avoid all of this, cosmetic surgeons use different methods of measurement. Instead of drawing imaginary lines they plot angles. This nullifies the head tilt issue and provides standardized numbers for objective assessment.
One such measurement is called the Facial Convexity Angle. It works by measuring the relation between the most prominent points on the brow ridge (G), and on the upper and lower jaws (SN, PG). Connecting these points usually yields an angle in the range of 175° to 145°. The higher the degree the further forward the face is.
Applying this to the two pictures below provides 174° for the first and 158° for the second. The first person has a forward face whereas the second one has a recessed face. Roughly speaking, faces that are 165° and above are considered forward, and faces under that are recessed.
Obviously this measurement did a good job illustrating the extent of growth on the two pictures above, but it’s not perfect. Many things can throw it off including a very prominent brow ridge or a very recessed lower jaw. That’s because the measurement is attempting to measure two things, the position of the upper and lower jaws, in one angle.
Each jaw can grow disproportionally of the other, hence the terms retrognathic and prognathic in orthodontics. In fact, Orthodontists use two different angles, referred to as SNA and SNB in cephalometric analysis, to determine the position of the face. Those give a more accurate measure but are highly technical and require an x-ray for hard tissue points. They will be covered in a separate post later.
To overcome this challenge without x-rays cosmetic surgeons use additional measures to form a more complete understanding of the face. Such measures take into account many other factors such as the size and position of the nose and lips for example. After all, forward growth is not the-be-it-all measure of beauty. There are people who are forward grown and don’t look good. (PICTURE)
Nonetheless, forward growth is highly correlated with beauty and the Facial Convexity Angle is pretty effective in measuring it. To illustrate, below are samples of popular actors and their angles plotted. You will find good evidence of this correlation.
It clearly takes time and practice to understand how to identify forward growth and appreciate its esthetic value. Over time you will develop a better perspective on which faces are forward and why they look better.
For a more in depth analysis make sure to check the second post about forward facial growth case analysis: recessed versus forward faces.
