What causes bad esr while having normal midface ratio?

Wide face but shorter midface region, or just close set eyes but short nose and philtrum ofcourse
 
it can mean that your face is too small for your skull. Charlie Kirk is the perfect example of this.
 

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it can mean that your face is too small for your skull. Charlie Kirk is the perfect example of this.
Wouldn't increasing the size of the face require increasing the skull further to keep facial thirds equal tho? Isn't it just having a big and wide skull in the first place
 

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