Balance vs. Symmetry

We have all heard that symmetry is one of the cardinal signs of a beautiful face.  Studies in the animal kingdom have led us to believe that symmetry truly makes all the difference when selecting an ideal mate.  However, I would like to propose that symmetry is not as important as we think for several reasons.  First, many of my patients that I see are models with the top agencies but when I study their faces they are as asymmetrical as my patients who are not models or are on the lesser attractive scale.  However, what separates them apart is balance, which we will talk about more in a moment.    Second, in my consent forms I always say “The two sides of the body are not the same and can never be made the same.”  I have memorized that line because it is truly important to communicate with a patient that symmetry is an elusive goal.  A recent study published in the Archives of Facial Plastic Surgery did mention that asymmetry that exceeds 3 mm could make us believe that there is an underlying facial paralysis but less than this may not be significant.

This woman has an asymmetric face with a brow lower on one side and a cheekbone more exposed on one side too. Even though fat transfer did not fix the asymmetry to an ideal result, the face overall is much more balanced afterward: the eyes are blended into the face better and are thereby more proportionate, the gaunt midface has been accentuated to create more of an oval face, and the narrow chin has also been blended in as well. This is the concept that balance trumps symmetry when prioritizing strategies for facial enhancement.

To me understanding the role of balance is what renders a face to be exceptionally attractive.  Balance means that the relative proportions of a face look to be harmonious.  Consider a nose that on one person would look attractive but on another smaller face may look simply too big for those facial features and merit a reduction rhinoplasty.  Consider the internal balance of the nose itself:  if the nasal tip is too big then reducing it can restore relative balance to the bridge of the nose or vice versa.  A small chin can make the cheeks appear too big, or a flatter cheek can make the nose look undesirably large.  Therefore, a goal should be a minor modification of these facial features to be more in balance but without radically changing a person’s identity through extreme plastic surgery.

The effect of one part of the face on another part of the face can be better understood with the following analogy.  Consider a glass of water on a television screen with no other reference points like an orange or a hand next to it.  If I asked you how big you thought this glass of water was you would not be able to answer with certainty.  However, if a shot glass were placed next to the first glass of water you would think the original glass of water looked very large now.  Conversely, if a pitcher of water were placed next to the glass of water, it would now look small.  This is the idea of balance, and it works in the face too.

Working with an artistically sensitive surgeon can be a fundamental component to achieving your desired wishes for facial enhancement.  Although symmetry is something that can be worked on (but not perfected), it is not oftentimes the most important goal even though that is what our thoughts may tell us at first.

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