Consensus on Changing Trends, Attitudes, and Concepts of Asian Beauty

Abstract

Background: Asians increasingly seek non-surgical facial esthetic treatments, especially at younger ages. Published recommendations and clinical evidence mostly reference Western populations, but Asians differ from them in terms of attitudes to beauty, structural facial anatomy, and signs and rates of aging. A thorough knowledge of the key esthetic concerns and requirements for the Asian face is required to strategize appropriate facial esthetic treatments with botulinum toxin and hyaluronic acid (HA) fillers.

Methods: The Asian Facial Aesthetics Expert Consensus Group met to develop consensus statements on concepts of facial beauty, key esthetic concerns, facial anatomy, and aging in Southeastern and Eastern Asians, as a prelude to developing consensus opinions on the cosmetic facial use of botulinum toxin and HA fillers in these populations.

Results: Beautiful and esthetically attractive people of all races share similarities in appearance while retaining distinct ethnic features. Asians between the third and sixth decades age well compared with age-matched Caucasians. Younger Asians' increasing requests for injectable treatments to improve facial shape and three-dimensionality often reflect a desire to correct underlying facial structural deficiencies or weaknesses that detract from ideals of facial beauty.

Conclusions: Facial esthetic treatments in Asians are not aimed at Westernization, but rather the optimization of intrinsic Asian ethnic features, or correction of specific underlying structural features that are perceived as deficiencies. Thus, overall facial attractiveness is enhanced while retaining esthetic characteristics of Asian ethnicity. Because Asian patients age differently than Western patients, different management and treatment planning strategies are utilized.

Level of evidence v: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266.

Keywords: Asian facial aging; Asian facial anatomy; Asian facial esthetics; Asian facial features; Consensus opinion; Facial injectables.

Fig. 1

Examples of ethnic Asian beauty in women from a the Philippines (photo courtesy of Dr. Herve Raspaldo); b Japan (photo courtesy of Dr. Akiko Imizumi); c Korea (photo courtesy of Dr. Kyle Seo); d Indonesia (photo courtesy of Dr. Steven Liew); and e China (photo courtesy of Dr. Steven Liew)

Fig. 2

Comparison of Asian (a, c) and Caucasian (b, d) skulls. a, b Anterior view. The Asian skull (a) is wider overall, with greater bitemporal, bizygomatic, and bigonial width of the temple, zygoma, and mandible, respectively, compared with those of the Caucasian skull (b). c, d Lateral view. The Asian skull (c) has less anterior projection, with a more retruded frontal bone and supraorbital ridge, recessed nasion, infraorbital rim, medial maxilla, maxillary process of the zygoma, anterior nasal spine, and pogonion of the mandible compared with the Caucasian skull (d). (Illustrations courtesy of Prof Kim)

Fig. 3

a Frontal and b lateral views of an Asian female face illustrating some of the morphological features (wide bitemporal, bizygomatic, and bigonial distances; retruded and concave medial maxilla; puffy upper eyelids; epicanthal folds) listed in Table 2. (Photos courtesy of Dr. Steven Liew)