Common East Asian facial structures and their aesthetic ideals

A sign of a good injector is avoiding a ‘cookie-cutter’ approach to injecting Botox, Dysport, and other products.

People who are ethnically Asian are notably heterogenous in facial features. As a result, a uniform approach to treatment without regard of ethnic background may yield dissatisfying results at best and unanticipated complications at worst. With this in mind, Sundaram et al. (2015) developed a patient-tailored guide based on three most common East Asian facial structures.

Please refer below to the medical terms used to describe facial landmarks:

• Palpebral fissure: Distance between the upper and lower eyelid

• Supratarsal crease: Double-eyelid

• Medial epicanthal fold: Skin of the upper eyelid that covers the inner corner of the eye

• Nasal dorsum: Bridge of the nose

• Nasal ala: The borders or corners of the nostrils

• Zygoma: Boney arch of the cheek

• Mandible: Part of the jaw

Type I: “Northern”

Awkwafina

Characteristics of facial landmarks

• Palpebral fissure: Narrow

• Supratarsal crease: None

• Medial epicanthal fold: May be present

• Nasal dorsum: Highest and longest of the 3 facial types

• Nasal ala: Narrow with oval/ellipsoid nostrils

• Mid-face: Mid-cheek area tends to be flatter than lateral areas

• Zygoma: Prominent

• Mandible: Prominent, giving a square shape

• Skin type: Typically fair

Treatment should focus on:

• Avoiding excessive eyebrow arching, which can be aesthetically displeasing when the face is wide

• Avoiding reducing the pretarsal roll, which widens the appearance of the narrow palpebral fissure

• Reducing the width of the face

• Reducing the prominence of the cheek bones and jaw angle to give a face a more tapered ‘V’ look

Type II: “Intermediate”

Stephanie Hsu

Characteristics of facial landmarks

• Palpebral fissure: Wider than Type I

• Supratarsal crease: Present or absent

• Medial epicanthal fold: Usually absent

• Nasal dorsum: Slightly lower and wider

• Nasal ala: Intermediate in width

• Mid-face: Less flattening of the mid-cheek region

• Zygoma: Varies

• Mandible: Some degree of taper but not prominent ‘V’ face shape

• Skin type: Fair or intermediate pigmentation

Treatment should focus on:

• Avoiding excessive eyebrow arching

• Avoiding reduction of the pretarsal roll if the palpebral fissure is narrow without a supratarsal crease

• Reducing facial width if desired

• Reducing prominence of cheek bones and mandible if appropriate

• Reducing nasal dilators if base of the nose is wide

Type III: “Southern”

Michelle Yeoh

Characteristics of facial landmarks

• Palpebral fissure: Widest

• Supratarsal crease: Present

• Medial epicanthal fold: Usually absent

• Nasal dorsum: Flat and short

• Nasal ala: Widest with wide and round nostrils

• Mid-face: Mid-cheek and lateral-cheeks tend to have some convexity

• Zygoma: Not prominent

• Mandible: Highest degree of tapering, giving narrow appearing lower face

• Skin type: More pigmented

Treatment should focus on:

• Subtle eyebrow arching can be aesthetically appropriate

• Reducing prominence of the base of the nose

Source:

Sundaram H, Huang P, Hsu N, Huh C, et al. (2015). Aesthetic applications of Botulinum Toxin A in Asians: An international, multidisciplinary, pan-Asian consensus. Plastic and Reconstructive Surgery.

These guidelines can be utilized on all facial structures that are outlined above, regardless of ethnic background. When researching a good Botox injector in your area, is it important to ask questions regarding their approach to treatment.

Clemens Face + Body is proud to be an Asian-owned and Boston-based aesthetic clinic. We value working with patients of all backgrounds and lifestyles. If you’re in the Brookline area and in search of a highly inclusive clinic, we got you.