Five Topographic Levels of the Face and Four Layers of Surgical Acting

Dimitrije E. Panfilov

The Right Hat For Your Face
Fig. 13.1. Five topographic levels of the face

The perception of the countenance happens below the conscious level, but it is determinative for the intercourse of two human beings. Harmonious order of facial proportions can be divided in five facial "lev-

  1. Forehead
  2. Eyebrows and eyelids
  3. Midface with nose
  4. Lips and chin
  5. Double chin and neck

There are four layers of surgical acting:

  1. Epidermis
  2. Skin with subcutaneous fat layer
  3. Muscle-superficial musculo-aponeurotic system-muscle layer
  4. Periosteum and bone

There are numerous operative techniques available today for each of those levels and layers. Nowadays we are not forced to do extended operations, which ac- We have, however, to respect the mimic units not cording to the study of Edward Ivy and Paul Lorenc exceeding our incisions or vectors of traction across from the USA result in more serious complications this limits or not to change too much soft-tissue ele-

and prolong the recovery time. We can combine less ments across the bone structure like in some cases of aggressive procedures of different facial "mosaic periosteal facelifts: it could produce an unnatural, stones" to improve the final outcome, to reduce the strange look. Suprema lex: our patients do not want to possible risks, and to shorten the recovery time. look altered (different - to be somebody else), but

13 Five Topographic Levels of the Face and Four Layers of Surgical Acting 67

Fig. 13.3. David with tension lines

want to look better! Under no circumstances we should change somebody's personal facial appearance; there should be no alteration of recognitive personal look. Scars have to be hidden in natural folds of the skin and should not cross the skin tension lines -then they can become almost invisible or at least hardly noticeable.

The supreme aim of our surgery should be the harmony of proportions among facial units to look pleasant and not to provoke repulsion. The human weakness for the beautiful has been scientifically confirmed by the brain researcher Knut Kampe from Hamburg.

We receive 80% of all information visually. Humans more than animals live totally in an optical world. The whiteness of the sclera allows the viewer to recognize where the other human being is looking , what attracts his/her attention. Such a phenomenon does not exist in primates. When two human beings communicate they look into the eyes of each other. We look through the pupils of the other person into the fundus occuli, which is built of optical nerve as the prolongation of the brain. Looking into the eyes, we can see into the thoughts of each other, because at the end of the look there is the brain at both ends.

Fig. 13.4. Plinius said: "Eyes are the windows of the soul." and Shakespeare wrote: "Love is born, lives and dies in the eyes." Panfilov: "Beauty is the metaphysics of the physics"

That is why Plinius said: "Eyes are the windows of the soul."

When we hate somebody, our pupils contract -sympathicus reaction. Subconsciously we see less of the hated person. When we love somebody our pupils dilate: the loved person becomes blurred - we do not see her/his imperfection. The saying is true: "Love is blind." The beauty of eyes determinates significantly the whole person, and Shakespeare wrote: "Love is born, lives and dies in the eyes." The eyes are indeed a very powerful instrument of our emotional expression.

Meeting the eyes of less attractive human beings can cause negative feelings. The level of pleasure increases as soon as those unbeautiful glances are turned away, the medical scientist Knut Kampe found.

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