Measuring facial symmetry: a perception-based approach using 3D shape and color.

OBJECTIVE: Facial symmetry is an important factor affecting esthetics. Thus, its restoration is an essential task in maxillofacial surgery. The aim of this study is to develop an objective measure of facial asymmetry by a novel approach where both the shape and the color are taken into account and to validate its correlation with perception. METHODS: Optical three-dimensional (3D) face scans of 30 healthy adults are performed. Face-specific asymmetry indices are calculated by quantifying color differences as well as spatial distances between 3D data of a face and its mirrored copy. Subjective ratings of symmetry and attractiveness of the faces by 100 subjects are used to validate these indices. RESULTS: The symmetry ratings show significant correlations with color and geometric asymmetry indices. The attractiveness ratings correlate only weakly with both indices. However, the product of the indices exhibits significant correlations with both attractiveness and symmetry ratings. CONCLUSION: The presented combined asymmetry index comprising shape and coloring turned out to reflect subjective perception of both facial symmetry and attractiveness. It thus promises to be a valid objective measure for facial esthetics, which could contribute, e.g., to the evaluation of surgical methods as well as to the design of craniofacial prostheses.