Anthropometric comparison of the idealized youth and hideous old man of Leonardo's profile drawings.

The aim of this study is to compare the old and ugly with the young and beautiful in Leonardo's profile drawings using soft tissue anthropometry.Thirty-one of Leonardo's profile drawings and portraits of the lateral view were collected and scanned. Among the 29, 9 young and 20 hideous old man scans had a measurable nasion-subnasale (n-sn) distance, and 49 anthropometric items (43 distances and 6 angles) were used for measurement as relative distances to the n-sn distance.The measured distances or angles did not differ significantly between the young and old in the 39 anthropometric items. However, the remaining 10 items were statistically significant. The young group had a significantly greater (P < 0.05) upper face height (n-stomion [sto]), nasolabial angle, and upper lip height (sn-sto) compared with the old group. However, the supraorbital depth (glabella-tragion), mandible height (sto-gnathion), nasal bridge height (n-pronasale), cutaneous lower lip height (labiale inferius-sublabiale), ear length (superaurale-subaurale), Rickett line-upper lip distance, and facial inclination were significantly greater (P < 0.05) in the old group compared with the young group.The difference of soft tissue cephalometric results between the young and old subjects can be the index in rejuvenating surgeries.

Correction of an alar web with a feather-edge rolled-in flap.

The aim of this study was to see the histological nature of the alar web and to introduce a featheredged rolled-in flap to reduce the alar web.On a cadaver, the perpendicular section of the alar web revealed a thickened dermis portion on both the skin side and the nasal side distal to the alar cartilage. According to histological results, we thought the thinning and rolling in of the distal margin of the end of the open rhinoplasty incision could reduce the alar web. An open rhinoplasty incision was made just distal to the hair-bearing vestibular skin and a V-Y shape incision created at the alar base. After the cartilage work, the skin of the distal end of the flap was featheredged to a 0.5-mm thickness. The distal margin was rolled in and sutured to the nasal lining. A bolster dressing was applied using a 4-0 nylon suture.Thirteen patients (8 males, 5 females) were operated on, and 8 patients were followed up for more than 12 months. Their preoperative and postoperative worm's eye views were compared. Four anthropometric distances were measured preoperatively and postoperatively. The columellar length increased significantly after the operation (P = 0.001 [independent 2-sample t test]) on the cleft side. Preoperatively, the alar width was significantly greater (P = 0.02 [paired-samples t test]) on the cleft side (0.17 ± 0.03 of an intercanthal distance) than the noncleft side (0.14 ± 0.03). After the operations, they became similar (0.16 ± 0.03 on cleft side, 0.16 ± 0.04 on the noncleft side; P = 1.00 [paired-samples t test]).We think this featheredged rolling-in flap might be a good method for the correction of an alar web since this technique increased the columellar length and decreased the alar width on the cleft side.