On Facial Asymmetry and Self-Perception

• Published in: Plastic and reconstructive surgery (1963) Vol. 133; no. 6; pp. 873e - 881e
• Main Authors: Lu, Stephen M., Bartlett, Scott P.
• Format: Journal Article
• Language: English
• Published: United States American Society of Plastic Surgeons 01-06-2014
• Subjects: Emotions; Facial Asymmetry - physiopathology; Facial Asymmetry - psychology; Humans; Photography; Self Concept; Smiling - physiology; Smiling - psychology
• ISSN: 0032-1052; 1529-4242
• DOI: 10.1097/PRS.0000000000000211

Self-perception has been an enduring human concern since ancient times and remains a significant component of the preoperative and postoperative consultation. Despite modern technological attempts to reproduce the first-hand experience, there is no perfect substitute for human, stereoscopic, three-dimensional vision in evaluating appearance. Nowadays, however, the primary tools available to a patient for examining his or her own appearance, particularly the face, are photographs and mirrors. Patients are often unaware of how cameras and photographs can distort and degrade image quality, leading to an inaccurate representation of true appearance. Everyone knows that mirrors reverse an image, left and right, and most people recognize their own natural facial asymmetry at some level. However, few realize that emotions are not only expressed unequally by the left and right sides of the face but also perceived unequally by others. The impact and effect of this "facedness" is completely reversed by mirrors, potentially creating a significant discrepancy between what a patient perceives of himself or herself and what the surgeon or other third party sees. This article ties together the diverse threads leading to this problem and suggests several ways of mitigating the issue through technology and patient counseling.