The V-shape face has become the latest aesthetic ideal for the Asian woman. As a result of the rising popularity of this V-shape look, there has been a surge in demand for lower face contouring procedures, both surgical and non-surgical. Non-invasive lower facial contouring procedures include neurotoxin treatment of the masseters, as well as chin augmentation with dermal fillers. These procedures add a new dimension to the aesthetic physician’s armamentarium of services by allowing them to reshape the Asian face with minimum downtime.

Recently, photographsofparticipants in a beauty pageant held in South Korea were posted on a Japanese blog, garnering much attention and debate. Many netizens commented that all 15 aspiring beauty queens featured had a disconcertingly similar appearance, alluding to the over-reliance on plastic surgery by young Korean women. However, if one were to look closely at their faces, one would realise that their features were actually dissimilar, but their overall face shapes were almost identical, prompting many to think they look alike.

All the Korean beauties taking part in the beauty pageant sported what is now referred to as the ‘V-shape face’; a trend that is taking Asia by storm.

Changes in the concept of beauty over time

Beauty not only changes across cultures, but also changes with the times. In Nancy Etcoff’s book1, she noted that changes in beauty over the years included a gradual narrowing of the eyelids from the extremely high-lidded in the 1950s, to smaller eyelids today. The 1950s nose was more upturned, or rotated, with a very sculpted or narrow tip. By the 1990s, noses with a wider tip and fuller bridge were preferred. Plump lips were always preferred, but lips are getting plumper, cheekbones more defined. The importance of creating a youthful look by maximally improving the jowls to create a narrow chin was popularised. Even body shape and size has changed over the years. Twiggy tipped the scales at a mere 40 kg in the 1960s, before the trend shifted to a more voluptuous 58 kg in the 21st century.

It is important to remember that through electronic and print media, we live in a ‘connected’ world. The majority of women are exposed to an average of 2000 images in advertisements each week. Over time it is expected that our internal averaging will ultimately become more homogeneous, creating a ‘universal’ face.

Racial differences in facial shape

Beyond issues of colour, there are differences in facial shape, fat pad location, and skin texture in ageing patients of different ethnicities.

Overall, Asian faces are generally wider than Caucasian faces. These differences are generalisations, as Asian faces tend to vary by ethnicity. For example, Japanese faces are relatively long with chubby cheeks and Chinese faces are relatively narrower. Caucasians tend to have more masculine features, by the standards of the rest of the world. Furthermore, Asian cheekbones tend to extend outward, while Caucasian cheekbones protrude upward. With regard to the lower face, Caucasian faces tend to have longer and sharper chin and jaw lines, while Asian faces generally have shorter and flatter mandibular contours.

Figure 1 Jawbone contouring surgery is increasingly common in Asia

Figure 1 Jawbone contouring surgery is increasingly common in Asia

Specifically, key angles and proportions including the nasofrontal angle, nasolabial angle, alar width as a proportion of intercanthal distance, and the width of columella relative to the nasal lobule may vary. Asians have narrower mouths, elongated intercanthal width and significantly wider lower nasal margins. The wider mandibles of Asian women are aesthetically important, so this area should not be exacerbated with excessive filler injections, which may lend a heavy appearance to the lower face. In fact, the rise of the V-shape face has led Asian women to favour skin tightening procedures, both invasive and non-invasive, over fillers to improve lower facial contours. In the region of the jawline, an increasing number of Asian women are now opting for neurotoxin injections to relax the masseter

muscles, resulting in the slimming of the jawline. More extreme improvements to the jawline region can be achieved through facial bone contouring surgery.