Aesthetic Plastic Surgery

, Volume 43, Issue 6, pp 1547–1552 | Cite as

Difference in Midface Rejuvenation Strategy Between East Asians and Caucasians Based on Analysis of Age-related Changes in the Orbit and Midcheek Using Computed Tomography

  • Jin Woo Kim
  • Jin Woo Han
  • Yong Kyu KimEmail author
Original Article Facial Surgery



The differences between Caucasian and East Asian faces could lead to different age-related bony changes. We analyzed computed tomography (CT) scan images of East Asians to find objective differences in midface rejuvenation strategy between East Asians and Caucasians.


We reviewed 54 East Asian individuals’ charts and facial CT images ranging in age-group: Group A (21–30 years), Group B (41–50 years), and Group C (61–70 years). No patients had congenital or acquired facial deformity and history of facial trauma. The anteroposterior length of the orbital roof and floor (LOR, LOF) and the angle of the anterior wall of the maxilla were recorded on parasagittal images through the midline of the orbit.


The LORs at their midpoints showed significant differences between Groups A and B (p < 0.01). The LOFs were also significantly different between Groups A and B (p < 0.001). The difference in the angle between the anterior maxillary wall and the orbital floor was not significant between Groups A and B. The lengths between Groups B and C showed no significant differences.


Our study demonstrated that the aging process in East Asians differs considerably from that in Caucasians, with characteristic significant changes in LOF and LOR. Since the aging process is different, the strategies to cope with aging should also differ. Volume restoration of the inferior orbital rim in the midface is one of the most important rejuvenation methods in East Asians.

Level of Evidence V

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Midface rejuvenation strategy Age-related changes East asians Caucasians Computed tomography 



This work was supported by 2019 inje University Busan paik hospital research grant.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed during this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

For this type of study, informed consent is not required.


  1. 1.
    Gonzalez-Ulloa M, Flores ES (1965) Senility of the face–basic study to understand its causes and effects. Plast Reconstr Surg 36:239–246CrossRefGoogle Scholar
  2. 2.
    Lambros VS (1999) What age(s) for face lifts? Plast Reconstr Surg 103:1076CrossRefGoogle Scholar
  3. 3.
    Pessa JE (2000) An algorithm of facial aging: verification of Lambros's theory by three-dimensional stereolithography, with reference to the pathogenesis of midfacial aging, scleral show, and the lateral suborbital trough deformity. Plast Reconstr Surg 106:479–488 discussion 489–490 CrossRefGoogle Scholar
  4. 4.
    Bartlett SP, Grossman R, Whitaker LA (1992) Age-related changes of the craniofacial skeleton: an anthropometric and histologic analysis. Plast Reconstr Surg 90:592–600CrossRefGoogle Scholar
  5. 5.
    Yaremchuk MJ (2001) Infraorbital rim augmentation. Plast Reconstr Surg 107:1585–1592 discussion 1593–1592 CrossRefGoogle Scholar
  6. 6.
    Mendelson BC, Hartley W, Scott M, McNab A, Granzow JW (2007) Age-related changes of the orbit and midcheek and the implications for facial rejuvenation. Aesthetic Plast Surg 31:419–423CrossRefGoogle Scholar
  7. 7.
    Shaw RB Jr, Kahn DM (2007) Aging of the midface bony elements: a three-dimensional computed tomographic study. Plast Reconstr Surg 119:675–681 discussion 682–683 CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Authors and Affiliations

  1. 1.Department of Plastic and Reconstructive Surgery, Busan Paik HospitalInje University School of MedicineBusanKorea
  2. 2.Apgujeong YK Plastic Surgery ClinicSeoulKorea

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