Facial Morphology in Permanent Makeup

It is common knowledge that a totally symmetrical face does not exist. However, for specialists in certain fields, for example facial plastic surgery or micropigmentation, it is vital to build the model of a “normal” face as a mould for their works. Such a face would be well balanced and as symmetrical as possible; this symmetry is represented with a number of virtual reference lines. With the image of the “normal” face in mind the practitioner would make wiser and more weighted decisions, exercising their work with a high degree of precision.

A human face is subject to constant changes happening for a numerous reasons. Among these reasons are: change in growth, muscle tone, fat and hair distribution, elastic tissue qualities. It is vital for the artist to remember about these changes to pick the most appropriate technique of pigment application. Thus, patients who are more advanced in age, require a more subtle rather than intense and heavy pigment distribution. It is also important to remember that due to the changes in skin elasticity and muscle tone their faces might differ significantly from the further discussed normal face.

The first step of any successful micropigmentation treatment is the correct face assessment. To be able to perform it in the most accurate way, the artist should be familiar with the basic concept of facial morphology and make the facial analysis their routine. To simplify the procedure of face assessment we are going to introduce to you the fundamental reference lines.

The analysis begins with referring to the midsagittal facial line (F1) dividing the face in vertical halves. Technically, this line does not necessarily define the middle of the nose. It should rather be drawn starting at the apex of the cranium down to the inferior middle area of the chin. In the ideal face, the midsagittal facial line does indeed coincide with the middle of the nose dividing the face in two equal parts. However, in practice the artist will notice that most faces have the nose deflected to one side.

The second most important reference line is the midhorizontal iris line (F2) which is perpendicular to the midsagittal facial line (F2).

The midhorizontal iris line (F2) is drawn through at least one iris (in the ideal face it is drawn through both). The artist chooses the eye that is the closest to the position that would divide the face in equal upper and lower portions.

The two fundamental reference lines are the most basic ones creating the canvas for the further face assessment. In a thorough facial morphology examination an artist should also use the subordinate reference lines described below. In a broad way they are divided into three main groups: vertical parallels, horizontal parallels and oblique lines.


Vertical parallels

N1 – a vertical line parallel to F1, it is drawn through the lateral side of the nares and extends further through the side of lacrimal caruncle. It defines the 1st part of the brow line.

H1 – a vertical line parallel to F1 and N1, it goes through the outer margin of the iris down and should ideally meet the corner of the lip.

L3 – a vertical parallel line that stems from the apex of the Cupid’s bow on each side and extends superiorly. It should divide the nares in equal halves.

Horizontal parallels

L1 – a horizontal line parallel to the F2 line is drawn at the inferior border of the lower lip. Ideally, it should divide the area of the face between the bottom of the chin and the tip of the nose in two equal parts.

L2 – a parallel line drawn, consequently, at the superior border of the upper lip.

B1 – a parallel line that should connect the nasal part of the brow with the temporal part.

B2 – a parallel line that defines the upper border of the eyebrows.

Oblique lines

N2 – an oblique line stemming from the lateral side of the nares and going through the lateral corner of the eye should in the ideal face define the most temporal part of the eyebrow (eyebrow’s tail). If extended inferiorly, this line should fall in the central point of Cupid’s bow.

H2 – an oblique line drawn from the lateral side of the nares at the outer border of the pupil extending superiorly should reach the top point eyebrow’s arch.


“Micropigmentation: Millenium”, published by Apex, 2010. Written by Charles S. Zwerling, Linda H. Dixon, Frank F. Christensen, Norman F. Goldstein, George P. Walker.

“Facial Asymmetry: Etiology, Evaluation, and Management” article from Chang Gung Med J Vol. 34 No. 4 July-August 2011, written by You-Wei Cheong, MD; Lun-Jou Lo, MD. 

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