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Circles of prominence

Article-Circles of prominence

Editor's note

In addition to providing fresh clinical data and evolving surgical technique, Cosmetic Surgery Times seeks to present the most thought-provoking insights on the discipline from academe. In this piece, Dr. Philip Young elucidates his premise regarding the intriguing metrics of facial beauty. If you have a scholarly paper or concept you would like to share with your surgical peers, please e-mail us at

Our understanding of facial beauty has not undergone any significant change since Leonardo Da Vinci developed the neoclassical canons. Some believe beauty is defined by the mystical number phi (1.618) that defines the proportions of the face. Others believe that "averageness" is beautiful. Many recent studies have now shown that these ideas are all incorrect. Other theories exist but the bottom line is that the answer has not been found.

PREVIOUS THEORIES The problem with previous theories is that they were based on external landmarks that observers of a new face find unimportant. The canons were based on landmarks such as the trichion, glabella, subnasale and mentum, which have little relevance to what people concentrate on when determining beauty.

Neuropsychologists have studied eye movements when people look at pictures of a face. They find that they concentrate on the eyes, nose and mouth and then other landmarks but return repeatedly to the eyes, nose and mouth. Specifically, the eye movements are centered predominately on the iris. When we think of how we talk to one another, we can come to the realization that we do indeed spend most of our time focusing on the iris from an everyday point of view.

CIRCLES OF PROMINENCE With that in mind, Circles of Prominence (COP) theorizes that the size of the iris determines every dimension on the face. Every shape and distance has a precise relationship on the face and thus has an ideal value. Between zero and infinity there has to be a median that the brain prefers. Because we spend so much time focusing on the iris, COP holds that it is the size of the iris or a proportion of it (i.e., 1/2 to 1 iris width, etc.) that defines the ideal. Application of this premise reveals that the nasal dorsum, nasal tip, alae, the distance from the subnasale to upper lip, and height of the lower lip are all one iris width (IW) in dimension (Figure 1).

SYMMETRY, BEAUTY The face is simply a collection of shapes within a larger oval with the eyes, nose and mouth as major shapes within the oval. When people are asked to judge whether a circle within a box is more aesthetically pleasing right in the center versus an asymmetric position, the majority will prefer the central location. This preference for order applies in the face as well. Because the eyes, nose and mouth are the main structures of the face, the distance between them should be separated symmetrically. Within these major structures, the iris, nasal tip and lower lip are the primary COP or centers of the eye, nose and mouth.

THE EYES Hence, the distance from the pupil to midline, from the horizontal level of the pupil to the nasal tip, from tip to lower lip, and from lower lip to the mentum should all be three iws (Figure 2).

The size of the iris also determines the distance between all structures. Within the eye there are four COP (Figure 3). The first and primary COP is the iris. The next COP is two IWs high and three wide.

The second COP is explained by the following: the distance between the limbus to the medial or lateral canthus is one IW; the distance from eyelid ciliary margin to palpebral fold is 1/2 IW, which is also the distance from the lower lid margin to the bottom of the shadow produced by the pretarsal muscle bunching. This creates the 2 x 3 IW dimension of the second COP.

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