The perception of facial asymmetry using 3-dimensional simulated images

Research output: Contribution to journalArticlepeer-review


  • Grainne McAvinchey
  • Fay Maxim
  • Barry Nix
  • Jelena Djordjevic
  • Rognvald Linklater

Colleges, School and Institutes

External organisations

  • Birmingham City University
  • Cardiff University
  • School of Visual Communication
  • Department of Orthodontics


Objective: To investigate the perception of facial asymmetry in young adults to identify the amounts of chin asymmetry that can be regarded as normal and may benefit from correction. Materials and Methods: Three-dimensional (3D) images of 56 individuals of mixed ethnicity were obtained and used to produce average 3D images of male and female faces. Distortion was then applied to these average faces using a 3D graphics package to simulate different amounts of chin point asymmetry. Five observer groups (lay individuals, dental students, dental care professionals, dental practitioners, and orthodontists) assessed timed presentations of 3D images, rating them as "normal," "acceptable," or "would benefit from correction." Time-to-event analysis was used to assess the level of chin asymmetry perceived as normal and beneficial for correction for each group. Results: The factors influencing the perception of facial asymmetry were the degree of asymmetry and the observer group. Direction of the asymmetry and gender of the assessed individual did not affect the perception of asymmetry, except in the 4- to 6-mm distortion range. The gender of the observer had no influence on perception. There were statistically significant differences in the amounts of asymmetry that the laypeople and orthodontists considered to be normal (5.6 ± 2.7 mm and 3.6 ± 1.5 mm, respectively; P < .001) and felt would benefit from surgical correction (11.8 ± 4.0 mm and 9.7 ± 3.0 mm, respectively; P < .001). Conclusions: Perception of asymmetry is affected by the amount of asymmetry and the observer group, with orthodontists being more critical.


Original languageEnglish
Pages (from-to)957-965
Number of pages9
JournalThe Angle Orthodontist
Issue number6
Early online date27 Mar 2014
Publication statusPublished - 1 Nov 2014


  • Facial asymmetry, Perception, Three-dimensional images

ASJC Scopus subject areas