摘要目的 构建北方汉族不同年龄组女性人群的三维平均脸,以探讨面部形态随年龄增长而产生的衰老变化.方法 2016年10月至2017年5月,中国医学科学院北京协和医院整形外科采用三维立体成像技术,建立北方汉族20～65岁普通女性共187人面部三维图像模型.受试对象根据年龄划分为4组,使用逆向工程软件和数学建模软件分别构建各年龄组的三维平均脸,进行观察描述、偏差分析和特征点间距的测量,分析北方汉族女性面部形态随年龄增长发生的变化.结果(1)共收集北方汉族普通女性面部三维图像模型187人,共分为4组.第1组(20～29岁)50人,第2组(30～39岁)44人,第3组(40～49岁)50人,第4组(50～65岁)43人.(2)随年龄增长,第1组与第2组仅眶周、口角有轻度差异;第2组与第3组相比,上睑松垂,额颞部明显后凹,下面部呈向下后方移动趋势;第3组与第4组偏差主要体现为凸起,由面部软组织松垂造成,其中上睑外侧、鼻唇沟脊以及嘴唇、颏部较为明显.(3)随年龄增长,平均脸外眦间宽、眼裂宽呈现明显下降趋势;鼻宽、鼻高、鼻长呈上升趋势;口宽、上唇皮肤高度呈明显上升趋势,上唇高及下唇高呈下降趋势.结论北方汉族成年女性面部形态随年龄变化在40～49岁时最为显著,额颞部、眶周、鼻下部、口周均发生变化,主要以面部容积缺失为主;从50岁以后开始明显出现面部软组织的松弛、下垂.三维平均脸技术具有临床可操作性,能反映某一特定人群面部的共同特征,未来具有应用于多样的临床研究的潜力.

abstractsObjective To construct the three-dimensional ( 3D) average face of Han women of different age groups in northern China. Methods From October 2016 to May 2017, a total of 187 facial 3D photographs of Han women aged from 20 to 65 in northern China were collected, using 3D photography technology. The subjects were divided into four groups according to their ages. The reverse engineering software and mathematical modeling software were used to construct the three-dimensional average faces of each group. Subjective description, deviation analysis and linear measurements were performed to analyze the facial morphology changing with age. Results ( 1 ) The average faces of the twenties and thirties showed insignificantly differences in periorbital area and cheilion. Those in the thirties and forties showed loosen of upper eyelids, obvious depression in frontal and temporal area, and downward and backward movement of lower face. The differences between the forties and fifties could be described as sagging and dropping, which may be caused by the drooping of facial soft tissue. They were most obvious in the lateral upper eyelid, followed by nasolabial groove and ridge, lips and chin. ( 2) The average epicanthus and ocular width narrowed with age, however, nasal width, height and length increased. Oral width and philtrum length significantly increased with age, accompanying with decreased upper and lower vermilion height. Conclusions The facial morphology of Han women in northern China changed most significantly when they in their forties. Facial soft tissue sagging and dropping mainly occurred in their fifties. The construction of 3D average face can be clinically applied and show the common facial features of a specific population. It has the potential to be applied in a variety of clinical studies in the future. Our findings can be used as guidance of facial rejuvenation treatment.