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We aim to measure the zygomatic width and protrusion changes in hard tissue after reduction malarplasty and then calculate facial proportion changes and analyze the relationship between facial proportion changes and patients’ satisfaction. We retrospectively reviewed our database and selected 36 eligible patients who underwent isolated reduction malarplasty in our department from March 2015 to July 2018. The preoperative and postoperative facial width and protrusion, as well as head height, in hard tissue were measured using ProPlan software. Patients’ satisfaction was evaluated by questionnaire. The correlations between the facial proportion changes and patients’ satisfaction were analyzed using Spearman correlation analysis. The preoperative and postoperative midface widths were 135.87 ± 4.09 mm and 129.06 ± 4.95 mm. The relative zygomatic protrusion was reduced by 3.29 ± 1.54 mm in the left and 2.88 ± 1.73 mm in the right after surgery. The ratio of the midface width to lower face width changed from 1.43 ± 0.05 to 1.36 ± 0.06 after surgery. And the ratio of the head height to midface width changed from 1.53 ± 0.05 to 1.61 ± 0.05 after surgery. The ratios were indeed close to the ideal ratios we presumed (4:3 and 1.618). Moreover, patients’ total and morphology satisfaction were both significantly higher with the postoperative ratio of the midface width to lower face width closer to 4:3 (R = − 0.732, P

To better our ability to analyze the facial disproportions of patients of Chinese ancestry, we compared the validity of four neoclassical canons of facial proportion in Chinese and North American Caucasians populations. We tested the frequency of four horizontal facial canons and their eight variations in 206 healthy adults (105 males and 101 females, 18-25 years old) belonging to the predominant ethnic group (Han: 400 million) of the Chinese population, and compared them to those of 103 healthy young North American Caucasian adults. The nose width corresponded to one-quarter of the face width (the nasofacial canon) significantly more frequently in Chinese participants (51.5%) than in Caucasian adults (36.9%). The nose was narrower than one-quarter of the face width in 38.8% of North American Caucasians and in 21.8% of Chinese; this difference was also statistically significant. In defiance of the naso-oral canon, the mouths of Chinese people were significantly more often narrower than 1.5 times the nose width (71.8%), while in North American Caucasian ethnics the mouth was significantly more frequently wider (60.2%).