A Biological Approach to Periorbital Aesthetics in Caucasian Women: A Review of the Literature.

The face plays an important role in human interactions, and the periorbital region is particularly important to allow recognition and attractiveness. There are several studies on the beauty of the periorbital region using a variety of methodologies, but few articles consider the attractiveness factors derived from evolutionary psychology such as symmetry, dimorphism, age and average, neoteny and facial expression. The aim of this study is to identify periorbital attractiveness criteria in Caucasian women based on experimental studies and to interpret them in the light of studies on biological attractiveness factors. A review of literature was conducted using PubMed (National Institutes of Health, Bethesda, MD), Cochrane Library Database (Wiley, Hoboken, NJ) and EMBASE (Elsevier, Amsterdam, the Netherlands). Studies published after March 20, 2022, were analyzed, and no date limit was applied in reference papers. The search strategy was focused on three main concepts: attractiveness AND evaluation AND facial feature of periorbital region. 780 articles were identified with this search strategy, 534 were excluded based on title and abstract and another 110 from full text assessment. 18 articles were finally included in the analysis. The main factors identified were an ascending intercanthal axis and eyebrow axis, a regular pretarsal plate as well as a well-defined upper lid crease, no scleral show, and an open eye fissure exposing the upper half of the iris. In our review we were able to identify objective anthropometric characteristics linked to biological attractiveness criteria that may be useful in preoperative planning and assessment of the periorbital region of patients.