The Golden Ratio and Aesthetic Surgery

The business of attaining and retaining beauty is an enigmatic and lucrative one, conspicuously lacking in scientific rigor despite attempts otherwise. We all know facial beauty when we see it, but how to unpick the lightning fast cognitive processes that lead to these snap judgements,1 and which underpin the painstaking endeavor of the aesthetic surgeon? Here, the demarcation between art and science is rarely more blurred. The intuitive aesthetic sense of the the experienced surgeon is a function of as-yet-undetermined analyses and computation, the demystification of which will eventually infuse our field with objectivity. Aristotle defined beauty as “a sense of harmonious or aesthetically pleasing proportionality,” and during this explosive era of Greek philosophy (c. 500 BC), multiple arithmetic principles such as the 1:1 “unity” ratio, the axial facial division into thirds, and the golden ratio came to light. The golden ratio, also known as phi or 1.618, is found by dividing a line such that the ratio of the short segment to the long segment is equivalent to the ratio of the long segment to the entire line (Figure 1). Initially described by Parthenon Phidias, it has been referred to as the Fibonacci ratio or the “divine proportion” and is found throughout nature, from the structure of DNA to the Milky Way, from flower petals to nautilus seashells, and depicted in human beauty in Da Vinci’s Mona Lisa and Vetruvian Man. Arithmetic relationship of the golden ratio. Beauty in symmetry arises from balanced proportions rather than simply mirror images. Symmetry is thought to be a phenotypic reflection of genetic superiority, thereby increasing sexual selection preference. Furthermore, studies have correlated beauty with happiness through increased economic advantage and earning potential, popularity, trustworthiness, and confidence, contributing to the notion that “beauty is power.”2 The most alluring ratio seen throughout our world is the golden ratio. This led Marquardt to perform cross-cultural surveys on beauty in the modern and historical day. He found that beauty is related to the golden ratio and is the same for both genders and for all races and cultures. He then developed the controversial Marquardt mask based entirely on the golden ratio as a model applied to human faces to determine optimum beauty. Bashour’s study supports the use of this mathematical model to produce an objective system for measuring facial attractiveness.3 Applying the mask to 72 European Caucasian individuals and judging their appearance in surveys, he found that the mask model correlated strongly with attractiveness.3 In contrast, however, Holland’s study found that Marquardt’s mask best describes facial proportions of “masculinised white women as seen in fashion models,” and does not accurately reflect the “ideal” faces of all other women, especially non-Caucasians.4 Individuals of different cultures have different perceptions of beauty, complicated by the dynamic nature of the face and the swift ability of the human eye to detect irregularities and asymmetries in movement. This is important when carrying out aesthetic procedures that may create a statically beautiful face but one that is less so on movement. This observation has led some surgeons to take videos of their aesthetic surgery patients rather than just static photographs, attempting to quantify beauty in motion subjectively and objectively5 and not apply a one-mask-fits-all approach to them. The aesthetic characterization of facial beauty is elusive and cannot be reduced to a simple “ideal” ratio alone.5 Nurture, cultural, and media exposures all intersect to shape our assessment, yet the rapidity of our evaluation within a split second of viewing a stranger’s face, and with remarkably similar judgements across cultures, belies a likely hardwired origin, rooted in evolutionary biology. The golden ratio is attractively simple and beguiling as a theory, but ultimately incomplete. The quest for a unifying theory continues, but there is evidence to support universally enduring standards of beauty as defined by similar mathematical principles. The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article. The authors received no financial support for the research, authorship, and publication of this article.