Singh, Prateush; (2025) FRAME: Facial Reconstruction, Aesthetics, Modelling and Exploration. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

BACKGROUND: Facial reconstruction is needed after congenital defects, cancer and trauma; frequently requiring multiple stages with disfiguring intervening steps, often with unclear expectations of the final end point for surgeon and patient. OBJECTIVES: This work aims to use 3D photography and computer modelling to improve patient expectations and plan surgical steps, improving outcomes and surgical training. To do this, we must investigate what are meant by “ideals” in attractiveness, how this correlates with other perceived attributes, and how this can be utilised clinically to benefit patients. METHODS: Methodology will review the literature on facial beauty, neurobiology and neuroaesthetics; develop and evaluate a peer-reviewed aesthetic database of female faces; analyse the perception of attributes with facial appearance; develop a novel craniofacial MDT-clinic reviewing clinical patients in real-time with 3D photography and computer modelling; develop a training database for surgical trainees; develop a case series of patients and evaluate post operative outcomes; explore face transplantation, and quantify parameters of facial attractiveness. RESULTS: A database of 2870 aesthetic female faces was created. 21 volunteers at UCL rated the attributes of attractiveness, perceived age, health, femininity, and happiness. Principle component analysis (PCA) clustering illustrated grouping by latent space parameters for facial dimensions and real space 3D morphable models (3DMMs). Literature reviews were performed on neuroaesthetics and facial parameter assessments. 38 measurable parameters were identified and measured. A craniofacial MDT-clinic was established to develop a clinical case series of 35 patients who underwent surgery, patient reported outcome measures (PROMS) scored, and a training database was developed. CONCLUSIONS: This PhD highlights the importance of addressing facial attractiveness in facial reconstructive surgery, the association of facial attractiveness with other perceived attributes, illustrates how integration of photography and computer modelling can improve patient outcomes and clinical training, quantifies facial attractiveness, and analyses the futures of facial transplantation.

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