Perspectives on the face (2006)
Author: M Michael CohenJr.
Publisher: Oxford University Press, Oxford, UK
Price: £46.00
ISBN: 0-19-530040-8
This fascinating and unusual book is aimed at a very broad readership, including biologists, a variety of clinicians, and art historians. The face is considered from eight different perspectives, so that one's first assumption is that each chapter would be written by an expert in that particular field, Michael Cohen being the editor. Astonishingly, however, he has written the entire work. His background as a clinical geneticist clearly shows through, particularly in the early chapters dealing with the evolution and embryology of the face, including a comparison of the development of the human skull with that of other mammals. One reason why this book is such an enjoyable read is in its witty use of illustrations, as when demonstrating the evolution of the human face from its original anterior to its present inferior relationship to the cranium, by comparing a Chevrolet Corvette with a Camper van!
Understandably, given the author's background, his description of facial development and growth has a very strong genetic rather than a functional leaning; indeed, functional matrices do not appear. Sadly, the work of Björk on mandibular growth rotations is also not cited. The chapter on anatomy/physiology is comprehensive, covering not only the facial structures but also those of the brain as well. The use of multiple tables in the chapter on dysmorphic and genetic perspectives will certainly prove very handy as a source of reference.
The surgical chapter begins with an abbreviated history of both craniofacial and maxillofacial surgery, with potted descriptions of the work of early pioneers such as Le Fort, Tessier, and others. Inevitably, there are some idiosyncracies, for example the description of the value of pre-surgical orthopaedics prior to cleft lip repair clearly reflects the views of the cleft team in Boston, but would not necessarily meet with worldwide agreement. Also, orthognathic surgery nowadays does not require the use of intermaxillary fixation. However, in general the book is extremely up-to-date and this particular chapter finishes with a section on facial transplantation, including a comment on the recent case in France.
The psychology section includes a description of mechanisms involved in facial recognition (in sheep: ‘ewe look familiar!’) and facial expression, seen from an evolutionary biological perspective. The discussion on the theories of attractiveness, with many references from the psychological literature, is stimulating. The subject matter in the later chapters of this book are of an anthropological and then, finally, artistic nature. The author's sense of humour surfaces at irregular intervals, for example under ‘dental customs’, listed among tribal rituals including filing and staining teeth, is including the following: ‘in North America moving teeth into ideal positions is a common practice for aesthetic purposes’ with a photograph of an unfortunate individual wearing orthodontic headgear. Various theories of ideal facial proportion are discussed; here, given the academic rigour with which many other theories are examined, the rather factual description of the golden proportion belies the fact that its validity has yet to be tested scientifically.
The book concludes with a philosophical discussion concerning the relationship between science and art in facial assessment. The sheer breadth of subject matter covered in this book is an achievement that has already been commented upon. Another is the enormous amount of valuable information condensed into each chapter. Ultimately, it is the author's success in integrating the eight facial perspectives and doing so with wit and humour that has made reading this book a valuable educational experience.
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