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Brief Communication |

The Angry Face Syndrome

Norman J. Pastorek, MD; W. Matthew White, MD
Arch Facial Plast Surg. 2011;13(2):131-133. doi:10.1001/archfacial.2011.14.
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The finding of frontal bossing, deep radix, straight nasal dorsum, and an overprojection of the nasal tip constitutes the angry face syndrome. Recognition of these patients and specific surgical attention to these features are especially rewarding to both patient and surgeon.

In our practice of facial plastic surgery, we consider patient body language and facial expression every day to make decisions about a patient's candidacy for surgery. While most body language and facial expressions are animated and dynamic, some static features are seen to convey aspects of psychological makeup. For example, a long, straight, wide nose is universally seen as masculine and confers a sense of strength or even invincibility to the person. The shorter, narrower, slightly retroussé nose gives a person a feminine character and a certain sense of vulnerability. Full lips, thin lips; small eyes, larger eyes all carry unspoken static messages that we intuitively interpret as being part of the person's psychological profile.

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anger ; face

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Figure 1.

Preoperative (left) and 1-year postoperative (right) images of a 30-year-old woman with angry face syndrome, including wide dorsum, tip, and alar base. A, Frontal views. B, Left oblique views. C, Left lateral views.

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Figure 2.

Preoperative (left) and 1-year postoperative (right) images of a 25-year-old man with angry face syndrome. A, Even in the frontal views, the radix graft can be seen to efface the great depth of the radix. B, Right oblique views. C, Left lateral views.

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Figure 3.

Preoperative (left) and 1-year postoperative (right) images of a 29-year-old man with angry face syndrome. A, Note that in the frontal views, the radix graft can be seen to have widened as well as projected the deep radix. B, Right oblique views, in which the tip has been slightly deprojected and the radix augmented. C, Left lateral views, in which the tip has been slightly deprojected and elevated, and the radix has been augmented.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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