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Two patients shown in unaltered images (left), and as digitally optimized by their own preferences and those of independent judges (right). DENISE KITAY

I'm going to rearrange your face," boasts the hooligan, but few can back up those words like Donald Giddon, D.M.D. '59, lecturer on orthodontics at the Harvard School of Dental Medicine. Giddon doesn't use fists, but a new computer program that displays a photo of your profile and then can alter it: moving the jaw in or the upper lip out, bumping up the nose--even giving you a one-inch overbite, if you covet that Neanderthal look. Although the program, which uses morphing technology, is fun to operate in its own right, it serves a clinical purpose for dentists, oral surgeons, orthodontists, and even plastic surgeons. Patients about to undergo treatment that will alter the bones or soft tissue of the face can use it to show their doctors how they want to look when they emerge.

"How do you tell somebody what you want to look like?" Giddon asks. "How does the doctor tell you what you can look like?" Standard practice in oral surgery has the patient instruct the surgeon via a series of verbal cues. But telling is not the same as showing. With an area as sensitive as someone's face, miscommunication can quickly lead to a strained relationship.

"[The program] allows the patient and the clinician to communicate using the same vehicle," Giddon says. The patient first sees an image of his or her profile on a monitor. One feature--the chin, for instance--will be vastly distorted, jutting out several inches. At the touch of a button, the chin begins to recede. When it reaches a point of "acceptability," the patient clicks the mouse button and holds it down. The chin continues receding; when it reaches a point of "unacceptability," the patient releases the mouse. The software can do this for five components of the lower face: upper lip, bimaxillary position, chin, mandible, and lower face height. Says Giddon, "The face is set up to unfold like a flower blooming in slow motion."

The results give the surgeon a range to work within, and a midpoint to shoot for. In a related study, participants viewed shifting images of several faces and chose both a range of acceptability and a "most pleasing" point for each feature. In almost every case, the most pleasing point was the midpoint of the range. "No matter where we start, the person brings the image back to the class 1 ['normal'] occlusion," Giddon says. "If someone has a normal occlusion, they invariably put 'make no change.' That's the validity of it."

Giddon, a former professor of dental ecology at Harvard, developed the software with computer programmer Jason Kinchen, orthodontist Carla Evans, D.M.S. '75, of the University of Illinois at Chicago, and post-doctoral researchers Regina Sconzo, D.M.D. '93, Denise Kitay, M.O.B. '93, Debbie Bernier, D.M.D. '95, M.O.B. '97, and Vincent Arpino. So far, the program can morph only profiles. But other procedures being developed will allow for frontal face and even full-body morphing.

Giddon, who has graduate degrees in both dental medicine and clinical psychology, would like to use these technologies to study the correspondences between appearance and mental health. He and his team have found, for instance, that the difference between an acceptable and an unacceptable feature can be as small as one twenty-fifth of an inch, or approximately one millimeter. He hopes to determine through further research the point at which distortions of one's own face evoke an emotional response.

One of Giddon's colleagues, Victor Johnston of New Mexico State University, has a database of features that can produce 34 billion permutations of the human face. People asked to select the most attractive or beautiful combination of features tended consistently towards two ideals: a man who resembled John F. Kennedy Jr., and a woman who looked remarkably like Baywatch's Yasmine Bleeth.

Another study asked four groups of judges--each comprising a patient, a patient's significant other, an oral surgeon, and an orthodontist--to determine a range of acceptability for the five components of the patient's lower face. Not surprisingly, the patient was the least tolerant, defining the narrowest ranges of acceptability. But the oral surgeon was next. The significant other was third, barely ahead of the orthodontist. Giddon explains: "The tendency of the significant other is to love you no matter what you look like."

~ Matt O'Keefe

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