Smiling in the East and the West : Anatomical, cultural and sociological considerations in facial reanimation surgery

Abstract

The importance of the smile as a means of communicative and metacommunicative signal in social engagement has been known and highlighted in studies dating back to the early 19th century. It remains a cornerstone of reconstructive surgeries for the paralyzed face. This paper calls attention to the differences between the Eastern and Western smile. Anatomical, cultural, and sociological peculiarities inform the way these populations smile and the way smiling itself is perceived. Reconstructive surgery of today would benefit from considering these aspects and allowing them to individualize the goals of reanimation procedures. (c) 2025 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/