Beyond the sphere of the English facial approximation literature: Ramifications of German papers on western method concepts

In the English literature, facial approximation methods have been commonly classified into three types: Russian, American, or Combination. These categorizations are based on the protocols used, for example, whether methods use average soft-tissue depths (American methods) or require face muscle construction (Russian methods). However, literature searches outside the usual realm of English publications reveal key papers that demonstrate that the Russian category above has been founded on distorted views. In reality, Russian methods are based on limited face muscle construction, with heavy reliance on modified average soft-tissue depths. A closer inspection of the American method also reveals inconsistencies with the recognized classification scheme. This investigation thus demonstrates that all major methods of facial approximation depend on both face anatomy and average soft-tissue depths, rendering common method classification schemes redundant. The best way forward appears to be for practitioners to describe the methods they use (including the weight each one gives to average soft-tissue depths and deep face tissue construction) without placing them in any categorical classificatory group or giving them an ambiguous name. The state of this situation may need to be reviewed in the future in light of new research results and paradigms.