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Note what signs you see.
I (W. Wertelecki, M.D.) see a facies, a term that denotes “a face that talks to you”. If you think the palpebral fissures are narrow, then you should measure them. If you think that the upper lip is flat and the vermalion is narrow or thin, then you should compared these features with the standardised chart to quntify the degree of deviation from averages. Further comments and perspectives are found in this patient’s photo-gallery.