Light-driven dynamic surface wrinkles for adaptive visible camouflage.

Camouflage is widespread in nature, engineering, and the military. Dynamic surface wrinkles enable a material the on-demand control of the reflected optical signal and may provide an alternative to achieve adaptive camouflage. Here, we demonstrate a feasible strategy for adaptive visible camouflage based on light-driven dynamic surface wrinkles using a bilayer system comprising an anthracene-containing copolymer (PAN) and pigment-containing poly (dimethylsiloxane) (pigment-PDMS). In this system, the photothermal effect-induced thermal expansion of pigment-PDMS could eliminate the wrinkles. The multiwavelength light-driven dynamic surface wrinkles could tune the scattering of light and the visibility of the PAN film interference color. Consequently, the color captured by the observer could switch between the exposure state that is distinguished from the background and the camouflage state that is similar to the surroundings. The bilayer wrinkling system toward adaptive visible camouflage is simple to configure, easy to operate, versatile, and exhibits in situ dynamic characteristics without any external sensors and extra stimuli.

Advanced Injection of Botulinum Toxin in the Nasal Muscles: A Novel Dynamic Change in Facial Expression.

BACKGROUND: Among the nasal muscles, the levator labii superior alaeque nasi (LLSAN) acts as a transitional muscle that conjugates with other nasal and perinasal muscles. Thus, when treating the nasal region with Botulinum toxin (BTX), it is important to understand local nasal muscular dynamics and how they can influence the muscular dynamics of the entire face. METHODS: This is a retrospective analysis of cases treated by an injection pattern encompassing the face, including nasal muscles. Photographs were taken at rest and during motion (frontal and oblique views), before and after treatment. RESULTS: A total of 227 patients have been treated in the last 18 months with the following results: eyebrow tail lifting, softness of crow's feet, improvement of the drooping of the tip of the nose, and shortening of the lip philtrum when smiling. We present cases illustrating the use of this approach. CONCLUSIONS: Treating the facial muscles globally (including the frontal, corrugators, procerus, orbicularis oculi, platysma, DAO, and nasal muscles) can improve the smile and facial expressions. This is believed to occur because the elevated portion of the upper lip muscle becomes stronger as the nasal part of the LLSAN is paralyzed. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Assessment of the Efficacy and Durability of IncobotulinumtoxinA in the Treatment of the Upper Face in Adult Women.

INTRODUCTION: IncobotulinumtoxinA (Xeomin®) is used in the treatment of dynamic wrinkles and the aesthetic repositioning of facial structures. The duration of its muscular effect typically extends for around 4 months. However, the residual aesthetic benefit can be observed for a longer period. To date, the long-term aesthetic benefit of incobotulinumtoxinA in facial aesthetics has not been systematically evaluated. This study aimed to evaluate longitudinally the duration and aesthetic benefits of incobotulinumtoxinA in the treatment of the upper face in adult women. METHODS: A quasi-experimental, evaluator-blind, clinical trial involving 28 adult women (30-60 years old) with facial movement lines, undergoing treatment of the upper face with incobotulinumtoxinA by two injectors, following an individualized protocol (ONE21 and glabellar contraction patterns) was performed. Participants were evaluated on the day of the intervention (day 0) and days 30, 120, 180, and 240, and subjected to standardized photographs. The following outcomes were evaluated blindly at each visit: Merz Aesthetics Facial Contraction Scale (MAS), GAIS (Global Aesthetic Improvement Scale), and patient satisfaction. Adverse effects were evaluated at each visit. RESULTS: Participants ranged in age from 30 to 60 years, 93% were self-declared white, and most of their baseline MAS scores for dynamic lines were moderate and severe. All the parameters presented significative reduction from baseline until day 180. At day 240, the dynamic MAS scores were lower than baseline for forehead lines in 15.4% (95% confidence interval (CI) 0.8-30.0%) of the participants, for glabellar lines in 38.5% (95% CI 18.8-58.1%), and for crow's feet lines in 26.9% (95% CI 9.0-44.8%). Aesthetic improvement compared to baseline was identified in 35% (CI 95% 23‒50%) of the participants at day 240, and 62% (CI 95% 42‒81%) of the sample kept reporting some satisfaction with the procedure. CONCLUSION: The aesthetic treatment of the upper face with incobotulinumtoxinA demonstrates enduring clinical benefits, and patient satisfaction lasting up to 180 days in most participants. The length of efficacy, which exceeded those reported in the literature, may be attributed to the use of techniques based on individualized assessment such as ONE21 and glabellar patterns of contraction.

IncobotulinumtoxinA for the Treatment of Glabella and Forehead Dynamic Lines: A Real-Life Longitudinal Case Series.

Background: There is substantial interpersonal variation in the patterns of muscular contraction that substantiates the use of personalized points of application and dosages in clinical practice to achieve optimal results. Nevertheless, there has been no real-life therapeutic series with botulinum toxin for aesthetic treatment of the face in which the subjects were systematically followed to assess its long-term benefit. Purpose: To assess the performance and length of the treatment of glabellar and forehead lines with IncobotulinumtoxinA in a real-life setting. Patients and Methods: We enrolled 20 adults with indications for the treatment of upper facial dynamic lines (glabella and forehead) with botulinum toxin. The protocols of injection points were personalized by the injectors. The participants were photographed under maximum facial contraction before the application (D0) and after 15, 90, 120, and 180 days. The photos were randomly assessed by two blinded experienced raters to consensually grade the dynamic lines according to the Merz Aesthetics Scales (MAS). Efficacy was defined as the reduction in the MAS score. Results: At D15, 18 (90%; 95% CI: 80%-100%) participants reached the zero score, or a 2-point reduction on the MAS score from the forehead and 16 (80%; 95% CI: 65-90%) reached that reduction for the glabella. These values from D90 were 14 (70%; 95% CI: 55-85%) for both sites. At D120, these values were 11 (55%; 95% CI: 35-75%) and 8 (40%; 95% CI: 25-55%) for the forehead and glabella. At D180, 10 (50%; 95% CI: 30-70%) participants presented a MAS score for forehead or glabella dynamic lines lower than the score assessed at D0. Conclusion: As much as 70% of the patients sustained a reduction of scores after 120 days of the treatment for dynamic glabellar and forehead lines. Half of the patients evidenced prolonged benefit at 180 days.

ONE21 technique for an individualized assessment and treatment of upper face wrinkles in five pairs of identical twins with IncobotulinumtoxinA.

BACKGROUND: Facial aging is a complex process, which, beyond a genetic predisposition, involves both physical and environmental factors. Even identical twins with the same genetic load may differ substantially in facial wrinkles and aging, demanding a personalized treatment approach. OBJECTIVE: To demonstrate the ONE21 technique as an excellent tool to a customized assessment and IncobotulinuntoxinA treatment to address phenotype discordances and epigenetic drifts in identical twins, expressed by different patterns of upper face muscle contractions and wrinkles intensity. PATIENTS/METHODS: Five pairs of identical Caucasian twin sisters, from 30 to 45 years of age, were evaluated for hyperfunctional upper facial wrinkles (forehead, glabella, and periorbital), assessing the individual anatomy, muscle function and habitual facial movements of each patient. All the subjects were treated with the ONE21 technique using IncobotulinumtoxinA and reevaluated 30 days after the procedure. RESULTS: Though the clinical-anatomical pattern of the forehead contraction was similar between the pairs, the strength of the muscles, the number and depth of wrinkles differed. This varied presentation demanded distinct points of distribution and dosages of incobotulinumtoxinA for all the twins, according to the ONE21 approach. The results 30 days after treatment were satisfactory in all the subjects. CONCLUSION: The ONE21 technique allows an objective and careful evaluation of the wrinkles of the upper face, based on an individualized assessment, which may vary even in identical twins.

High-Contrast Dynamic Reflecting System Based on Pneumatic Micro/Nanoscale Surface Morphing.

Cephalopods offer a fascinating dynamic reflecting system to create desired colors and patterns through contracting and releasing their soft skins in response to environmental stimuli. Inspired by this natural display strategy, we designed a novel dynamic reflecting system based on pneumatic micro/nanoscale surface morphing. This system consists of a thin metal skin/elastomer bilayer modulated by a microfluidic-based gas injector. Benefited from the "wrinkled-specular" transition of the metal's surface under a small pneumatic actuation (4 kPa), an unprecedented reflectance contrast of 93 for broad-band (500-750 nm) modulation is achieved. This remarkable response also has excellent cycle stability (>2500 times) and fast response time (∼0.2 s). These advantages enable a robust and ultrasensitive optical gas pressure sensor with a sensitivity of 178 kPa-1, which is 3-4 orders of magnitude higher than those of conventional optical gas pressure sensors based on either a Fabry-Pérot interferometer or a Mach-Zehnder interferometer. Moreover, as proof-of-concept applications, we also experimentally demonstrated a curvature-variable convex mirror and noniridescent dynamic display, suggesting that our pneumatically dynamic reflecting system will potentially broaden the applications in adaptive optical devices, sensors, and displays.

Photodynamic Pattern Memory Surfaces with Responsive Wrinkled and Fluorescent Patterns.

Reversible pattern systems, namely pattern memory surfaces, possessing tunable morphology play an important role in the development of smart materials; however, the construction of these surfaces is still extensively challenging because of complicated methodologies or chemical reactions. Herein, a functionalized basement is strategically integrated with a multi-responsive supramolecular network based on hydrogen bonding between aggregation-induced emission luminogens (AIEgens) and copolymers containing amidogen (poly(St-co-Dm) to establish a bilayer system for near-infrared (NIR)-driven memory dual-pattern, where both the fluorescence emission and wrinkled structures can be concurrently regulated by a noninvasive NIR input. The motion of the AIEgens and photo-to-thermal expansion of the modified base allow temporal erasing of the fluorescent wrinkling patterns. Meanwhile, when exposed to 365 nm UV radiation, the fluorescent patterns can be independently regulated through photocyclization. The fluorescent wrinkling pattern presented herein is successfully demonstrated to promote the level of information security and capacity. This strategy provides a brand-new approach for the development of smart memory interfaces.

One21: A Novel, Customizable Injection Protocol for Treatment of the Forehead with IncobotulinumtoxinA.

It is well known that incobotulinumtoxinA (INCO) is an effective approved treatment for dynamic wrinkles of the upper face caused by the action of mimetic muscles over time. In doing so, it is important to maintain a balance between muscle groups and a natural facial appearance. Patients differ enormously in their facial anatomy regarding structure and function, both within and between genders, ethnicities, and age. Therefore, treating all patients with the same injection pattern and the same doses can result in undesired outcomes. There is a need for a tailored approach to achieve optimal results, as well as to increase patient satisfaction. With this in mind, the novel one21 injection technique which allows for individualized treatment has been developed for the treatment of horizontal forehead lines using INCO, resulting in a positive impact on eyebrow position and shape. This technique is the next step in a customized approach, giving natural-looking results and high patient satisfaction.