Aesthetic experience enhances first-person spatial representation.

Episodic autobiographical memories are characterized by a spatial context and an affective component. But how do affective and spatial aspects interact? Does affect modulate the way we encode the spatial context of events? We investigated how one element of affect, namely aesthetic liking, modulates memory for location, in three online experiments (n = 124, 79, and 80). Participants visited a professionally curated virtual art exhibition. They then relocated previously viewed artworks on the museum map and reported how much they liked them. Across all experiments, liking an artwork was associated with increased ability to recall the wall on which it was hung. The effect was not explained by viewing time and appeared to modulate recognition speed. The liking-wall memory effect remained when participants attended to abstractness, rather than liking, and when testing occurred 24 h after the museum visit. Liking also modulated memory for the room where a work of art was hung, but this effect primarily involved reduced room memory for disliked artworks. Further, the liking-wall memory effect remained after controlling for effects of room memory. Recalling the wall requires recalling one's facing direction, so our findings suggest that positive aesthetic experiences enhance first-person spatial representations. More generally, a first-person component of positive affect transfers to wider spatial representation and facilitates the encoding of locations in a subject-centered reference frame. Affect and spatial representations are therefore important, and linked, elements of sentience and subjectivity. Memories of aesthetic experiences are also spatial memories of how we encountered a work of art. This linkage may have implications for museum design.

Single immediate implant placement in the maxillary aesthetic zone with and without connective tissue grafting: Results of a 5-year randomized controlled trial.

AIM: To assess the 5-year effects of grafting connective tissue while undertaking single immediate implant placement and provisionalization at the mid-buccal mucosa level (MBML). Secondary outcomes were buccal bone wall thickness (BBT), marginal bone level (MBL) and patient satisfaction. MATERIALS AND METHODS: Sixty patients with a single failing tooth in the maxillary anterior region were provided with an immediately placed and provisionalized implant. At implant placement, the patients randomly received either a connective tissue graft from the maxillary tuberosity (n = 30, test group) or no graft (n = 30, control group). The alveolar socket classification was mainly Type 2A. Data were collected before removing the failing tooth (T0 ), and at 1 (T1 ), 12 (T12 ) and 60 (T60 ) months after final crown placement. The primary outcome was the change in MBML compared with the pre-operative situation. Additionally, the change in BBT, MBL, aesthetics (using the Pink Aesthetic Score-White Aesthetic Score), soft-tissue peri-implant parameters and patient satisfaction were assessed. RESULTS: At the 5-year follow-up, 27 patients could be analysed from each group. In each group, one implant was lost during the osseointegration period, within 3 months of placement, resulting in an implant survival rate of 96.7% in both groups. MBML change at T60 was -0.6 (-1.1 to -0.1) mm in the control group and 0.1 (-0.4 to 0.5) mm in the test group (p = .008). BBT and MBL, aesthetics, soft-tissue peri-implant parameters and patient satisfaction showed stable results and satisfied patients, without clinically relevant differences between the groups. CONCLUSIONS: This 5-year follow-up study shows that grafting connective tissue when replacing a single failing tooth with immediately placed and provisionalized implant results in favourable peri-implant tissues and fewer MBML changes.

Comparing the modified socket-shield technique with the conventional immediate implantation technique in the anterior dentition: A 5-year retrospective clinical study.

AIMS: The aim of this retrospective clinical study was to compare the 5-year radiological and clinical outcomes of patients undergoing immediate implantation with or without the modified socket-shield technique. MATERIALS AND METHODS: Patients who underwent anterior tooth replacement via the modified socket-shield technique (MSST) or the conventional immediate implantation technique (CIIT) between 2016 and 2017 were included. The labial bone thickness was assessed at different measurement levels (0, 2, 4 and 6 mm apical to the implant shoulder (IS)) postoperatively (T1), 6 months postoperatively (T2) and 5 years postoperatively (T3). The pink aesthetic score (PES) was evaluated before surgery (T0) and at T2 and T3. Implant success, complications and patient satisfaction were evaluated at every visit. RESULTS: Thirty-six patients (18 in the MSST group) underwent follow-up for 5 years, with no cases of implant failure. Two cases of exposure were detected in the MSST group, but there were no significant effects on hard or soft tissue. Patients in the MSST group showed less and more stable bone resorption than did those in the CIIT group at any measurement level and any time. A higher PES was achieved in the MSST group. Patient satisfaction was similar in both groups. CONCLUSIONS: The MSST is a reliable immediate implantation method because of its ability to preserve the alveolar bone and provide superior recovery of aesthetics.

Improved brachial skin hydration and appearance with hyperdiluted calcium hydroxylapatite.

INTRODUCTION: The search for minimally invasive treatments for areas not covered by clothing, such as the arms, has increased, particularly to combat flaccidity resulting from factors such as aging and weight loss. This study evaluated the efficacy of calcium hydroxyapatite (CaHA), an injectable biostimulator, in improving flaccidity and hydration of the skin of the arms. MATERIALS AND METHODS: Six women between 40 and 50 years old with visible signs of brachial flaccidity were selected. Calcium hydroxyapatite was injected into the arms in a 1:4 dilution (1.5 mL per side), with subjective evaluation based on the GAIS score and objective hydration analysis using corneometry. RESULTS: After a single application of CaHA, there was a significant increase in skin hydration (12.2%), objectively assessed by corneometry. Patient and physician satisfaction was high, evidenced by visible improvements in photographs and by the GAIS score. No significant adverse events were reported, demonstrating the safety of the procedure. DISCUSSION: Our clinical observations confirm the ability of CaHA to visibly improve arm flaccidity. In addition, hydration measures support previous histological studies demonstrating increases in dermal proteoglycans. Compared to other studies, the increase in skin hydration with CaHA was similar to those obtained with hyaluronic acid, suggesting comparable results with a more comfortable and less invasive technique. CONCLUSION: This study demonstrates the efficacy of CaHA in improving hydration of brachial skin after a single treatment. Despite the limitations of the sample size, the research contributes to the medical literature, highlighting the utility of the 3 mL CaHA presentation for brachial treatment with objective results in skin hydration.

Intracorporeal evaluation of hyaluronic acid fillers with varied rheological properties and correlations with aesthetic outcomes.

BACKGROUND: Understanding the differences in soft tissue filler rheology and how these properties can impact clinical results is a fundamental concepts for any injector. This study aimed to assess the tissue integration characteristics of hyaluronic acid (HA) fillers manufactured with different technologies (Non-Animal Stabilized HA [HA-N] or Optimal Balance Technology [HA-O]) using ultra-high-frequency ultrasound. METHODS: Twelve female participants with mild-to-moderate midface volume loss and temporal hollowing were enrolled and treated with HA-N and/or HA-O. Participants were seen at five visits (screening/baseline [treatment], and Weeks 1 [optional touch-up], 4, 6, and 8 [follow-up visits]). Ultrasound was used to evaluate the degree of product integration. RESULTS: On ultrasound, HA-N presented with distinct borders, minimal tissue integration, and a capacity to displace tissues. Conversely, HA-O tended to spread horizontally within the same tissue plane and integrated within tissues. The volumizing capacity of the HA-O fillers was dependent on particle size. CONCLUSION: HA-N is suited for deep injections in areas such as the upper lateral cheek and under the muscle of the temporal region when a lifting effect is desired; HA-O is best suited for subcutaneous injections, in areas of dynamic movement or for patients with thin skin; and can be injected subcutaneously or supraperiosteally when a volumizing effect is desired.

Development and psychometric testing of the Aesthetics of Everyday Life Scale in Aging (AELSA).

BACKGROUND: The aesthetics of everyday life improves physical and mental health and social communication. This study aims to develop and test a novel instrument that assesses the aesthetics of the everyday life of older adults. METHODS: A mixed-methods study with a sequential exploratory approach was conducted from November 2021 to December 2022. Item generation and questionnaire formation were developed through interviews with older adults and a literature review (stage 1). A cross-sectional study was then conducted to test the psychometric properties of the novel scale among 380 older adults referred to Urban Comprehensive Health Service Centers (stage 2). The construct validity was tested via exploratory factor analysis (EFA) and with the principal component analysis method. Internal consistency and reliability of the scale were evaluated with Cronbach's alpha and test-retest with a 2-week interval. RESULTS: The initial scale was prepared with 39 items. In stage 2, EFA revealed a seven-factor model with 34 items. Internal consistency was acceptable for extracted sub-scales (Cronbach's alpha range: 0.67- 0.93) and the total score (0.926). The intra-class correlation coefficient for test-retest reliability was 0.90. CONCLUSIONS: The AELSA is a valid and reliable instrument for evaluating the aesthetics of everyday life in older adults. the scale will help policymakers in formulating interventions to improve mental health and well-being in older adults. Moreover, Further studies is need to provide more support of construct validity.

Can good neighbourhood perception magnify the positive effect of favourable built environment on recreational walking in China?

BACKGROUND: It remains unknown whether good neighbourhood perception can enhance the benefits of favourable built environment to physical activity. Moreover, the moderation pattern is less understood in developing countries. OBJECTIVES: This work aims to examine the moderation effects of perceived neighbourhood safety and aesthetics on the relationship between built environment and time for recreational walking. METHODS: We performed the examination using a sample of 760 residents in Fuzhou City, China. The Negative Binomial Regression Model was developed to examine the moderation roles of neighbourhood safety and aesthetics on the impact of built environment, adjusting for the effects of location, socioeconomic, personal preferences and social environment factors. Moreover, two sensitivity analyses were performed to test whether the moderators found are robust to the control of residential self-selection, and differential measures of conceptually-comparable aspects of built environment. RESULTS: We found stronger associations of time for recreational walking with road density and proportion of parks and squares POIs for residents with high perception of neighbourhood safety, compared to those with low perception of neighbourhood safety. There was a greater effect of the proportion of parks and squares POIs, when perceived aesthetics was high than when perceived aesthetics was low. The findings of neighbourhood safety and aesthetics as moderator, were robust in the two sensitivity analyses. No significant moderation effect was found for land use diversity. CONCLUSIONS: High perceived neighbourhood safety can magnify the positive effects of road connectivity and accessibility to parks and squares. Neighbourhood aesthetics positively moderates the association of time for recreational walking with accessibility to parks and squares. The findings emphasize the need to consider safety- and aesthetics-specific differences in estimates of built environment effects. Improvements in neighbourhood safety and aesthetics are key to effective interventions in built environment to better promote physical activity.

Essential shape: The role of essentialist beliefs in preferences for misshapen produce.

Understanding the reasons behind consumer rejection of misshapen produce is important because of its dramatic consequences on food waste. Drawing on psychological essentialism, we conduct seven studies to investigate the role of produce shape-related essentialist beliefs (i.e., the belief that produce shape is determined by an underlying and unobservable essence) in consumers' evaluations of misshapen produce. Our findings show that essentialist beliefs about produce shape are divided into four distinct dimensions (i.e., biological basis, discreteness, informativeness, and immutability). We find that endorsing discreteness beliefs decreases preferences for misshapen produce. Immutability beliefs produce the opposite effect, whereas informativeness and biological basis have little to no effect. These effects operate through typicality judgments. These findings suggest that considering essentialist beliefs have the potential to help enhance the acceptance of edible albeit misshapen produce.

Effects of bitten food images in marketing communications.

Marketing communications (e.g., food packages, restaurant menus, coupons, social media posts) often include images of bitten and non-bitten (i.e., complete) foods. Taking an empirics first approach, the current research explores how and why these images influence consumers. A field study shows a higher redemption rate for discount coupons featuring a bitten (vs. non-bitten) food. However, a controlled online study fails to replicate this effect. Two additional preregistered studies shed light on the inconsistent results observed online and in the field by identifying two competing mechanisms catalyzed by bitten food images. Bitten food images lead to vicarious enticement, an automatic process in which a viewer makes sense of a bitten food image by picturing someone approaching and tasting the food, as well as emotional conflict (i.e., the simultaneous activation of positive and negative thoughts and feelings). While vicarious enticement has a positive impact on product responses, emotional conflict has a negative impact. The effect of bitten (vs. non-bitten) food images on product responses appears to depend on the strength of these two mechanisms in a given context. These findings yield insights for researchers examining visual characteristics of food images as well as advertisers designing marketing communications.

Customized planning of the visible maxillary arch width in harmony with interparopia width and smile width for female facial aesthetics.

BACKGROUND: The visible maxillary arch width (VAW) is an important aesthetic-determining feature. To date, there is no well-established methodology to determine the aesthetically optimal VAW in customized treatment planning. METHODS: In this study, the common traits of the dentofacial configuration were investigated in most attractive Asian and Caucasian female smiles. The smiling photo of a subject was digitally modified based on combined variations of VAW, smile width (SW), transverse facial dimensions (TFD), and vertical facial dimensions. These modified photos were assessed for aesthetics. The aesthetically essential parameters were identified, and their mathematic correlations and reference ranges were determined for different vertical facial patterns. Using the obtained results, a mathematic guidance was constructed for customized smile designing. The applicability of this guidance was tested in Asian females. RESULTS: The most attractive Asian and Caucasian female smiles have intraracial and interracial commonalities in the VAW-to-TFD ratios. The interparopia width (IPD) predominated over facial widths in determining well-matched VAW and SW. For optimal smile aesthetics, the VAW and SW were correlated as simulated by the formula 1.92 IPD ≤ VAW + 2.3 SW ≤ 2.17 IPD, plus the VAW-to-IPD ratio within 0.54 to 0.62 and the SW-to-IPD ratio within 0.61 to 0.71, ranges tailored to vertical facial patterns. This constitutes a mathematic guidance for customized planning of the aesthetically optimal VAW. This guidance was preliminarily validated to be applicable to Asian females. CONCLUSIONS: The VAW-to-TFD ratios were essential for Caucasian and Asian female smile aesthetics. The mathematic guidance could serve as a reference for customized smile designs for Asian females.

Reconsidering the role of nasolabial angle in premolar extraction decision-making: A case-series study.

OBJECTIVES: To evaluate the impact of changes in upper incisor inclination and position on the alteration of the nasolabial angle (NLA) in a series of cases involving the extraction of four first premolars. MATERIALS AND METHODS: The study included 41 patients who underwent orthodontic treatment with premolar extractions. The patients were divided into two groups based on their pretreatment NLA values: Group 1 (NLA ≤ 100°) and Group 2 (NLA > 100°). Measurements of NLA, U1.NA and U1-NA were obtained before and after treatment and U1-Ls pretreatment measure was registered. Statistical analyses were performed to compare the differences in NLA, U1.NA and U1-NA between the two groups and to evaluate the influence of these variables added to U1-Ls (T1) on NLA changes. RESULTS: The results showed that Group 1 exhibited significant changes in NLA, while Group 2 did not. However, both groups showed significant changes in U1.NA and U1-NA. In Group 1, 80% of the individuals presented an increase in NLA and 20% no changes. In Group 2, 10% presented a decrease, 57% no changes and 33% an increase in NLA values. Multiple linear regression analysis indicated that the group factor had a statistically significant influence on NLA variation. Additionally, in Group 2, a negative correlation was observed between changes in U1.NA and NLA. CONCLUSIONS: The findings suggest that individuals with higher pretreatment NLA values tend to maintain their NLA values even after the correction of upper incisor inclination.

Effects of nasoalveolar molding on nasolabial aesthetics in patients with cleft lip and palate during pre-adolescence: A systematic review and meta-analysis of retrospective studies.

This study aims to analyze long-term effects of nasoalveolar molding (NAM) as a part of cleft primary management protocols on nasolabial aesthetics for patients with non-syndromic cleft lip and palate by conducting a systematic review and meta-analysis. Six electronic databases and two journals were searched up to July 2023. Studies comparing nasolabial outcomes between NAM and non-NAM protocols were selected for further analysis. Nasolabial aesthetics were the outcome of interest. Data extraction, methodological quality assessment, risk of bias assessment, meta-analysis and subgroup analysis were performed. Seven retrospective cohort studies were selected for a qualitative review and four for a quantitative analysis. The risk of bias assessment was moderate for most studies. Only studies utilizing the Asher-McDade rating (AMR) were included for meta-analyses. The protocols with NAM exhibited a significantly lower AMR score for vermillion border than other protocols. AMR scores for nasal form and nasal symmetry from protocols with NAM were significantly lower than protocols without any pre-surgical infant orthopaedics (PSIO) but not significantly different from protocols with other PSIO techniques. The AMR score for nasolabial profile from protocols with NAM was not significantly different from other protocols. However, subgroup analysis demonstrated that protocol combining NAM and primary rhinoplasty significantly lowered AMR scores for nasal form, nasal symmetry and nasolabial profile. For patients with unilateral cleft lip with or without palate (UCLP), this study found that a protocol combining NAM and primary rhinoplasty improved nasolabial outcomes while a protocol with NAM alone offered only limited benefits. For patients with BCLP, the available evidence remains inconclusive. Performing NAM in combination with primary rhinoplasty improves nasolabial aesthetics in patients with UCLP. PROSPERO (CRD4202128384).

Comparison of the Effectiveness of Different Methods for Pain Reduction During Injection Procedures in the Frontalis Muscle.

BACKGROUND: Forehead aesthetic injections are a well-known source of discomfort, and many analgesic non-invasive techniques have been proposed to ameliorate pain. However, no study has compared all these techniques for aesthetic purposes. Therefore, this study aimed to compare the effectiveness of topical cream anesthesia, vibratory stimulus, cryotherapy, pressure, and even no intervention, on pain during and immediately after injection, when considering aesthetic injections in the forehead. METHODS: Seventy patients were selected and had their foreheads divided into 5 parts, which received four different analgesic techniques, and one control zone was added. A numeric rating scale was used to assess pain, two direct questions were asked to evaluate patients' preference and discomfort with the techniques, and the adverse events were quantified. The injections were performed in the same sequence, with three minutes of rest between them and in a single session. Comparisons among analgesic methods for pain relief were performed by the one-way analysis of variance (ANOVA), considering a significance level of 5%. RESULTS: No significant differences were found among the analgesic methods, and between the methods and the control zone, both during and immediately after the injections (p > 0.05). The preferred method for pain relief was the use of topical anesthetic cream (47%), while the most uncomfortable technique was manual distraction (pressure) (36%). Only one patient reported an adverse event. CONCLUSIONS: No analgesic method to diminish pain was superior to the others or was better than no method. Nevertheless, the topical anesthetic cream was the preferred technique, causing less discomfort. LEVEL OF EVIDENCE III: 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 .

Fat Grafting to the Breast for Aesthetic Indications: Techniques and Outcomes in 165 Consecutive Patients.

PURPOSE: Fat grafting to the breast for aesthetic indications has become increasingly popular. Herein, methods, aesthetic outcomes, and complications are reviewed in a retrospective case series. METHODS: Female patients (n=165) with an average age of 45 years (range: 17-78 years) who underwent fat grafting to breast were evaluated. Demographic parameters, the type of procedure, the amount of fat transferred, the site(s) of fat harvest, operative times, and the patient's postoperative recovery and outcomes were recorded. RESULTS: Of the 165 patients, 105 had breast augmentation with fat only. Of these 105 patients, 14(8%) had implant removal with and without capsulectomy, and 61(37%) had mastopexies. Composite augmentation was performed in the remaining 60 patients. The average amount of fat used was 208 cc (range: 10 to 945 cc) per breast. Forty-five patients (27%) underwent a second procedure. Of the 165 patients, 37(22%) had adverse events unrelated to the fat graft, including suture abscesses, scarring, and minor incision cite skin breakdown. Four patients (2.4%) had a complication related to fat grafting including 'lump' formation between the breast, abnormal mammograms, and the need for simple aspiration of a lipid cyst. CONCLUSIONS: Autologous fat grafting should be considered for both primary and secondary aesthetic breast surgery to enhance outcomes. Complications related to fat grafting are uncommon. Revisional and secondary surgeries may be needed to achieve the desired outcome. Power-assisted liposuction, with vibratory infiltration of the tumescent solution, auto-infusion of fat, and Expansion Vibration Lipofilling using a closed system has become our preferred technique. Fat grafting to breast can be considered for both primary and secondary aesthetic breast surgery Complications related to fat grafting are uncommon There does not appear to be an overall increase in complications of associated mastopexy and composite augmentation LEVEL OF EVIDENCE V: 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 .

The Ideal Chinese Lip: Impact of Lip Contours and Proportions.

BACKGROUND: The lips are one crucial determinant of facial attractiveness. Current studies investigating lip attractiveness were mostly conducted in Caucasians, and the results could not directly apply to Asians. Aside from lip proportions, lip contours play an important role in attractiveness but it is unclear how people perceive different lip contours. The aim of this study was to investigate the aesthetic perception of various lip shapes by Chinese to identify the most attractive lip morphology for women and men, respectively. METHODS: 303 Chinese participants were invited to rate the attractiveness of identical lip images with different contours and proportions in a young female and a young male. Stratified analyses were performed to assess the effect of gender, age and occupation on the preference of lip shapes. RESULTS: The lips that were rated to be most attractive had a flat upper vermilion border, an M-shaped oral fissure and a U-shaped lower vermilion border in both genders. Most respondents considered an upper-to-lower vermilion proportion of 1:1 to be more attractive, regardless of the gender of the lip models, and the lip thickness-to-width proportions of 1:2 and 1:2.5 were perceived most attractive for female and male, respectively. CONCLUSIONS: This study adds to our understanding of how lip contours contribute to attractiveness and that Chinese have distinctive aesthetic preferences for lip morphology, which possibly stem from racial characteristics and cultural differences. With such knowledge, practitioners may better tailor the treatment strategy when performing lip rejuvenation procedures. LEVEL OF EVIDENCE III: 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 .

Adverse Events Associated with Hyaluronic Acid Filler Injection for Non-surgical Facial Aesthetics: A Systematic Review of High Level of Evidence Studies.

BACKGROUND: Hyaluronic acid (HA) dermal fillers are widely used in aesthetic medicine. While generally safe, potential complications can arise. OBJECTIVE: This systematic review aims to identify and classify potential complications linked to the use of HA dermal fillers, as informed by high-quality, low-risk-of-bias studies. METHODS: This review follows the Cochrane review standards for clinical systematic reviews. This systematic review analyzed 48 high level of evidence studies on the use of hyaluronic acid (HA) dermal fillers in non-surgical facial aesthetics and the adverse events that occurred.The inclusion criteria were randomized control studies on HA dermal fillers and their complications. Excluded were case reports, case series, observational studies, and other non-randomized research due to their inability to provide generalized conclusions and their inherent publication bias. RESULTS: Adverse events were classified into three categories: expected reactions, product or technique-related adverse events, and severe adverse events. Most adverse events were short-lived injection site reactions, which resolved spontaneously. Specific HA fillers and injection techniques influenced the occurrence of adverse events, which generally resolved within weeks without treatment. Severe adverse events were rare, persisting for months and requiring active medical intervention. DISCUSSION: This classification system can enhance understanding, prevention, and treatment of HA filler complications, and support patient education. The common complications were injection site reactions, with persistent symptoms treated with topical steroids, NSAIDs, or hyaluronidase. Severe complications included severe edema, angioedema and others, often necessitating specific treatments. CONCLUSION: HA dermal fillers are generally safe and effective, with most adverse events being transient and mild to moderate in severity. Severe adverse events, although rare, do occur and are generally non-treatment related. Informed consent, patient education, and professional training are crucial for safe and successful outcomes. Level of Evidence II 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 .

New Aesthetic Unit (NAU) Method: A Comprehensive Method Based on Accurate Anatomical Assessment and Precise Multilayering Panfacial Treatment for Hyaluronic Acid Fillers.

BACKGROUND: Recent progress in anatomy enables a more sophisticated approach to treat patients with facial aesthetic concerns (PFAC) with HA fillers. Furthermore, advances in rheology have offered a range of HA fillers with different biomechanical properties adapted to different indications. METHODS: Based on recent anatomical and rheological progresses, the author has developed a new methodology that couples an accurate patient assessment tool and a panfacial precise treatment instrument. In the presented method, the face is divided into 6 units called New Aesthetic Units (NAU). NAUs are classified on the extent of volume deficiency and asymmetry, ranging from none to moderate to severe deficiencies. After discussion with the patient regarding the assessment findings, a customized treatment plan, including timelines and number of sessions, is recommended. The modalities of the treatment are exhaustively described for each NAU based on multilayering, best practice medicine, and expert consensus available in the literature. RESULTS: Before-and after-case studies are presented to illustrate how the NAU method is used in routine practice for the treatment of two patients with HA fillers. CONCLUSION: The NAU method is not only a practical and accurate roadmap for the assessment and treatment of PFAC with HA fillers, but also facilitates communication between injectors and patients and data analysis. 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 .

Anthropometry and Current Aesthetic Concept of the Lower Third of the Face and Lips in Caucasian Adult Population: A Systematic Review and Meta-Analysis.

BACKGROUND: The lack of standardization of the norms and aesthetic concept of the lower third of the face and lips creates challenges in reconstructive surgery and aesthetic procedures. A large-scale, anthropometric measurements summary poses an alternative for establishing universal patterns. METHODS: A systematic review was conducted by searching PubMed, Embase, Google Scholar and Web of Science using keywords: lip, face, aesthetics, beauty, anthropometry and Caucasian. Seventy records were included in the review and checked in detail in terms of available data. RESULTS: The study contains a meta-analysis of twelve parameters with sufficient quantitative data-lip width, nose width, facial width, lower third of the face height, midline mandible height, total height of the upper and lower lip, upper and lower vermilion height, cutaneous upper lip height and nasolabial and mentolabial angle. CONCLUSIONS: The review provides a detailed database of primary anthropometric studies of lips and perioral regions of the healthy Caucasian population. The attractiveness of the region is focused on uniformity of proportions. Notably, results acquired with different methods of measurement are not interchangeable. Despite many published anthropometric studies, systems for conducting the measurements and reporting the results are not sufficiently unified to quantitatively assess meticulous key aesthetic clinical parameters. LEVEL OF EVIDENCE I: 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 Table of Contents or online Instructions to Authors www.springer.com/00266 .

Ellansé: Advanced Technology and Advantageous Selection of New Collagen Stimulating Agents for Face Rejuvenation.

Facial injections have a comparative mature market and system in China, but all kinds of injection materials have their own advantages and disadvantages, even hyaluronic acid, as the most common injection material, can form an unnatural stiffness after injection. Currently, Ellansé, a biodegradable collagen stimulator, has shown superior aesthetic results while ensuring safety and naturalness, making it a more preferable choice for a variety of facial injections. The purpose of this review is to introduce the features and benefits of Ellansé, so that doctors in the field can better understand and learn how to use it properly and minimize the risk of complications, and have a better choice for the medical aesthetic field in China in numerous aspects. The papers with the keyword "Ellansé" is very few in number, and there is a lack of systematic overview. Ellansé itself has unique advantages for the Chinese population, as it is an attractive option for the treatment of aging face due to high patient satisfaction, long-lasting results and low side effects (Guo et al. in J Cosmet Dermatol 21(5):1959-1966, 2022). More clinical data will be available in the future to confirm its performance and longevity in various sites. LEVEL OF EVIDENCE V: 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 .

What are Board-Certified Plastic Surgeons Posting on Instagram?

BACKGROUND: Plastic surgeons increasingly use social media to market their practices and educate prospective patients. Previous studies have investigated plastic surgery content on Instagram from the angle of hashtags and most popular plastic surgeons. However, very little is understood about what plastic surgeons themselves post on Instagram and what plastic surgery content average users engage with. OBJECTIVES: The aim of this study was to analyze Instagram posts from accounts related to plastic surgeons in the USA to establish suggestions for growing one's practice with this powerful platform to reach patients. METHODS: Board-certified plastic surgeons from all US regions that were active from February 1, 2023 to April 12, 2023 were randomly chosen. Their Instagram accounts were accessed for post analysis. For procedural posts, engagement statistics and multiple variables were collected. Dixon's outlier test was used to determine outliers in the data. ANCOVA and Tukey analysis was used to determine whether procedure type influenced engagement. RESULTS: 120 surgeon accounts were identified with 2157 posts analyzed, yielding notable differences in posts among regions. Most posts were aesthetic procedures (94.4%) and of female patients (90.3%). Surgical procedures were also predominant (86.1%). In addition, Reels had higher engagement than photograph posts. Users engaged with Body procedures at the highest rate. CONCLUSIONS: This cross-sectional analysis shows plastic surgeons tend to overwhelmingly post female patients, aesthetic procedures, and surgical content. These insights may be used to guide social media content and improve the effectiveness of Instagram as a tool for marketing or education. 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.