Understanding Public Perceptions of Nipple and Scar Characteristics After Chest Wall Masculinization Surgery.

BACKGROUND: Surgical chest masculinization procedures, especially gender-affirming top surgery (GATS), are becoming increasingly prevalent in the USA. While a variety of surgical techniques have been established as both safe and effective, there is limited research examining ideal aesthetic nipple appearance and incision scar pattern. This study employs patient images to understand the public's perception on top surgery outcomes when adjusting for BMI ranges and Fitzpatrick skin types. METHODS: Images from RealSelf modified via Adobe Photoshop depicted various scar types and nipple-areolar complex (NAC) sizes/positions. A Qualtrics survey was distributed utilizing Amazon Mechanical Turk. Statistical analysis was performed through JMP Pro 17 for ordinal and categorical values, with a p value less than or equal to 0.05 statistically significant. RESULTS: A moderately sized and laterally placed NAC was preferred. A transverse scar that resembles the pectoral border between the level of the inframammary fold and pectoral insertion was deemed most masculine and aesthetic. Majority of results demonstrated that this is unaffected by Fitzpatrick skin types. Increased BMI images impacted public preferences, as a nipple placed farther from the transverse incision (p = 0.04) and a transverse scar position closer to the IMF was preferred in higher BMI patients. CONCLUSIONS: An understanding of the most popular NAC and scar choices, as well as how these factors may differ when considering a Fitzpatrick skin type or BMI categorization was attained. This validates the importance of patient-centered approach when employing surgical techniques in GATS. Future studies intend to obtain reports from actual patients considering GATS. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable.

Oronasal Fistula Closure and Defect Reconstruction: Two Case Reports Using Periodontal Plastic Surgery Principles.

OBJECTIVES: Oronasal fistulas are common sequelae following cleft lip and palate surgery and can significantly impact a patient's quality of life. They result from various factors, including surgical techniques, tissue management, and patient-specific factors. This case report explores the modern approach to oronasal fistula closure using periodontal plastic surgery principles. MATERIALS AND METHODS: The report presents two cases of patients with oronasal fistulas due to previous maxillofacial surgical intervention. These patients underwent microsurgical procedures that involved partial flap thickness preparation of the fistula areas, the use of connective tissue grafts from the palate, and meticulous suturing techniques to ensure graft integrity. The procedures were performed in stages, and postoperative care was provided. RESULTS: Both cases demonstrated successful fistula closure and graft survival. The patients reported improvements in breathing, speech, aesthetics, and quality of life. The second case also included guided bone regeneration and implant placement. CONCLUSIONS: Oronasal fistulas resulting from maxillofacial surgery can be effectively treated using periodontal plastic surgery techniques, significantly improving patients' quality of life and aesthetic outcomes. This approach represents a valuable addition to the existing repertoire of oronasal fistula closure methods.

The role of aesthetics in tourist satisfaction in the Ghanaian hospitality industry.

Purpose: The study examines the role of aesthetics in tourist satisfaction in the Ghanaian hospitality industry. Design/methodology/approach: The study is quantitative and cross-sectional in nature. A total of 5 tourist destinations and 350 tourists were selected using purposive sampling technique. Data for the study was gathered using self-reported questionnaires and analysed using Statistical Package for Social Sciences (SPSS). A total of 300 retrieved questionnaires representing 85.7 % of response rate was used for data analysis. Findings: The study results proved that the three main types of aesthetics that influence tourists' visitation to tourist destinations are visual product aesthetics, package aesthetics and taste aesthetics. The study also discovered that visual product aesthetics, package aesthetics and taste aesthetics had significant positive correlations with tourist satisfaction. Again, the results established that, aesthetic types (visual product aesthetics and package aesthetics) have significant positive impact on tourists' satisfaction whereas taste aesthetics has a negative effect on tourists' satisfaction. Research limitations/implications: The Ghanaian hospitality sector should push creativity to new heights by ensuring that venues change their appearance and ambiance through the use of creative lights, music, and food setups, so as to often attract consumers and offer them a completely unique experience each time. The hospitality sector also need to provide more effective and dependable channels for user complaints, recommendations, and contributions, as well as consumer feedback systems. Originality/value: The study adds to literature on aesthetics and tourist satisfaction as well as contributes to the agenda towards tourist destination sustainability.

Safe Zones for Facial Fillers: Anatomical Study of SubSMAS Spaces in Asians.

The study "Spaces of the Face for Filler Procedures: Identification of subSMAS Spaces Based on Anatomical Study" explores the anatomy of facial spaces crucial for safe and effective filler injections. By delineating the subSMAS (sub-superficial musculoaponeurotic system) spaces, this research highlights how these virtual compartments, bordered by fat, muscles, fascia, and ligaments, facilitate independent muscle movement and reduce the risk of damaging critical structures. The thicker and more robust skin of East Asians necessitates deeper filler injections, emphasizing the significance of accurately identifying these spaces. A cadaver study with dyed gelatin validated the existence and characteristics of these subSMAS spaces, confirming their safety for filler procedures. Key spaces, such as the subgalea-frontalis, interfascial and temporalis, and prezygomatic spaces, were examined, illustrating safe zones for injections. The findings underscore the importance of anatomical knowledge for enhancing facial aesthetics while minimizing complications. This study serves as a guide for clinicians to perform precise and safe filler injections, providing a foundation for further research on the dynamic interactions of these spaces and long-term outcomes.

Bad beauty: Aesthetic judgments are influenced by references to morally contentious content in photographs.

Affective responses can influence evaluative judgments, but how are subjective beauty ratings affected by references to morally contentious elements in aesthetic stimuli? In an online experiment (N = 460), we investigated the relationship between two types of descriptive texts (Neutral vs. Negative) and the beauty ratings of 25 photographs that depict sources of environmental pollution. For each photograph, the neutral descriptive text contained general information, whereas the negative descriptive text addressed the pollution source. Further, we explored whether this relationship is mediated by changes in positive and negative affect, and how it interacts with the biospheric values of participants. Our results showed that (1) participants in the Negative Condition rated the photographs as less beautiful than in the Neutral Condition, (2) this relationship was partially mediated by changes in negative affect, and (3) in the Negative Condition, participants with higher levels of biospheric values rated the photographs as less beautiful. Our results indicate that individual values, as well as affective responses induced by aesthetic stimuli, directly influence subjective beauty. This aligns with current theoretical frameworks and fills a gap in experimental research. Finally, we discuss limitations and directions for future studies. PSYCHINFO CLASSIFICATION CODE: 2340.

The origins and development of aesthetics.

All people (and some other animals) have aesthetic responses to sensory stimulation, responses of emotional pleasure or displeasure. These emotions vary from one person and culture to another, yet they share a common mechanism. To survive, an adaptive animal (as opposed to a tropic animal) needs to become comfortable with normality and to have slight abnormalities draw attention to themselves. Walking through a jungle you need to notice a tiger from a single stripe: if you must wait to see the whole animal, you are unlikely to survive. In Homo sapiens, the brain's adaptive neurochemistry does this naturally, partly because the brain's neuronal networks are structured to react efficiently to fractal structures, structures that shape much of nature. In addition, previous associations may turn a slight variation from normal into feelings of either pleasure or danger. The details of these responses-what is normal and what variations feel like-will depend upon an individual's experience, but the mechanism is the same, no matter whether a person is tasting a wine, seeing a face or landscape, or hearing a song. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.

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 .

A Study on the Aesthetic Parameters and Proportions of the External Contour for Minimally Invasive Facial Injection.

OBJECTIVE: The aim of this study was to further guide the diagnosis and treatment programs for clinical facial contouring with injectable fillers by studying the facial contour parameters and proportion preferences consistent with Asian aesthetics. METHODS: A total of 89 subjects (42 males and 47 females aged 20-60 years) who met the inclusion criteria were enrolled in this study. The subjects were grouped by age, sex, and external contour attractiveness score, and the external contour aesthetic parameters and proportions of the subjects in different groups were measured and analysed. RESULTS: The upper facial breadth and lower facial breadth decreased with age, with significant differences between the 50-60-year age group and other age groups (P < 0.01). The nasomental angle showed a decreasing trend with age, with significant differences between the 40-49-year age group and the 20-29-year and 30-39-year age groups (P < 0.05). Males and females were significantly different in calva height, total head height, lower facial height, and calva height to total head height ratio (P < 0.05). With increasing age, the external contour attractiveness scores of males and females both showed decreasing trends, with significant differences between the 50-60-year age group and other age groups (P < 0.05). CONCLUSION: The calva height and the cranioauricular angle have a significant impact on external contour attractiveness. In general, temporal depression, cheek sagging, lateral cheek depression, and an ill-defined mandibular border will occur due to ageing, collagen loss, ligament laxity and sagging, and soft tissue atrophy and sagging, reducing the attractiveness of the external contour. 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 .

Impact of Dental Midline Shift on the Perception of Facial Attractiveness in Young Adults.

Background/Objectives: The aim of this study was to quantify the threshold of a dental midline shift that would compromise facial attractiveness and indicate a need for treatment from the points of view of laypeople and dental professionals. Methods: Whole-face natural photographs of a male and a female model were digitally manipulated to create various degrees of upper and lower dental midline shifts through bodily movement of the upper or lower midlines as well as alteration of the axial inclination of the upper teeth. The samples were then assessed by two groups of observers (laypeople (LP) and dental professionals (DP)). Results: The lower midline shift did not negatively affect the DP and LP's perceptions of smile attractiveness. The first significant loss of attractiveness was registered by the DP with an upper midline shift of 1 mm in the female model. However, the LP registered this at 2 mm. The DP registered the necessity of treatment at a threshold of 2 mm in the female model and 3 mm in the male model. LP identified the need for treatment at 3 mm for both males and females. The female model was judged more critically than her male counterpart by both female and male observers. Conclusions: DP assess the midline deviation more critically than LP. Both DP and LP were more sensitive to midline deviations in the female model regardless of their own gender. Both groups registered the need for treatment at a higher threshold than the reduction in smile attractiveness.

Appraising mandibular prognathism in class III malocclusion following orthognathic surgery: Patient-reported and cephalometry-based outcomes.

Patients with class III malocclusion often exhibit mandibular prognathism and complain of "prognathic appearance". The overall positive effects of orthognathic surgery on facial appearance have been demonstrated using patient-reported outcome measures (PROMs), but studies investigating the correlation between subjective PROMs results and objective measurements of imaging studies are sparse in the literature. This study recruited consecutive patients with skeletal class III malocclusion who underwent two-jaw orthognathic surgery between January 2016 and January 2021. The PROMs survey was conducted focusing on subjective perception of mandibular appearance. Lateral cephalometric images were measured to examine the correlation with the PROMs results. A total of 96 patients were eligible for this study. Of these, 74 patients (77.1%) reported complete correction of prognathic appearance postoperatively, whereas 22 patients (22.9%) perceived residual prognathic appearance. In a comparison of postoperative measurements between completely and incompletely satisfied patients, there were significant differences in SNB, ANB, convexity, facial angle, Nv-B, Nv-Pog, SN'B', soft tissue facial angle, lip-chin-throat angle, N'v-B', and N'v-Pog'. The PROM results were significantly associated with the objective measurements of imaging studies. Investigating the correlation between PROMs and objective measurements enables integration of patients' perception of the outcomes into future therapeutic strategy and surgical planning, contributing to the enhancement of patient satisfaction.

The Recent Use, Patient Satisfaction, and Advancement in Digital Smile Designing: A Systematic Review.

Digital smile designing (DSD) is a concept of dentistry which combines the old and the new and becomes a different world in the world of smile aesthetics and functionality. Dental aesthetics is not just a cosmetic issue but a multidimensional part of oral health that has a great impact on psychological well-being, social life, functional capabilities, and, hence, the quality of life. To put it simply, the recognition of its significance stresses the necessity of complete dental care which is the one that combines beauty and function as well as health. This systematic review aims to analyze the recent use and patient satisfaction of DSD and to show the recent advances in DSD. A thorough literature search was conducted across the online databases for articles about the implementation of digital smile analysis in dentistry. The articles that were published between 2013 and 2023 on DSD were selected which included randomized and non-randomized trials and observational studies covering the effectiveness, advantages, and patients' opinions about the treatment. The National Institutes of Health tool was applied for bias assessment. Ten studies were selected to address the use of DSD in dentistry based on the inclusion criteria. The findings from these studies suggest that DSD is useful in improving communication, reducing working time, minimizing errors, enhancing patient satisfaction, and providing clinical adequacy for final prosthetic pieces, indicating the usefulness of this approach in dental procedures. Smile designing using digital technologies has the potential to improve dental aesthetics and treatment procedures while showcasing their reliability and clinical effectiveness.

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.

Scientific experimental articles are modernist stories.

This paper attempts to revive the epistemological discussion of scientific articles. What are their epistemic aims, and how are they achieved? We argue that scientific experimental articles are best understood as a particular kind of narrative: i.e., modernist narratives (think: Woolf, Joyce), at least in the sense that they employ many of the same techniques, including colligation and the juxtaposition of multiple perspectives. We suggest that this way of writing is necessary given the nature of modern science, but it also has specific epistemic benefits: it provides readers with an effective way to grasp the content of scientific articles which increases their understanding. On the other hand, modernist writing is vulnerable to certain kinds of epistemic abuses, which can be found instantiated in modern scientific writing as well.

Feedback on a socio-aesthetic program for the benefit of young patients with self-endangerment.

OBJECTIVES: Socio-aesthetics is a practice born in psychiatric departments but has since developed particularly in the field of oncology. For our part, since January 2018, we have initiated an experiment of this type at the Espace Unit of the CHU in Nantes, a unit that takes care of young patients who find themselves in a situation of crisis and endangerment of themselves. METHODS: The qualitative evaluation of the interest of a socio-aesthetic mediation (relaxation modelling, facial care, make-up) with young patients was carried out by a collection of their feelings. RESULTS: Youth who expressed an overall judgment of socio-esthetic mediation appreciated it in 61% of cases. They express their satisfaction with words such as "I liked", "I loved", "I'm happy", "it was too good", "super good" or "great". CONCLUSION: This successful socio-aesthetic therapy practice experiment will continue with a quantitative analysis to demonstrate the relevance of this type of service to psychiatric patients.

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.

Strength and conditioning in dance: A systematic review and meta-analysis.

To assess the evidence for the effect of strength and conditioning on physical qualities and aesthetic competence in dance populations, three electronic databases (PubMed, Scopus, SPORTDiscus) were searched (until September 2022) for studies that met the following criteria: (i) dancers aged >16 years; (ii) structured strength and conditioning intervention; and (iii) with physical qualities and aesthetic competence as outcome measures. Methodological quality and risk of bias of the included studies were assessed through the systematic review tool "QualSyst". Meta-analyses of effect sizes (Hedges' g) with forest plots explored the effects of the strength and conditioning interventions. Thirty-six studies met the inclusion criteria and were included in this review. Meta-analysis indicated strength and conditioning significantly (p < 0.05) improved lower body power (g = 0.90, 95% CI: 0.53-1.27), upper body strength (g = 0.98, 95% CI: 0.39-1.57), lower body strength (g = 1.59, 95% CI: 0.97-2.22), and flexibility (g = 0.86, 95% CI: 0.05-1.66). Strength and conditioning interventions were found to be effective at improving physical qualities in dancers, recommending their participation in additional sessions to enhance overall fitness and ultimately dance performance. It is recommended that future strength and conditioning intervention research should include sample size calculations, with participants recruited from a specific dance genre and skill level in order to evaluate how strength and conditioning influences dance performance.

Comparison of smile attractiveness in cases with gummy smile treated with botulinum toxin and maxillary impaction surgery: A retrospective study.

This study aimed to compare the smile's attractiveness in patients submitted to the treatment of gummy smiles with botulinum toxin or maxillary impaction surgery. The retrospective sample comprised 26 patients divided into two groups: Group 1 (BTX): 13 patients (12 females and 1 male) with a mean age of 28.06 years (s.d. = 6.09) and mean gingival exposure during smile of 5.18 mm (s.d. = 1.51) treated with botulinum toxin; Group 2 (SURGICAL): 13 patients (9 females and 4 males) with a mean age of 30.59 years (s.d. = 5.72) and mean gingival exposure during smile of 5.21 mm (s.d. = 1.55) treated with orthognathic maxillary impaction surgery. The group of evaluators comprised 317 participants, divided into 143 orthodontists (85 females and 58 males) with a mean age of 41.40 (s.d. = 9.30); 62 dentists (47 female and 15 male) with a mean age of 35.44 (s.d. = 10.44), and 112 lay people (74 female and 38 male) with a mean age of 46, 91 (s.d. = 10.11) in a questionnaire on Google Forms. Without knowing the therapy used, the evaluators assigned scores to the photographs of the posed smile taken before (T1) and after (T2) treatment. Intergroup comparison of smile attractiveness was performed using the t-independent, one-way ANOVA, and Tukey tests. There was a significant improvement in smile attractiveness with treatment in both groups; however, the improvement was significantly better in the surgical group than in the BTX group. Orthodontists rated smile attractiveness significantly higher than dentists and laypersons for the final phase of the BTX and surgical groups. There was a significant improvement in the smile attractiveness with botulinum toxin application and orthodontic-surgical treatment. However, orthognathic surgery promoted a greater improvement in smile attractiveness than the application of botulinum toxin.

3D evaluation model of facial aesthetics based on multi-input 3D convolution neural networks for orthognathic surgery.

BACKGROUND: Quantitative evaluation of facial aesthetics is an important but also time-consuming procedure in orthognathic surgery, while existing 2D beauty-scoring models are mainly used for entertainment with less clinical impact. METHODS: A deep-learning-based 3D evaluation model DeepBeauty3D was designed and trained using 133 patients' CT images. The customised image preprocessing module extracted the skeleton, soft tissue, and personal physical information from raw DICOM data, and the predicting network module employed 3-input-2-output convolution neural networks (CNN) to receive the aforementioned data and output aesthetic scores automatically. RESULTS: Experiment results showed that this model predicted the skeleton and soft tissue score with 0.231 ± 0.218 (4.62%) and 0.100 ± 0.344 (2.00%) accuracy in 11.203 ± 2.824 s from raw CT images. CONCLUSION: This study provided an end-to-end solution using real clinical data based on 3D CNN to quantitatively evaluate facial aesthetics by considering three anatomical factors simultaneously, showing promising potential in reducing workload and bridging the surgeon-patient aesthetics perspective gap.

On the connection between creativity and aesthetics.

Within cognitive psychology, there are separate experimental fields devoted to the study of creativity, on the one hand, and aesthetics, on the other, with virtually no cross-talk between them. In this article, I propose a means of uniting creativity and aesthetics via a consideration of the mechanisms of cultural evolution. I call this the creativity/aesthetics cycle. The basic tenet of the model is that creativity and aesthetics mediate, respectively, the processes of variation (production) and selection (perception or consumption) in evolutionary models of culture. By means of this cycle, creators produce works that they hope will be evaluated positively by consumers, where such appraisals ultimately feed back to influence the subsequent decision-making processes of creators. I discuss the implications of this model for the fields of creativity and aesthetics.

The Application of artificial intelligence in restorative Dentistry: A narrative review of current research.

This review explores the transformative impact of artificial intelligence (AI) on restorative dentistry. By discussing the diagnostic processes, treatment planning, image analysis, prosthodontics, and material/biomaterial research, this study highlights the role of AI in optimizing precision and efficiency. It emphasizes personalized material selection, accelerated biomaterial research, and AI-enabled clinical workflows for enhanced patient outcomes. The review concludes with insights into the challenges, ethical considerations, and future trends, emphasizing the collaborative efforts needed for continued innovation in AI-driven restorative dentistry.