A smartphone application for personalized facial aesthetic monitoring.

BACKGROUND: Methods available at home for capturing facial images to track changes in skin quality and evaluate skincare treatments are limited. In this study, we developed a smartphone camera application (app) for personalized facial aesthetic monitoring. MATERIALS AND METHODS: A face alignment indicators (FAIN) system utilizing facial landmark detection, an artificial intelligence technique, to estimate key facial parts, was implemented into the app to maintain a consistent facial appearance during image capture. The FAIN system is composed of a fixed target indicator and an alignment indicator that dynamically changes its shape according to the user's face position, size, and orientation. Users align their faces to match the alignment indicator with the fixed target indicator, and the image is automatically captured when alignment is achieved. RESULTS: We investigated the app's effectiveness in ensuring a consistent facial appearance by analyzing both geometric and colorimetric data. Geometric information from captured faces and colorimetric data from stickers applied to the faces were utilized. The coefficients of variation (CVs) for the L*, a*, and b* values of the stickers were higher compared to those measured by a colorimeter, with CVs of 14.9 times, 8.14 times, and 4.41 times for L*, a*, and b*, respectively. To assess the feasibility of the app for facial aesthetic monitoring, we tracked changes in pseudo-skin color on the cheek of a participant using skin-colored stickers. As a result, we observed the smallest color difference ∆Eab of 1.901, which can be considered as the experimentally validated detection limit using images acquired by the app. CONCLUSION: While the current monitoring method is a relative quantification approach, it contributes to evidence-based evaluations of skincare treatments.

Aesthetic Outcomes and Patient Satisfaction in Laparoscopic vs. Open Incisional Hernia Repair: Have We Asked the Patients?

Background: Incisional hernias are predominantly treated through open or laparoscopic surgery, with each method influencing recovery and patient-reported outcomes. This underscores the need for reliable assessment tools such as the EuraHS-QoL questionnaire to evaluate quality of life after surgery. Methods: This prospective single-center study was aimed at evaluating aestethic outcomes and patient satisfaction following laparoscopic versus open hernia repair. It involved 222 patients categorized by type of approach. The EuraHS-QoL questionnaire was used preoperatively and at 1- and 3-months post-surgery, with data analysis performed using Origin Pro 2018 and SPSS software version 28.0. Results: Among the participants, 152 were females and 70 males, with 78% undergoing open surgery and 22% laparoscopic. Findings revealed superior patient outcomes with laparoscopic repair in terms of pain management, daily activities, and aesthetic satisfaction. Patients reported significantly lower pain levels and fewer restrictions in daily activities post-laparoscopic surgery. While initial postoperative cosmetic results favored laparoscopic methods, the perceived differences in abdominal shape diminished over time. Conclusions: Laparoscopic repair significantly improves quality of life compared to open surgery, as shown by EuraHS-QoL scores. These results support the use of laparoscopic techniques in appropriate cases due to their benefits in pain reduction and faster functional recovery.

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'.

Cross-cultural comparison of beauty judgments in visual art using machine learning analysis of art attribute predictors among Japanese and German speakers.

In empirical art research, understanding how viewers judge visual artworks as beautiful is often explored through the study of attributes-specific inherent characteristics or artwork features such as color, complexity, and emotional expressiveness. These attributes form the basis for subjective evaluations, including the judgment of beauty. Building on this conceptual framework, our study examines the beauty judgments of 54 Western artworks made by native Japanese and German speakers, utilizing an extreme randomized trees model-a data-driven machine learning approach-to investigate cross-cultural differences in evaluation behavior. Our analysis of 17 attributes revealed that visual harmony, color variety, valence, and complexity significantly influenced beauty judgments across both cultural cohorts. Notably, preferences for complexity diverged significantly: while the native Japanese speakers found simpler artworks as more beautiful, the native German speakers evaluated more complex artworks as more beautiful. Further cultural distinctions were observed: for the native German speakers, emotional expressiveness was a significant factor, whereas for the native Japanese speakers, attributes such as brushwork, color world, and saturation were more impactful. Our findings illuminate the nuanced role that cultural context plays in shaping aesthetic judgments and demonstrate the utility of machine learning in unravelling these complex dynamics. This research not only advances our understanding of how beauty is judged in visual art-considering self-evaluated attributes-across different cultures but also underscores the potential of machine learning to enhance our comprehension of the aesthetic evaluation of visual artworks.

Outcomes of dorsal nasal augmentation using costochondral graft.

Objective: To assess functional and aesthetic outcomes in patients having undergone dorsal nasal augmentation with costochondral graft in a tertiary care setting. METHODS: The single-centre, retrospective, observational study was conducted at Shifa International Hospital, Islamabad, Pakistan, and comprised data of patients who underwent dorsal nasal augmentation using costochondral graft between January 1, 2018, and December 31, 2022. Aesthetic outcomes in terms of patient satisfaction were assessed using Facial Appearance, Health-related Quality of Life and Adverse Effects scores. Data was analysed using SPSS 26. RESULTS: Of the 46 patients, 28(61%) were males and 18(39%) were females. The overall mean age was 28.39±9.13 years. Dorsal nasal deficiency occurred secondary to congenital causes in 12(26.1%) patients, trauma 19(41.3%) and prior surgery 15(32.6%). Postoperative complication rate was 7(15%); 3(6.5%) had recipient site infection and 2(4.3%) had rib graft resorption. Besides, 1(2.2%) patient reported pain 2 months postoperatively and 1(2.2%) had hypertrophic scarring. Patient satisfaction with the outcome was noted in all the 10 parameters analysed. Most commonly reported problem was that the nose was 'looking thick/swollen' by 12(26.1%) patients, but the issue resolved during 1-year follow-up. Conclusion: Costochondral graft was found to be an ideal material for dorsal nasal augmentation, with high patient satisfaction rate.

A multi-centric, single-blinded, randomized, parallel-group study to evaluate the effectiveness of nasoalveolar moulding treatment in non-syndromic patients with complete unilateral cleft lip, alveolus and palate (NAMUC study): a study protocol for a randomized controlled trial.

BACKGROUND: Cleft lip and palate (CLP) are among the most common congenital anomaly that affects up to 33,000 newborns in India every year. Nasoalveolar moulding (NAM) is a non-surgical treatment performed between 0 and 6 months of age to reduce the cleft and improve nasal aesthetics prior to lip surgery. The NAM treatment has been a controversial treatment option with 51% of the cleft teams in Europe, 37% of teams in the USA and 25 of cleft teams in India adopting this methodology. This treatment adds to the already existing high burden of care for these patients. Furthermore, the supporting evidence for this technique is limited with no high-quality long-term clinical trials available on the effectiveness of this treatment. METHOD: The NAMUC study is an investigator-initiated, multi-centre, single-blinded randomized controlled trial with a parallel group design. The study will compare the effectiveness of NAM treatment provided prior to lip surgery against the no-treatment control group in 274 patients with non-syndromic unilateral complete cleft lip and palate. The primary endpoint of the trial is the nasolabial aesthetics measured using the Asher McDade index at 5 years of age. The secondary outcomes include dentofacial development, speech, hearing, cost-effectiveness, quality of life, patient perception, feeding and intangible benefits. Randomization will be carried out via central online system and stratified based on cleft width, birth weight and clinical trial site. DISCUSSION: We expect the results from this study on the effectiveness of treatment with NAM appliance in the long term along with the cost-effectiveness evaluation can eliminate the dilemma and differences in clinical care across the globe. TRIAL REGISTRATION: ClinicalTrials.gov CTRI/2022/11/047426 (Clinical Trials Registry India). Registered on 18 November 2022. The first patient was recruited on 11 December 2022. CTR India does not pick up on Google search with just the trial number. The following steps have to be carried out to pick up. How to search: ( https://ctri.nic.in/Clinicaltrials/advsearch.php -use the search boxes by entering the following details: Interventional trial > November 2022 > NAMUC).

Nature experiences affect the aesthetic reception of art: The case of paintings depicting aquatic animals.

Art is a promising pathway to raise emotional engagement with nature, while enabling an indirect exposure to nature through aesthetic experience. However, the precise relationships between aesthetic experiences of art and experiences of nature remain unclear. The aim of this observational study is to highlight the effect of nature experiences on the aesthetic reception art, based on Early Modern paintings (16th-18th century). By focusing on marine ecosystems, that are difficult to directly interact with, the results presented are intended to explore whether marine activities and fish consumption affect the aesthetic reception of artworks depicting marine biodiversity. A photo-questionnaire survey based on four paintings has been conducted with 332 French participants with a diverse range of marine practices, fish consumption and artistic sensitivity. Fish consumption and value attributed to fish as food had a significant positive impact on the aesthetic reception, suggesting that taste and food consumption could be considered as a relevant nature aesthetic experience that elicits affective and emotional responses. Results also showed an indirect effect of fishing and diving on the aesthetic reception of paintings whose iconography relates with the observers' experiences. These findings are of particular interest in both environmental psychology and ecological mediation through art. This study brings evidences of the connection between art and nature experiences, and that art could be an innovative way of experiencing nature. Finally, this study also highlights the need to broaden the scope of nature experiences, for instance by including food.

An Approach to Selection of Face-Lift Techniques for Different Types of Faces: An Analysis of 1000 Asian Patients Over 9 Years.

BACKGROUND: A face-lift or rhytidectomy is the procedure most directly associated with rejuvenation. There are several surgical techniques for face-lifts, but criteria for the selection of techniques, based on the patient's face shape, are lacking. In this study, we report on our experience with specific indication criteria for each technique and the consequent achievement of good outcomes. METHODS: From 2015 to 2023, 1 surgeon performed face-lifts on 1000 patients. Three different superficial musculoaponeurotic system (SMAS) techniques (SMAS dissection, SMASectomy, and SMAS plication) were applied depending on the degree of sagging of the patient's lower face, lateral facial profile, and SMAS mobility and condition. Superficial musculoaponeurotic system dissection was considered for the improvement of a square face, sagging jowls, and marionette lines. Superficial musculoaponeurotic system plication was applied with patients with less sagging jowls and prominent zygoma with concave lateral facial profile. SMASectomy was applied with patients with convex lateral facial profiles or when the SMAS was too thin or damaged. Patient postoperative satisfaction was surveyed using the FACE-Q score 1 year post surgery. RESULTS: Most of the patients attained natural-looking and long-lasting aesthetic outcomes and exhibited high satisfaction. The patients indicated that they looked about 11.2 ± 5.2 years younger than their actual age after the surgery. The mean satisfaction scores for each facial feature were as follows: cheeks (91.1 ± 7.8), marionette lines (88.5 ± 13.6), lower face and jawline (92.5 ± 14.2), under chin (87.8 ± 15.1), and neck (86.2 ± 18.5). Complications such as facial nerve injury, infection, hematoma, and flap necrosis were very rare. CONCLUSIONS: Establishing criteria for the selection of face-lift surgical techniques based on the degree of lower face sagging, lateral facial profile, and SMAS mobility and condition led to good outcomes. These criteria can be used by physicians to determine the most effective face-lift surgery technique based on a patient's individual features, which may improve surgical outcomes.

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.

How material sensory properties and individual differences influence the haptic aesthetic appeal of visually presented stimuli.

Touch plays a crucial role for humans. Despite its centrality in sensory experiences, the field of haptic aesthetics is underexplored. So far, existing research has revealed that preferences in the haptic domain are related to stimulus properties and the Gestalt laws of grouping. Additionally, haptic aesthetics is influenced by top-down processes, e.g., stimulus familiarity, and is likely to be modulated by personality and expertise. To further our understanding of these influences on haptic aesthetic appraisal, the current study investigated the imagined haptic aesthetic appeal of visually presented material surfaces, considering the role of haptic expertise, Need for touch, personality traits. The results revealed a positive influence of familiarity, simplicity, smoothness, warmth, lightness, dryness, slipperiness and a negative influence of complexity on individuals' aesthetic responses. While the study failed to support the predicted influence of Need for touch and haptic expertise on aesthetic responses, results did reveal an influence of openness to experience, conscientiousness and neuroticism. Despite the limitations related to the indirect stimuli presentation (vision only), the findings contribute to the relatively unexplored role of bottom-up and top-down features in haptic aesthetics that might be incorporated into the design of consumers' products to better meet their preferences.

Pitfalls of social media for aesthetic eye surgery patients: assessing YouTube's aesthetic canthoplasty content.

PURPOSE: YouTube, a popular source for diverse information, hosts a wealth of content on aesthetic canthoplasty. Yet, concerns linger about the accuracy and reliability of these videos, with potential for inaccuracies, biases, or misleading information. This study aims to evaluate the quality and reliability of YouTube content on this sought-after facial enhancement procedure. METHODS: The study employs four distinct scoring tools: the Global Quality Score (GQS), the Medical Quality Video Evaluation Tool (MQ-VET), the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V), and the Video Power Index (VPI). RESULTS: Analysis of a total of 173 YouTube videos relevant to aesthetic canthoplasty revealed scores that were primarily indicative of poor quality and reliability.(Mean score ± SD, PEMAT A/V: 30.75 ± 28.8, MQ-VET: 28.57 ± 12.6, GQS: 1.7 ± 1) Notably, these videos were predominantly uploaded by healthcare professionals (82.1%), and they focused more on advertisements (46.2%) than on scientific or educational information. Their elevated viewership and engagement metrics (likes, comments, and shares) attest to their significant popularity and influence. (Mean VPI score: 176.6 ± 635.8). CONCLUSION: YouTube's influence on aesthetic eyelid surgery is undeniable, shaping patient choices and expectations. However, unrealistic beauty ideals, heightened body dissatisfaction, and social comparisons lurk within its content, potentially harming psychological well-being and surgical decisions. Prioritizing qualified medical guidance and critical evaluation of online information are crucial for patients. Authors and platforms must act responsibly: authors by producing high-quality content, platforms by tackling misinformation.

The Fisher Subunit Anatomical Approach for Cleft Lip Revisions: An Evolution and Case Series.

ABSTRACT: Many techniques exist to reapproximate a cleft lip but can leave unsatisfactory results with nonanatomic scars and a short upper lip, creating a need for revision. Many revisions focus on adjacent tissue transfers and realignment of landmarks, but in the senior authors' experience, recreating the defect and utilizing the Fisher repair for revision have led to aesthetically pleasing results and less noticeable scars. A database was collected that included all cleft lip revisions performed at a large, comprehensive children's hospital from October 2018 to July 2021. Inclusion criteria included any cleft patient with a cleft lip revision performed by two craniofacial surgeons. Data collected included sex, characteristics of the cleft lip, age at initial and index repair, type of initial repair, previous revisions, type of revision with any additional tissue rearrangement, and any nose repair. Sixty-five patients were included in the study for analysis. The type of initial repair was known in sixty-four cases (98%), and fifty-four were Millard repairs (83%). Twenty-two patients (33%) had a previous revision prior to their index revision. Sixty patients (92%) underwent the Fisher repair technique for their index revision and forty-six patients (70%) underwent nasal revision. In follow-up, all patients demonstrated an improvement in lip aesthetics. This study demonstrates a large subset of patients that have undergone cleft lip revision using the Fisher technique. In the senior surgeons' experience, the Fisher repair technique in the setting of cleft lip revision is an ideal way to address the shortcomings of historical repair techniques.

Redo surgery to improve urinary function, sexual function and cosmesis in male patients with exstrophy-epispadias complex complications. Technical principles and pearls based on case scenarios.

The bladder exstrophy-epispadias complex includes some of the most challenging conditions treated by pediatric urologists. They are associated with the need for multiple intricate reconstructive procedures, aimed at restoring the anatomy and function of the bladder, urethra and external genitalia. These patients often endure multiple redo reconstructive procedures to improve urinary function, sexual function and cosmesis throughout the first two decades of life. In this article, we present the 30-year experience of a single surgeon performing redo surgery for males born with epispadias and bladder exstrophy. Through detailed documentation of 6 clinical cases, we highlight technical aspects that may contribute to a successful surgical reconstruction in these patients. The article is focused specifically on patients undergoing redo epispadias repair with or without concomitant continence procedures. We make the case for complete penile disassembly with external rotation of the corpora to correct recurrent dorsal curvature; this approach also allows the surgeon to have access to the proximal urethra and bladder neck after opening the intersymphiseal scar/band. This is useful when additional procedures on the bladder, such as bladder neck tailoring, are necessary. We also highlight the importance of avoiding reverse Byars' flaps when performing skin closure, due to the resulting midline scar. Besides being associated with a poor cosmetic outcome, it can also contribute to recurrent dorsal curvature. The authors advocate for rotational skin flaps to cover the penile shaft. Correction of dorsal curvature and improved cosmesis obtained with complete penile disassembly sometimes comes at the expense of the urethra being left as a hypospadias (figure). This will require further surgeries (usually a 2-stage buccal mucosa graft), much like the treatment of proximal hypospadias. Redo epispadias surgery in males remains a challenge. The systematic approach offered by the case scenarios may help guide surgeons dealing with this difficult condition. Patient with complications after repair of classic bladder exstrophy. A) Stone retrieved from posterior urethra after complete penile disassembly. B) After opening the inter-symphiseal scar, the bladder has been opened and the bladder neck tailored. C) Complete penile disassembly has been completed with corporal bodies and urethra individualized. D,E,F) Final appearance of the repair; abdominal wall was closed with anterior rectus sheath flaps, penile skin was closed with rotational flaps and urethra ended up as a hypospadias.

In Vitro Cytocompatibility Analysis and Comparison of Different Hyaluronic Acid Fillers for Minimally Invasive Esthetics.

BACKGROUND/AIM: To overcome the natural visual consequences of the physiological aging process, the use of biodegradable fillers made of hyaluronic acid or sodium carboxymethyl cellulose is increasingly popular in modern esthetic medicine. Clinicians can choose from a wide range of fillers with variable compositions and rheological properties, and therefore with different application areas and injection depths. The aim of this study was to analyze and compare the most commonly used fillers for facial augmentation regarding their in vitro biocompatibility and to find potential correlations to their rheological properties. MATERIALS AND METHODS: In the present study, direct and indirect in vitro cytotoxicity analysis according to DIN EN ISO 10993-5 were performed on 39 different filler materials for facial augmentation. RESULTS: All fillers analyzed in this study overall showed satisfactory results in the direct and indirect cytocompatibility tests. While no material was outside the threshold values in the 2,3-bis-(2-methoxy-4-nitro-5-sulphenyl)-(2H)-tetrazolium-5-carboxanilide (XTT) cell viability and bromodeoxyuridine (BrdU) cell proliferation assays or in the live-dead staining, only 7 out of the 39 fillers reached the required values in the lactate dehydrogenase assay. CONCLUSION: All biodegradable fillers examined in this study were found to be sufficiently cytocompatible. Although the qualitative analysis of the test results showed differences between the fillers, no concrete correlation between test performance and composition or manufacturer of the fillers was found. Future efforts are required to provide clinicians with even better support in choosing the right filler for optimal outcome and patient satisfaction.

Genioplasty - A Review.

Genioplasty, a key technique for dentofacial abnormalities, is essential for establishing facial harmony. This surgical procedure entails an osteotomy of the chin, which alters its three-dimensional location to restore overall face equilibrium. Modern genioplasty, which is frequently performed alone or in combination with rhinoplasty, facelifts, and orthognathic surgery, employs a variety of materials for chin augmentation, ranging from autologous to alloplastic. Recent improvements include porous graft materials such as high-density polyethylene. Despite the need for secure osteotomy segments, soft tissues around the mandible have a natural propensity to return to their original anatomical position. In the discipline of genioplasty, face esthetics and facial evaluation have been a prominent emphasis, with historical evidence emphasizing the relevance of the chin in harmony, balance, and character perception. Customized implants provide a single therapy for rare anatomical defects, generally with lower morbidity, making them critical for patients undergoing many procedures or suffering from syndromic disorders. Virtual surgical planning advances will continue to give dependable solutions for small and complex chin position issues. Modern surgeons will continue to combine history, anatomy, rigorous evaluation, excellent execution, and technological breakthroughs to achieve the best possible outcomes for their patients, raising their social standing.

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.

Asian Male Blepharoplasty and Rhinoplasty.

The authors present the contemporary landscape for males seeking Asian blepharoplasty and Asian rhinoplasty, with special emphasis on the unique anatomical and aesthetic considerations for this patient population. The authors highlight the latest techniques used to achieve superlative results.