Basic concepts in facial and neck thread lifting procedures.

In this review article, our objective is to elucidate fundamental principles and offer practical illustrations concerning the procedures involved in facial and neck thread lifting. Moreover, we aim to explore associated concepts such as the fixing point, hanging point, and anchoring point terminologies, along with the elucidation of vectors. Additionally, we will provide anatomically oriented explanations of the lifting process required for each facial region using thread lifting methods like V, U, and I techniques using floating type threads (Secrete line, Hyundai Meditech., Inc., Wonjusi, Republic of Korea). Furthermore, our intention is to delve deeply into the concepts of tensile strength, anchoring strength, and holding strength, contextualizing their practical applications within this specific field.

Biomechanics Explains Variability of Response of Small Hypertropia to Graded Vertical Rectus Tenotomy.

PURPOSE: Small angle hypertropia in sagging eye syndrome is conveniently treated by graded vertical rectus tenotomy, yet adjustable technique under topical anesthesia has been recommended due to variability of effect. We performed graded tenotomy in an experimental model to elucidate the effect reason for variability of response to this surgical procedure. DESIGN: Experimental study: Methods: 32 fresh bovine rectus musculotendon specimens were prepared including continuity with insertional sclera, and extending for a total 40mm length to the proximal muscle bellies, and trimmed to 16mm width. Specimens were anchored by the clamps at the scleral insertion and muscle belly ends within a physiological chamber. After preconditioning and elongation to 10% strain was imposed by a linear motor, tensile force was allowed to stabilize at a plateau state. Then 25, 50, 75, 90, 100% marginal tenotomies were perormed progressively as remnant forces were measured. RESULTS: Tendon thickness averaged 0.29±0.05mm and width 19.71±2.25mm. On average, remnant force decreased linearly (R2=0.985) from 4.23±1.34, 2.76±0.88, 1.70±0.73, 1.01±0.49, 0.39±0.10, and 0 N, at 0, 25, 50, 75, 90, 100% tenotomy. However, there was marked individual variability in effect among specimens, with coefficient of variation 32, 32, 43, 49, and 27%, respectively CONCLUSION: On average there is a linear relationship between graded rectus tenotomy and percentage force reduction, but the effect among individual tendons is large, paralleling the reported variation in surgical effect. This explains and implies continued advisability of adjustable technique in this procedure.

Age-related nonparalytic hypertropia: Clinical features.

PURPOSE: Age-related nonparalytic hypertropia (ARNH) is reported to be involved in sagging eye syndrome, where excyclotorsion is large and the lower eye is more extorted. The primary aim of this study was to describe the clinical profiles of patients with ARNH. The secondary aim was to compare cyclotorsion in patients with ARNH with that in normal individuals. METHODS: Inclusion criteria for ARNH were insidious onset of diplopia at distance after 50 years of age, nonparalytic hyperdeviation and follow-up >6 months. Objective cyclotorsion was measured as the disc-to-fovea angle (DFA) on fundus photographs obtained from two groups: 75 patients with ARNH (age, 74.1 ± 7.9 years) and 75 sex- and age-matched normal controls (73.9 ± 8.1 years). RESULTS: The hypertropia angle was 4.6 ± 2.8 prism dioptres. One patient also experienced diplopia at near-gaze. DFA in ARNH (right/left eye; 11.0 ± 4.8°/11.6 ± 3.9°) was larger than that of the control (6.6 ± 3.7°/9.2 ± 3.5°) (p < 0.0001). The DFA in the non-dominant eye (12.5 ± 4.1°) was larger than that in the dominant eye (10.2 ± 4.3°) (p = 0.0003). The lower eye did not have the larger DFA in 29 patients. CONCLUSION: The angle of hyperdeviation in patients with ARNH was small. The DFA in the ARNH group was larger than that in the normal group. The lower eye was not the eye with a larger DFA in 39% of ARNH, inconsistent with sagging eye syndrome. Decreased phoria adaptation (fusional ability) may trigger diplopia in patients with ARNH.

Magnetic resonance imaging findings of high myopic strabismus with sagging eye-like symptoms, heavy eye syndrome, and non-highly myopic eyes with sagging eye syndrome.

INTRODUCTION: Progressive esotropia accompanied by restricted abduction and supraduction due to high myopia is known as esotropia fixus with high myopia or heavy eye syndrome (HES). Some conditions, such as sagging eye syndrome (SES), show esotropia for distance or cyclovertical strabismus with no abduction limitations despite highly myopic eyes. We evaluated the magnetic resonance imaging (MRI) findings and clinical features of HES, high myopia with SES-like symptoms (highly myopic SES), and SES. METHODS: We reviewed all patients diagnosed with HES, highly myopic SES, and SES who underwent MRI of the orbits and brain over 6 years. To quantitatively assess the orbital anatomy, we compared the conditions of the superior rectus muscle (SR), lateral rectus muscle (LR), and inferior rectus muscle (IR) using orbital MRI among the three groups. RESULTS: Among the 14 patients (27 eyes) with high myopia, 5 (9 eyes) had HES, and 9 (18 eyes) had highly myopic SES. Eleven patients (22 eyes) with SES were also compared with these 14 patients. The mean axial length was 29.6 ± 1.0 mm in participants with HES, 29.0 ± 1.5 mm in those with HES-SES, and 23.7 ± 0.9 mm in those with SES. The average distance esotropia was 48.0 ± 19.9Δprism, 4.6 ± 1.5Δprism, and 6.1 ± 4.6Δprism for participants with HES, highly myopic SES and SES, respectively. The average distance hypertropia was 5.3 ± 5.9Δprism in participants with highly myopic SES and 4.8 ± 2.7Δprism in those with SES. The mean vertical angle of the LR was 32.6 ± 10.8°, 18.1 ± 5.4°, and 14.6 ± 6.8°; the mean tilting angle of the LR was 31.6 ± 9.2°, 15.9 ± 6.0°, and 13.8 ± 5.9°; and the mean displacement angle between the LR and SR was 152.3 ± 16.7°, 125.0 ± 7.1°, and 112.5 ± 7.5° for participants with HES, highly myopic SES and SES, respectively. The LR-SR displacement angle in HES-SES was significantly larger than in SES (p < .001) but the vertical and tilting angles were not. Also, the IR shift showed no significant difference with HES-SES and HES (5.8 ± 1.4 mm and 5.3 ± 1.2 mm) but not with SES (4.0 ± 0.8 mm) (p < .0001). DISCUSSION: SES-like symptoms can develop in highly myopic eyes; however, MRI showed that the state of the LR muscle in highly myopic SES deviated almost similarly to that in SES; however, the eyeball was more dislocated than in SES. This may be useful in deciding the appropriate operative procedure.

Comparisons between eyebags, droopy eyelids, and eyebrow positioning identified by photo-numeric scales or identified by written descriptive scales: Insights from the Singapore/Malaysia cross-sectional genetics epidemiology study (SMCGES) cohort.

BACKGROUND: We evaluate skin sagging phenotypes (eyebags, droopy eyelids, low eyebrow positioning) using written descriptive scales and photo-numeric scales. We also study how anti-ageing interventions and digital screen time influence skin sagging. AIM: We compare the two phenotype assessment methods with each other. METHOD: Skin sagging and personal lifestyle data obtained from 2885 ethnic Chinese young adults from the Singapore/Malaysia cross-sectional genetics epidemiology study (SMCGES) cohort were collated and compared. RESULTS: Significant correlations (p-value < 0.001) between written descriptive scales and photo-numeric scales were observed for eyebags (0.25) and eyebrow positioning (0.08). Significant correlations (p-value < 0.001) were observed after combining both scales for eyebags (0.38), droopy eyelids (0.30), and eyebrow positioning (0.30). Anti-ageing interventions are associated with delayed progression of eyebags from 18-45 years old, droopy eyelids from 31-45 years old, and eyebrow positioning from 35-40 years old. Significantly lower (p-value < 0.02) eyebrow positioning is associated with both <1 and 1-3 h of screen time stratified by age. CONCLUSION: Written descriptive scales provide comparable results to photo-numeric scales. However, validating and adapting photo-numeric scales for different populations identifies phenotypes better. Anti-ageing interventions are beneficial at different age ranges. Screen time is associated with skin sagging in young (18-30 years old) participants.

Evaluation of the effect of sagging correction calibration errors in radiotherapy software on image matching.

To investigate the impact of sagging correction calibration errors in radiotherapy software on image matching. Three software applications were used, with and without a polymethyl methacrylate rod supporting the ball bearings (BB). The calibration error for sagging correction across nine flex maps (FMs) was determined by shifting the BB positions along the Left-Right (LR), Gun-Target (GT), and Up-Down (UD) directions from the reference point. Lucy and pelvic phantom cone-beam computed tomography (CBCT) images underwent auto-matching after modifying each FM. Image deformation was assessed in orthogonal CBCT planes, and the correlations among BB shift magnitude, deformation vector value, and differences in auto-matching were analyzed. The average difference in analysis results among the three softwares for the Winston-Lutz test was within 0.1 mm. The determination coefficients (R2) between the BB shift amount and Lucy phantom matching error in each FM were 0.99, 0.99, and 1.00 in the LR-, GT-, and UD-directions, respectively. The pelvis phantom demonstrated no cross-correlation in the GT direction during auto-matching error evaluation using each FM. The correlation coefficient (r) between the BB shift and the deformation vector value was 0.95 on average for all image planes. Slight differences were observed among software in the evaluation of the Winston-Lutz test. The sagging correction calibration error in the radiotherapy imaging system was caused by an auto-matching error of the phantom and deformation of CBCT images.

Elastogenic potential and antisagging properties of a novel Murraya koenigii extract.

BACKGROUND: The process by which functional elastic fibers are produced, namely elastogenesis, is complex and difficult to assess in vitro. Identifying efficient elasticity-boosting ingredients thus represents a challenge. AIMS: The elasticity-boosting properties of a novel extract of Murraya koenigii leafy stems were assessed in vitro in 3D culture models before being evaluated in human female volunteers. METHODS: Synthesis of elastic fiber related proteins was evaluated in a skin-equivalent model. Using multiphoton microscopy, the structural organization of elastin deposits was studied within a scaffold-free dermal microtissue. Biomechanical properties of the 3D microtissue were also measured by atomic force microscopy. In vivo, fringe-projection and image analysis were used to evaluate nasogenian fold severity in a panel of Caucasian female volunteers. The impact of gravity on visible signs of facial aging was assessed by clinical scoring carried out alternatively in the supine and sitting positions. RESULTS: We showed the Murraya koenigii extract increased protein expressions of elastin and fibrillin-1 in a 3D skin equivalent model. Using scaffold-free dermal microtissue, we confirmed that Murraya koenigii extract allowed a proper and ordered network of elastin deposits and consequently improved tissue elasticity. Clinical data showed that a twice-daily application for 98 days of the extract formulated at 1% allowed to visibly reduce nasogenian fold severity, jowl severity and to mitigate the impact of gravity on the facial signs of aging. CONCLUSION: The newly discovered extract of Murraya koenigii leafy stems represents an innovative antiaging ingredient suited for elasticity-boosting and antisagging claims.

Comparison of head tilt test between sagging eye syndrome and acquired unilateral trochlear nerve palsy.

PURPOSE: To investigate the distinction between sagging eye syndrome (SES group) and acquired unilateral trochlear nerve palsy (Trochlear group) in the Bielschowsky head tilt test (BHTT). METHODS: Fifteen patients in the SES group (mean age 74.6 ± 5.2 years) and 14 patients in the Trochlear group (55.2 ± 15.9 years) visited the Department of Ophthalmology, Hyogo Medical University Hospital between November 2016 and October 2022 for treatment of their diplopia. Eye position was measured with the alternate prism cover test, and values for fixation of the dominant eye, or unaffected eye, were used. Cyclodeviation was measured with the synoptophore and the Glaucoma Module Premium Edition of the SPECTRALIS optical coherence tomography. In the BHTT, eye position was measured in three head postures: primary position (PP), head tilt to the side with hypertropia (Hyper), and head tilt to the side with hypotropia (Hypo). The differences in vertical deviation between PP and Hyper (Hyper - PP), PP and Hypo (PP - Hypo) and Hyper - Hypo were measured and compared. RESULTS: Vertical deviation in primary position was 7.3 ± 4.5 PD in the SES group and significantly larger (17.1 ± 8.4 PD) in the Trochlear group (p = 0.002). The vertical deviation in Hyper was significantly larger in the Trochlear group with 7.7 ± 4.7 PD and 22.1 ± 9.4 PD, respectively (p < 0.001), whereas the that in Hypo was not significantly different between the two groups with 6.5 ± 3.4 PD and 8.4 ± 6.6 PD, respectively (p = 0.725). The SES group showed no significant difference according to the 3 head postures (p = 0.311), while the Trochlear group showed a significantly different with smaller mean values in vertical deviation in Hypo (p < 0.001). The difference in the vertical deviation for the 3 head postures was the largest in Hyper - Hypo (1.7 ± 2.1 PD and 13.6 ± 7.1 PD, respectively), and the accuracy of SES was at the cutoff value of 6 PD, and it was considered not to be SES if the value was 6PD or higher. The accuracy of SES determination was 100% sensitivity and 100% specificity, and the area under the curve was 1.0. CONCLUSION: The difference in Hyper - Hypo in the BHTT may be the most useful index in differentiating SES from acquired unilateral trochlear nerve palsy; if the difference was more than 6 PD, the probability of SES was very low.

Eficiência clínica de fios de polidioxanona no tratamento da flacidez tissular abdominal pós-parto: relato de caso / Clinical efficiency of polydioxanone threads in the treatment of postpartum abdominal tissue flaccidity: case report

Este estudo relata um caso de flacidez abdominal após 3 gestações no qual foi utilizada a técnica de fios de polidioxanona (PDO) lisos e espiculados, técnica ainda não descrita na literatura paratratarestaqueixa.Apacientefoiacompanhadapor90dias,ehouvemelhoradaabertura da prega umbilical, do tônus da pele, de densidade dérmica e da flacidez tissular após 60 dias. Neste período, a paciente declarou estar totalmente satisfeita e foiestabelecidaaaltadotratamento.Comestepresenterelatodecasopodemosconcluirquea terapia combinada de fios de PDO parafusos e fios de PDO espiculados (Sculpt®) apresentam resultados muito expressivos em relação a qualidade da pele promovendo melhora visível na flacidez tissular

Thisstudyreportsacaseofabdominalflaccidityafterthreepregnancies,inwhichthetechnique ofsmoothandspiculatedpolydioxanonethreadswasused,atechniquenotyetdescribedinthe literature to treat this complaint. The patient was followed up for 90 days, but there was an improvement in the opening of the umbilical fold, skin tone, increase in dermal density and especially a reduction in tissue flaccidity in 60 days. During this period, the patient declared thatshewascompletelysatisfied,anddischargefromtreatmentwasestablished.Withthiscase report, we can conclude that the combined therapy of PDO threads screws and PDO threads spiculated (Sculpt®) presentvery expressive results about the quality of the skin, promoting a visible improvement in tissue flaccidity

Miopexia supra-ecuatorial del recto lateral en el tratamiento del síndrome «sagging/heavy eye» miópico / Supraequatorial displacement with lateral rectus myopexy for treatment of myopic sagging/heavy eye

Objetivo Describir los resultados de sujetos con síndrome «sagging/heavy eye miópico» operados mediante la miopexia supraecuatorial del recto lateral. Método Estudio retrospectivo de 9 casos entre 2017-2023. Se analizaron desviación horizontal, vertical, ambliopía, diplopía, ducciones, torsión, pruebas sensoriales antes y después de la cirugía, patología macular y resonancia magnética orbitaria. El tratamiento se consideró exitoso cuando desaparecía o mejoraba la diplopía y una desviación vertical≤5 dioptrías prismáticas (Dp) al final del seguimiento. Resultados La edad media (DE) fue: 62,11 (4,6) años (100% mujeres). El 88,88% presentaba diplopía. La hipotropía media preoperatoria fue: 11,33Dp (DE 3,16), y la desviación vertical final 3,44Dp (DE 3,05). Tras la cirugía, la hipotropía se invirtió en un caso, quedó subcorregida en 5 y se alcanzó ortoforia en otros 3. La técnica se asoció a la cirugía de otro músculo recto en 4 sujetos. El tiempo medio de seguimiento posquirúrgico fue de 34 meses (DE 34,62). Seis de las 9 pacientes quedaron con una desviación vertical≤5Dp. En 3 pacientes se consiguió eliminar totalmente la diplopía, mientras que en 5 quedó intermitente (3 con patología macular) Conclusión En el tratamiento del «sagging/heavy eye miópico», el supradesplazamiento ecuatorial con miopexia del recto lateral constituye una opción terapéutica si la hipotropía es menor de 12Dp o la técnica de Yokoyama no está indicada. Se obtuvo un buen resultado en más de la mitad de los casos, suprimiéndose totalmente la diplopía en 3 y quedando en otros 5 de forma intermitente (AU)

Purpose To describe the outcome of the patients diagnosed of sagging/heavy eye associated to myopia, that were operated on with the supra-equatorial displacement with lateral rectus myopexy. Methods A retrospective study of 9 cases between 2017 and 2023. The following data were analyzed: horizontal and vertical deviation, diplopia, amblyopia, ductions, ocular torsion, sensorial test, macular pathology, and the orbital magnetic resonance. Treatment was considered successful if the diplopia was improved or eliminated and a final vertical deviation≤5prism diopters (PD). Results The mean age (SD) was: 62.11 (4.6) years (100% women). A total of 88.88% presented diplopia. The mean preoperative hypotropia was: 11.33PD (SD 3.16), and the mean final VD 3.44PD (SD 3.05). After surgery, the hypotropia was overcorrected in one case, under corrected in 5, and orthophoria was achieved in another 3. The technique was associated with surgery of another rectus muscle in 4 subjects. The mean follow-up time after surgery was 34 months (SD 34.62). Six of the 9 patients improved with a vertical deviation≤5PD. In 3 patients, the diplopia was eliminated, while in 5 it remained intermittent (3 with macular pathology). Conclusion Supra-equatorial displacement with lateral rectus myopexy for treatment of myopic sagging/heavy eye is a therapeutic option if hypotropia is less than 12PD or the Yokoyama technique is not indicated. A good result was obtained in most cases, although diplopia could only be totally suppressed in three, and another five remained intermittent (AU)

Brain Sagging Dementia.

PURPOSE OF REVIEW: Brain sagging dementia (BSD) is a rare but devastating form of early-onset dementia characterized by intracranial hypotension and behavioral changes resembling behavioral variant frontotemporal dementia. This review aims to provide a comprehensive overview of BSD, highlighting its pathomechanism, diagnostic tools, and available treatment options. RECENT FINDINGS: BSD exhibits a complex clinical manifestation with insidious onset and gradual progression of behavioral disinhibition, apathy, inertia, and speech alterations. Additionally, patients may exhibit brainstem and cerebellar signs such as hypersomnolence and gait disturbance. Although headaches are common, they may not always demonstrate typical orthostatic features. Recent radiological advances have improved the detection of CSF leaks, enabling targeted treatment and favorable outcomes. Understanding the pathomechanism and available diagnostic tools for BSD is crucial for a systematic approach to timely diagnosis and treatment of this reversible form of early-onset dementia, as patients often endure a complex and lengthy clinical course.

Investigating the efficacy of topical application of Ipomoea carnea herbal cream in preventing skin damage induced by UVB radiation in a rat model.

Ultraviolet-B irradiation is a common environmental stressor that has detrimental effects on human skin. Natural sunscreens are well-known for their ability to benefit inflamed sunburn and dry skin. This study examined the effect of formulated Ipomoea carnea herbal cream on UVB-induced skin damage. We screened the bioactive compounds of I. carnea crude extract, showing significant antioxidant activity. Additionally, we evaluated the cytotoxicity, revealing that I. carnea extract has less toxicity to vero cells (IC50 98.45 µg/mL) than to A375 cells (IC50 48.95 µg/mL). Based on this, we formulated the I. carnea herbal cream (FIHC) at 50, 100 and 200 mg concentrations and evaluated its organoleptic characteristics. Then, the rats were exposed to UVB radiation (32,800 J/m2) four times/week (on alternate days) before the cream was applied topically to the dorsal skin surface. Under UVB stress without treatment, rats showed deep dermal damage. In contrast, rats treated with the FIHC exhibited significantly reduced sunburn. Moreover, the histopathological and biochemical assays were confirmed by the topical application of FIHC, which had potentially reduced the skin elasticity and maintained the imbalanced enzyme and non-enzymatic antioxidant activity. Our findings amply demonstrate that the FIHC significantly accelerated the recovery of UVB-induced lesions through antioxidant and down-regulation of skin photodamage.

Supraequatorial displacement with lateral rectus myopexy for treatment of myopic sagging/heavy eye.

PURPOSE: To describe the outcome of the patients diagnosed of sagging/heavy eye associated to myopia, that were operated on with the supra-equatorial displacement with LR myopexy. METHODS: A retrospective study of 9 cases between 2017-2023. The following data were analyzed: horizontal and vertical deviation, diplopia, amblyopia, ductions, ocular torsion, sensorial test, macular pathology, and the orbital magnetic resonance. Treatment was considered Successful if the diplopia was improved or eliminated and a final vertical deviation (VD) ≤5 prism diopters (PD). RESULTS: The mean age (SD) was: 62.11 (4.6) years (100% women). A total of 88.88% presented diplopia. The mean preoperative hypotropia was: 11.33 PD (SD 3.16), and the mean final VD 3.44 PD (SD 3.05). After surgery, the hypotropia was overcorrected in one case, under corrected in 5, and orthophoria was achieved in another three. The technique was associated with surgery of another rectus muscle in 4 subjects. The mean follow-up time after surgery was 34 months (SD 34.62). Six of the 9 patients improved with a vertical deviation ≤5 PD. In 3 patients, the diplopia was eliminated, while in 5 it remained intermittent (three with macular pathology). CONCLUSION: Supra-equatorial displacement with LR myopexy for treatment of myopic sagging/heavy eye, is a therapeutic option if hypotropia is less than 12 PD or the Yokoyama technique is not indicated. A good result was obtained in most cases, although diplopia could only be totally suppressed in three, and another five remained intermittent.

[High intensity focussed ultrasound for skin tightening]. / Hochintensiver fokussierter Ultraschall zur Hautstraffung.

High intensity microfocussed ultrasound (HIFU) is currently used for skin tightening and recently also for fat reduction. The HIFU uses bundled ultrasound waves that are focussed by a type of concave mirror to bundle thermal energy. The indications for HIFU include, in particular, sagging skin that does not need a plastic surgical operation for tightening. In most cases only one or two treatment sessions are needed. More expensive HIFU treatment can be further optimized by maintenance therapy with radiofrequency (RF). The greatest disadvantage of HIFU is that the treatment is very painful.

[Radiofrequency : Monopolar, bipolar, multipolar and fractional]. / Radiofrequenz : Mono-, bi- und multipolar sowie fraktional.

In addition to the laser technology, other physical methods are increasingly being used for medical and therefore medical cosmetic purposes. The most frequently used energy sources include the various application forms of radiofrequency (RF). The aim of the use of RF is to vaporize and coagulate tissue through a tissue temperature of >70 °C and to achieve a temperature of 42-44 °C especially in deeper layers, in order to promote a thermally induced collagen regeneration that enables skin tightening over the dermis. Unipolar, monopolar, bipolar, multipolar and fractional RF are suitable for medical applications. The result to be expected cannot compete with surgical lifting but RF is effective in cases of moderately sagging skin.

Perception gap of aged facial appearance; self-perception is younger than actual status due to angle of viewing.

BACKGROUND: Facial morphology changes with aging, resulting in an aged appearance that is a great matter of concern for people. However, it is not clear whether people perceive their own facial appearance accurately, in part because there are few methods to evaluate this. AIM: The aim of this study is firstly to establish an evaluation system for the perception gap of aged facial appearance between the self-perceived status and the actual status, and then to use this evaluation system to quantify the perception gap and to clarify the mechanism of this gap METHOD: Thirty-six middle-aged female volunteers were first asked to rate their facial aging-related morphology according to a 6-grade set of photos taken at a 45° angle from the front showing progressive stages of sagging severity, without looking either in a mirror or at photos of themselves (self- or "subjective" perception). Then they were shown photos of their face taken at a 45° angle from the front, and asked again to rate their sagging grade based on these photos ("objective" rating). In addition, facial photos taken from several angles from the front to the side were evaluated for sagging severity by trained evaluators. RESULTS: This system for analyzing perception gap revealed that the self-perception of aged appearance was significantly younger than the actual situation in three facial areas, namely the cheek, around the eyes and the facial contour, and the gap corresponded to an age difference of as much as 8 years in middle-aged females. Trained evaluators found that the severity of sagging judged from photos taken from a frontal direction was significantly less than in photos of the same subject taken from side angles. This suggests that recognition of sagging is more difficult from the front, which is the direction from which people view their own face in daily life. Indeed, viewing photos taken from the side, a rare viewing angle of one's own face, increased the motivation to improve aged appearance in more than 70% of the subjects in a questionnaire survey. CONCLUSION: The results suggest that people perceive their own facial appearance as less aged than it actually is. The reason for this appears to be that viewing from the front, the usual viewing angle of one's own face in daily life, results in lower perceived sagging severity, likely due to reduced depth perception.

Vellus hair condition is related to dermal elasticity and facial sagging severity.

BACKGROUND: Sagging of facial skin is a critical factor associated with an aged appearance. However, the mechanism of sagging has not been fully elucidated. The facial skin contains vellus hair (fine hair), but the contribution of vellus hair to skin condition and facial aging has yet to be studied. AIM: We aimed to clarify the influence of vellus hair on the physical properties and sagging severity of facial skin by establishing an evaluation system for vellus hair condition. METHOD: Photographs were taken to assess the vellus hair condition in the cheek area in 30 middle-aged female volunteers. Skin elasticity was measured with a cutometer and sagging severity was evaluated by using previously established photograph-based grading criteria. RESULTS: Facial skin vellus hairs were divided into three types: fine, thick, and normal thickness. Based on this observation, we established a 6-grade photograph-based grading system based on the dominant type of vellus hair in the target area and used it to evaluate vellus hair condition at the cheek. We found that vellus hair condition is significantly positively related to skin elasticity parameters Ua/Uf (representing overall elasticity including creep and creep recovery), Ur/Ue (representing net elasticity without viscoelastic creep), and Ur/Uf (ratio of elastic recovery to total deformation). Further, vellus hair condition was significantly negatively correlated to sagging severity. CONCLUSION: Our results suggest that vellus hair condition positively contributes to the skin's physical properties, and consequently deterioration of the vellus hair condition promotes an aged facial appearance.

Relationship between the abdominal sagging index and the reproductive performance of the Roman goose.

OBJECTIVE: This research aimed to explore the changes in the observed abdominal sagging index (ASI) and reproductive performance of Roman male and female geese during the breeding period. METHODS: The 339 six-month-old breeding geese (109 male; 230 female) were used in this study, in which five male and five female geese were slaughtered on a monthly basis to record the ASI. RESULTS: The short diameter of the testes of the male goose when the female goose lays eggs and in the second, third, and fourth months was significantly wider than in the fifth months (19.0, 20.8, 21.4, and 19.6 vs 12.7 and 14.0 mm/bird; p = 0.0105). On the other hand, the testicular weight of the male goose in the second and third months after the female goose lays eggs was significantly higher than that in the second and fifth months after laying (0.33% and 0.37% vs 0.11% and 0.19%; p = 0.0212). During the exploring period, the length and weight of the fallopian tube, the weight of the ovary, the number of follicles in 2 to 3 cm, the number of follicles in 3 to 4 cm, the fallopian tube weight in the carcass weight percentage, and the ovary weight in the carcass weight percentage all demonstrated a significant curve response. Further, female ASI was positively correlated with reproductive tract length (r = 0.815; p<0.05) and egg production per female (r = 0.790; p<0.05). CONCLUSION: The ASI classification method is more objective and easy to distinguish. This scoring method has a high correlation with the number of eggs laid by each goose and the length of the reproductive tract, inferring that the goose observation could take advantage of ASI during egg-laying and can predict the reproductive system development during the laying period and determine when the breeding goose begins to lay eggs.

Novel conformation of hyaluronic acid with improved cosmetic efficacy.

BACKGROUND: Hyaluronic acid presents a valuable cosmetic ingredient that occurs naturally. Its direct links to skin aging has led to its broad application. The aim of this study was to improve the cosmetic efficacy of high molecular weight hyaluronic acid (HMWHA) without chemical modifications and evaluate such improvements through clinical and in vitro studies. METHODS: A novel formulation of HMWHA (SCAI-HA) was prepared and investigated to comparatively assess 6 clinical and 2 in vitro parameters concerning its dermatological cosmetic efficacy and biological properties. The dermatological and cellular parameters examined in this study include skin hydration, transepidermal water loss (TEWL), skin elasticity, wrinkles, facial sagging, dermal density, cytotoxicity, and collagen synthesis. RESULTS: SCAI-HA exhibited the ability to improve the tested dermatological parameters (hydration, elasticity, wrinkles, and density) to magnitudes comparable to those of HMWHA. In addition, SCAI-HA showed notably improved capacities for attenuating facial sagging and TEWL and promoting cellular collagen synthesis in normal human dermal fibroblasts. CONCLUSION: SCAI-HA presents a novel conformation of HMWHA with improved cosmetic efficacy in mitigating (i) facial sagging, (ii) TEWL, and promoting, and (iii) collagen synthesis. These findings denote the enhancement of SCAI-HA as a cosmetic ingredient with potential anti-aging properties.