Eye shape illusions induced by eyebrow positions

A Combined Approach Using IncobotulinumtoxinA and CPM-Hyaluronic Acid Injections for the Periorbital Complex Improvement: A Pilot Study

Background

Previous reports have objectively demonstrated the efficacy of botulinum toxin for brow elevation. No previous clinical trial has reported a combined approach to botulinum toxin A injection with hyaluronic acid (HA) injection in the upper face for periorbital region beautification focusing on eyebrow reshaping.

Objectives

To evaluate the effect of IncobotulinumtoxinA injection using the ONE21 technique combined with HA injection (CPM technology) to redefine brow shape and position.

Methods

A prospective pilot study was designed to evaluate the effect of IncobotulinumtoxinA injection using the ONE21 technique-with a preestablished scheme of doses and injection-site distribution-combined with HA injection (CPM technology) periosteally into the palpebromalar groove and subdermally in the anterior temporal region, to redefine brow shape and position. Objective eyebrow measurements were taken by an independent investigator using the Merz Aesthetic Scale (MAS) for brow positioning. Patient satisfaction was also evaluated. Some patients were also assessed using the Vectra System (Canfield Scientific, Parsippany, NJ).

Results

Eleven females, aged 29 to 55 years, were included in this prospective pilot study. The totality of patients (11/100%) had at least ≥1-point improvement in the MAS brow positioning. All patients (100%) reported significant aesthetic improvement of their periorbital region and appearance, with 82% of the patients much improved. Mild side effects, such as ecchymosis and transient temporal edema, were reported.

Conclusions

The combined technique improved the appearance of the orbital area by uplifting the lateral eyebrow and creating an almond-shaped eye effect, which characterizes the trending marketing term Foxy eyes. Further studies, including more cases, are needed to obtain a statistically significant outcome.

Level of Evidence 4

Defining Ideal Double Eyelids With a Morphometric Analysis in Asians

BACKGROUND

Double eyelids are always considered crucial aesthetic symbols. Despite numerous studies conducted on the attractiveness of double eyelids, there remains a dearth of research on quantitative and morphological evaluation of ideal double eyelids.

OBJECTIVES

In this we study aimed to investigate the optimal height and morphological characteristics of ideal double eyelids.

METHODS

Participants were presented with a total of 9 images, consisting of 1 single eyelid image and 8 double eyelid images, featuring 2 distinct shapes and 4 varied pretarsal shows. Respondents were instructed to assign scores ranging from 1 (least attractive) to 5 (most attractive) for each image. Subsequently, the scores for each image were analyzed based on population demographics, followed by the calculation of aesthetic metrics.

RESULTS

The whole cohort deemed images with a 2-mm fold to be more attractive than 1 mm (P < .001), followed by 3 mm and 0 mm (single eyelid), and finally, 4 mm. Morphologically, significant differences were found between images with the same pretarsal shows of 3 mm (P < .001) and 4 mm (P = .026). Most subgroup analysis results were aligned with those of the cohort, with gender being the most significant factor in distinguishing double eyelid aesthetics. Additionally, aesthetic characteristics of 2-mm folds were found to be comparable to appealing double eyelids in previous studies.

CONCLUSIONS

In this study we validated the optimal heights and morphology of double eyelids, thereby addressing the existing gap in aesthetic studies on double eyelids. These findings hold significant implications for surgical planning, effect assessment, and other periocular procedures related to upper blepharoplasty.

LEVEL OF EVIDENCE: 4

Photo-Assisted Anthropometric Analysis of Double Eyelid Blepharoplasty in Young Chinese

BACKGROUND

Double eyelid blepharoplasty has gained popularity over decades among Asians. Quantitative assessment of the morphologic changes after double eyelid blepharoplasty remains obscure. A photo-assisted digital method was introduced to measure the outcomes of double eyelid surgery in young Chinese.

METHODS

A total of 168 Chinese patients who underwent esthetic upper blepharoplasty were recruited from October 2018 to October 2020. The participants were divided into mini-incision, full-incision, and full-incision double with epicanthoplasty (FIDE) groups. Changes in the eyeball exposure area (EEA), brow eyelid margin distance [brow eyelid distance (BED)], and palpebral crease height after surgery were analyzed using ImageJ software.

RESULTS

There was an overall increase in EEA in the 3 groups after upper blepharoplasty surgery. The FIDE group showed the most increase in EEA among these groups. Furthermore, BED was significantly decreased in each group after upper eyelid blepharoplasty; however, the mini-incision double group showed the least BED reduction. The palpebral crease height at 90 days was significantly lower than that at 7 days after surgery.

CONCLUSIONS

The photo-assisted anthropometric analysis offers a simple and objective measurement for double eyelid blepharoplasty. The eyes appear larger because of the increase in EEA and decrease in BED after double eyelid blepharoplasty. Distinct results were produced by different surgical techniques. The FIDE group showed the maximum increase in EEA and a decrease in BED. These findings provide important references for preoperative planning and postoperative measurement.

Eyebrow Shape Preference Across Age, Gender, and Self-reported Ethnic Group

BACKGROUND

Preference in eyebrow shape has been studied in young women, but less so in older adults, men, and a wide variety of ethnic groups.

OBJECTIVE

To identify preference in eyebrow shape across age groups, genders, and ethnic groups for both the survey responder and the observed subject.

METHODS

Digital images of subjects from 3 age groups (18-39, 40-59, and 60+ years), 2 genders (female and male), and 4 self-identified ethnic backgrounds were edited to correspond to 5 brow shapes (Anastasia, head-up, horizontal, rounded, and tail-up). Panels of images representing the same subject with different brow shapes were displayed and responders ranked them in order of attractiveness via an online survey.

RESULTS

Six hundred fifty-two responders answered the survey. Survey responders generally preferred the Anastasia shape, but not in all subgroups. Strength of preference in eyebrow shape was more marked when observing images of women and less marked when observing men.

CONCLUSION

An arched brow, such as the Anastasia shape, was the preferred eyebrow shape. This study is limited by its survey nature, underrepresentation of self-identified Black study responders, and categorization of data. Despite these findings, the authors advocate determining eyebrow shape preference individually with patients during cosmetic consultations.

Viewpoint Invariance of Eye Size Illusion Caused by Eyeshadow

Previous research found that application of eyeshadow on the upper eyelids induces overestimation of eye size. The present study examined whether or not this eyeshadow illusion is dependent on viewpoint. We created a three-dimensional model of a female face and manipulated the presence/absence of eyeshadow and face orientation around the axis of yaw (Experiment 1) or pitch (Experiment 2) rotation. Using the staircase method, we measured perceived eye size for each face stimulus. Results showed that the eyeshadow illusion occurred regardless of face orientation around axes of both yaw and pitch rotations. Crucially, the illusion’s magnitude did not vary across face orientations; lack of interaction between the illusion’s magnitude and face orientation was confirmed by small values of Bayes factors. These findings ruled out the hypothesis that eyeshadow serves as a depth cue and leads to overestimation of eye size due to size-distance scaling. Alternatively, the present findings suggest that the eyeshadow illusion can be well explained by the assimilation between the eyes and eyeshadow, which also facilitates assimilation between the eyes and eyebrows. Practical implications and the present findings’ generalizability are also discussed.

Data-Driven Research on the Matching Degree of Eyes, Eyebrows and Face Shapes

There is a close relationship between the attractiveness of the face and the facial features. The shape of the facial features determines the level of attractiveness, in which the eyes and eyebrows are particularly vital. In this article, we proposed a method to study the facial attractiveness by combining global face shape and local geometric features of eye and eyebrow and using computer big data analysis for assistance. Firstly, we collected 300 images of East Asian female and use machine learning methods to evaluate the attractiveness scores of face images. Secondly, geometric models were constructed separately for the eyebrows and the eyes to obtain their geometric and shape features. Correlation analysis was performed on the obtained data to study their shape matching of different facial attractiveness rating levels. Finally, the relationship between the shape of face and eyebrows was analyzed by combining the facial ratio and the geometric features of the eyebrows. The research in this article can provide reference for medical and beauty institutions and women’s makeup, and further study in the field of facial aesthetic analysis based on geometric features.

"The Evolution of Eyebrow Morphology: The Westmore Model Revisited"

BACKGROUND

The most widely recognized eyebrow model was described by Westmore in 1974. With the rapidly changing concept of beauty, an accurate up-to-date model is needed.

METHODS

The Westmore model was tested on fashion models that were randomly selected from the covers of the 1965-1975 (group 1) and 2006-2016 (group 2) Vogue magazine. The eyebrows of fashion models, which represent the beauty ideals of these decades, were objectively measured and compared. We proposed a modified eyebrow model more adapted to the modern standards of beauty, applied it to group 2, and objectively compared it to the Westmore model. This new model was validated on a group of randomly selected Caucasian women.

RESULTS

Thirty women were included in each group. The medial edge of the eyebrow was better defined by the Westmore model in group 1 compared to group 2. The lateral edge of the eyebrow was better defined by the Westmore model in group 2. The peak of the eyebrow was not well defined by the Westmore model in both groups. The new model was more adapted than the Westmore model for both the medial edge and the peak of the eyebrow in group 2. It was also accurate in non-model Caucasian women.

CONCLUSION

Eyebrow morphology has evolved since the description of the Westmore model. Our model represents a simple way to accurately predict the eyebrow landmarks according to the modern ideals of beauty.

Chen's Double Eyelid Fold Illusion: An Eye Size Assimilation Illusion Induced by a Supratarsal Fold in the Brow-Eye Unit, A Preliminary Report

BACKGROUND

Double eyelidplasty can enhance the eye size and facial attractiveness of Asian individuals with single eyelids. The authors hypothesize that a supratarsal fold can induce an eye size assimilation illusion to enhance eye dimensions and aesthetics, and seek to define the optimum vertical proportion between a supratarsal fold and the eye fissure associated with maximal induction of the size assimilation illusion.

METHODS

A photometric study of the replicated photographs of ten female Taiwanese patients after double eyelidplasty was designed. Each photograph was edited by shifting the supratarsal folds vertically at a regular fold/eye ratio increment of 0.1. The perceived attractiveness of edited photographs of each patient was rated by 100 adult observers using a score of 1-5. The palpebral parameters were measured and analyzed.

RESULTS

The mean rating score increased gradually when a supratarsal fold was added and peaked when the fold/eye ratio was 0.3 and the mean Chen's double eyelid fold ratio was 0.631 ± 0.023. After the peak, the mean score decreased gradually and was lower than the photograph without a fold when the fold/eye ratio exceeded 0.5 and the mean Chen's ratio exceeded 0.729 ± 0.027.

CONCLUSION

Within the optimal ranges of the fold/eye ratio and Chen's double eyelid fold ratio, eyes are perceived as larger and more attractive due to a hybrid presentation of two interdependent eye size assimilation illusions induced by a supratarsal fold in the brow-eye unit. "Chen's double eyelid fold illusion" is proposed to describe this complex visual phenomenon.

LEVEL OF EVIDENCE IV

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Effects of Lip Color on Perceived Lightness of Human Facial Skin

Whereas geometric illusions in human faces have been reported by several studies, illusions of color or lightness in faces have seldom been explored. Here, we psychophysically investigated whether lip color influences facial skin’s perceived lightness. Results of Experiment 1 demonstrated that redder lips lightened and darker lips darkened the perceived complexion. These lightness or darkness inducing effects differ from the classical illusion of lightness contrast in nonface objects for two reasons. First, illusory effects are more assimilative than contrastive. Second, the inducing area (i.e., lips) is much smaller than the influenced area (facial skin). Experiment 2 showed that the assimilative lightness induction was caused by holistic processing of faces. This is the first study to scientifically substantiate the claim of cosmetics manufacturers and makeup artists that lip colors can alter perceived facial skin color. Implications for face perception, lightness illusion, and perceptual effects of cosmetics are discussed.

Chen's Double Eyelid Fold Ratio

BACKGROUND

Double eyelidplasty can construct palpebral folds and enhance beauty perception for Asians with single eyelids. A new palpebral parameter for the quantitative interpretation of surgical outcomes is proposed on the basis of a photometric study of the altered proportions of Asian eyes after double eyelid operation.

METHODS

A total of 100 Asian adults with single upper eyelids who were satisfied with the enlarged eyes by operation were included in the study. A retrospective measurement of palpebral parameters in the frontal profile both preoperatively and 6 months postoperatively was performed. The proportions of various parameters in the eyebrow-eye aesthetic unit were calculated and analyzed.

RESULTS

Double eyelidplasty can augment the vertical dimension of palpebral fissure by 27.9% increase on average. The vertical ratio of palpebral fissure to the eyebrow-eye unit is augmented by 34.4% increase. The vertical ratio of the subunit below double eyelid fold peak to the unit is augmented by 82.6% increase.

CONCLUSIONS

Double eyelidplasty can substantially enlarge the vertical dimensions of the eyes of Asians with single eyelids. The eyes are perceived to be larger because of the visually assimilated illusion of the superimposed eyelid fold and the relative proportions of the eyebrow-eye unit. The authors propose using a vertical ratio of the subunit below double eyelid fold peak in the eyebrow-eye unit to measure the visually perceived proportion of the eye in the unit. This ratio can be applied clinically for a quantitative evaluation of the surgical outcome after double eyelidplasty.