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Mora Hurtado AC, Elbuluk N, Taylor SC. Neuromodulators in Skin of Color: An International Review. Dermatol Surg 2024; 50:S73-S79. [PMID: 39196838 DOI: 10.1097/dss.0000000000004313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2024]
Abstract
BACKGROUND As the racial/ethnic diversity of the US population grows, it is imperative for dermatologists to recognize the nuances in the aesthetic treatment of diverse populations. OBJECTIVE This comprehensive review explores the safety and efficacy of botulinum toxin A (BTX-A) in skin of color (SOC) populations and highlights variations in aging patterns, skin properties, and aesthetic concerns in SOC populations. MATERIALS AND METHODS A review of PubMed/MEDLINE databases from 2004 to 2024 was performed using combinations of the terms botulinum toxin, SOC, Fitzpatrick, race/ethnicity, and Asian, Latin American, Caribbean, Middle Eastern, African, and Pacific countries. RESULTS Twenty-three articles examining the use of BTX-A in SOC populations were identified. Twelve studies were from East Asia, 5 from the United States and/or Canada, 3 from South Asia/Southeast Asia, 2 from South America, and 1 from the Middle East. Available data suggest that BTX-A is efficacious and well tolerated in SOC populations. CONCLUSION Increased SOC representation in clinical trials may guide the development of tailored treatment approaches to optimize aesthetic outcomes for patients with SOC. A comprehensive knowledge of the variations in aging patterns, skin properties, and aesthetic concerns across SOC populations is essential for providing culturally sensitive cosmetic dermatologic care for diverse populations.
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Affiliation(s)
| | - Nada Elbuluk
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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2
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McCleary SP, Nirbhay J, Moghadam S, Le C, Roostaeian J. Racial Perspectives on Facelifts: Evaluating Techniques and Outcomes Across Diverse Populations. Aesthet Surg J 2024; 44:785-796. [PMID: 38408032 DOI: 10.1093/asj/sjae046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Facial aesthetic surgery is one of plastic and reconstructive surgery's most sought-after and evolving areas. The growing diversity in both local and worldwide populations compels us to reevaluate our previous approaches and underscores the significance of departing from a singular aesthetic standard. Thankfully, the historical practice of stereotypical racial profiling has become less prevalent in the literature. Regrettably, however, the comparative terminology persists, characterizing non-Caucasian races as deviating from the "norm," which typically refers to the White or Caucasian race. Additionally, there is a lack of contemporary literature comparing the distinctive considerations relevant to rhytidectomy across multiple racial populations. OBJECTIVES The aim of this study was to succinctly outline the current body of literature examining the impact of race on facial aging and rhytidectomy, laying the groundwork for subsequent discussion on the relationship between race and facial aesthetic surgery. METHODS A comprehensive literature review was conducted using PubMed (National Institutes of Health, Bethesda, MD), identifying all studies published before 2023 discussing facial aging and rhytidectomy, specifically in non-Caucasian patients. RESULTS A total of 22 publications was identified. Asians were the most described group, with 12 publications, followed by Black/African with 5 and Hispanic/Latinx with 4. CONCLUSIONS In today's context, the aesthetic surgeon must possess the knowledge and readiness to provide culturally sensitive, patient-centered care guided by subtle anatomical nuances, informed by anecdotal recommendations, and ultimately, aimed at effectively addressing aging concerns within diverse populations. LEVEL OF EVIDENCE: 3
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3
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Sinha MD, Sinha PK. Liquid Facelift. Atlas Oral Maxillofac Surg Clin North Am 2024; 32:35-41. [PMID: 38307633 DOI: 10.1016/j.cxom.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Affiliation(s)
- Maya D Sinha
- Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
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Williams S, McDonald KA, Beach RA. Same But Different: An 18-Month Cross-Sectional Study of Cosmetic Procedures in Patients With Skin Phototype I-III Versus IV-VI in Toronto, Canada. Dermatol Surg 2024; 50:272-276. [PMID: 38113172 DOI: 10.1097/dss.0000000000004034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND Patients with darker skin phototypes self-report less facial aging than their lighter-skinned counterparts. However, the association of skin phototype with the type of cosmetic procedures received, is yet to be established in a Canadian context. OBJECTIVE To compare the pattern of nonsurgical cosmetic procedures performed on people with different Fitzpatrick SPTs. MATERIALS AND METHODS Cross-sectional study of patient encounters from October 2020-April 2022. Charts and photographs were reviewed and analyzed for age, sex, SPT, and procedure type. Participants were stratified by SPT into 2 cohorts: SPT I-III and SPT IV-VI. SPTs were collapsed into groups based on definitions of "skin of color" (SPT IV-VI) in previous literature. RESULTS We analyzed 350 patients with mean age 43.4, of whom 320 (91%) were female and 30 (9%) were male. The SPT I-III cohort was older (mean age 45 vs 38.5 years, p < .0001) and more frequently underwent neuromodulator injection. The SPT IV-VI cohort more frequently underwent microneedling, platelet-rich plasma, or electrodessication. CONCLUSION There are distinct patterns of cosmetic procedures performed. The SPT I-III cohort more commonly received procedures to manage facial aging. The SPT IV-VI cohort was younger and more commonly underwent procedures to manage hyperpigmentation.
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Affiliation(s)
- Stephen Williams
- Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Renée A Beach
- DermAtelier on Avenue-Medical & Cosmetic Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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5
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Cohen JL, Goodman GJ, De Almeida AT, Jones D, Carruthers J, Grimes PE, de Maio M, Swift A, Solish N, Fagien S, Carruthers A, Sangha S. Decades of beauty: Achieving aesthetic goals throughout the lifespan. J Cosmet Dermatol 2023; 22:2889-2901. [PMID: 37632289 DOI: 10.1111/jocd.15968] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/04/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Several elements, including age, influence judgments of beauty and attractiveness. Aging is affected by intrinsic factors (e.g., genetics, race/ethnicity, anatomical variations) and extrinsic factors (e.g., lifestyle, environment). AIMS To provide a general overview of minimally invasive injectable procedures for facial beautification and rejuvenation to meet the aesthetic goals of patients across their lifespan, organized by decade. METHODS This case study review describes aesthetic considerations of females in their third to sixth decade of life (i.e., 20-60 years of age or beyond). Each case study reports the treatments, specifically botulinum toxin type A and soft tissue fillers, used to address aesthetic concerns. RESULTS Signs of aging, as well as aesthetic goals and motivations, vary by age groups, cultures, and races/ethnicities. However, there are overarching themes that are associated with each decade of life, such as changes in overall facial shape and specific facial regions, which can be used as a starting point for aesthetic treatment planning. Appropriate patient selection, thorough aesthetic evaluation, product knowledge, and injection technique, as well as good physician-patient communication, are essential for optimal treatment outcomes. CONCLUSIONS Nonsurgical facial injectable treatments can successfully enhance and rejuvenate facial features across different age ranges. A comprehensive understanding of facial aging and the aesthetic considerations of patients by the decade contributes to optimal treatment planning and maintenance.
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Affiliation(s)
- Joel L Cohen
- AboutSkin Dermatology and DermSurgery, Greenwood Village, Colorado, USA
| | - Greg J Goodman
- Adjunct Professor of Dermatology, Monash University, Clayton, Victoria, Australia
| | - Ada Trindade De Almeida
- Medical Director and Cosmetic Dermatologic Surgeon, Clinica de Dermatologia, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
| | - Derek Jones
- Skin Care and Laser Physicians of Beverly Hills, Los Angeles, California, USA
| | - Jean Carruthers
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Pearl E Grimes
- Vitiligo & Pigmentation Institute, Los Angeles, California, USA
| | | | - Arthur Swift
- Westmount Institute of Plastic Surgery, Montreal, Quebec, Canada
| | | | - Steven Fagien
- Aesthetic Eyelid Plastic Surgery, Boca Raton, Florida, USA
| | | | - Sara Sangha
- Allergan Aesthetics, an AbbVie Company, Irvine, California, USA
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Singh P, Oregi P, Dhar S, Krumhuber E, Mosahebi A, Ponniah A. Face Structure, Beauty, and Race: A Study of Population Databases Using Computer Modeling. Aesthet Surg J Open Forum 2023; 5:ojad072. [PMID: 37638342 PMCID: PMC10456199 DOI: 10.1093/asjof/ojad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
Background Understanding the differences in facial shapes in individuals from different races is relevant across several fields, from cosmetic and reconstructive medicine to anthropometric studies. Objectives To determine whether there are features shared by the faces of an aesthetic female face database and if they correlate to their racial demographics using novel computer modeling. Methods The database was formed using the "top 100 most beautiful women" lists released by "For Him Magazine" for the last 15 years. Principal component analysis (PCA) of 158 parameters was carried out to check for clustering or racial correlation with these clusters. PCA is a machine-learning tool used to reduce the number of variables in a large data set, allowing for easier analysis of the data while retaining as much information as possible from the original data set. A review of the literature on craniofacial anthropometric differences across ethnicities was also undertaken to complement the computer data. Results Two thousand eight hundred and seventy aesthetic faces formed the database in the same racial proportion as 10,000 faces from the general population as a baseline. PCA clustering illustrated grouping by latent space parameters for facial dimensions but showed no correlation with racial demographics. There was a commonality of facial features within the aesthetic cohort, which differed from the general population. Fourteen papers were included in the review which contained 8142 individuals. Conclusions Aesthetic female faces have commonalities in facial features regardless of racial demographic, and the dimensions of these features vary from the baseline population. There may even be a common human aesthetic proportion that transcends racial boundaries, but this is yet to be elucidated. Level of Evidence 5
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Affiliation(s)
- Prateush Singh
- Corresponding Author: Mr Prateush Singh, Royal Free Hospital, Pond Street, London, NW3 2QG, United Kingdom. E-mail:
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7
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Reeves J, Kooner JS, Zhang W. Accelerated ageing is associated with increased COVID-19 severity and differences across ethnic groups may exist. Front Public Health 2022; 10:1034227. [PMID: 36582365 PMCID: PMC9792858 DOI: 10.3389/fpubh.2022.1034227] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022] Open
Abstract
Background While increased age is an established risk factor for COVID-19, there is great heterogeneity in outcomes within age groups. This is because chronological age does not reflect health, unlike biological age. We intend to investigate the association between accelerated ageing and COVID-19 outcomes through the lens of three measures, namely phenotypic age acceleration (PhenoAgeAccel), telomere length (Adjusted T/S Ratio) and facial ageing, and to examine whether there are differences across ethnic groups. Methods Taking participants from the UK Biobank, we associated accelerated ageing with severe COVID-19 outcomes, defined as COVID-related hospitalisation or death. Separate logistic regressions models were created for age and the three accelerated ageing-related variables, adjusting for a variety of covariates in each model. Multivariable logistic regression models were also created within White, Black, Asian and Other ethnic groups to assess for potential differing associations. Forward likelihood ratio logistic regression models were created to evaluate importance of the variables and to assess for patterns of association across the total population and ethnic groups. Results After adjusting for all covariates, the odds ratio (OR) and 95% confidence interval (95% CI) of COVID-19 severe outcomes for age was 1.080 (1.074-1.086). After further adjusting age for the accelerated ageing variables, the ORs were 1.029 (1.020-1.039) for PhenoAgeAccel and 0.847 (0.772-0.929) for Facial Ageing's "Younger Than You Are" while Adjusted T/S ratio and "Older Than You Are" were statistically insignificant. The OR for age remained similar across ethnic groups. Both PhenoAgeAccel and younger facial ages in the White population and PhenoAgeAccel in the Black population had ORs of 1.031 (1.021-1.042), 0.853 (0.774-0.939), and 1.049 (1.001-1.100), respectively. Both Adjusted T/S Ratio and older facial ages showed statistical insignificance in all ethnicities. In forward logistic regression, age and PhenoAgeAccel were the age-related variables selected most frequently in all models. Interpretation Accelerated ageing is associated with increased COVID-19 severity. The mechanisms at work here are likely immunosenescence and inflamaging. This association indicates that anti-ageing treatment may improve COVID-19 outcome. The results within ethnic groups and that of telomere length were inconclusive, but point to a need for future, more focused research on the topic.
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Affiliation(s)
- Joshua Reeves
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- The Medical School, University of Sheffield, Sheffield, United Kingdom
| | - Jaspal S. Kooner
- Department of Cardiology, Ealing Hospital, London North West University Healthcare NHS Trust, London, United Kingdom
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
- MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Weihua Zhang
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- Department of Cardiology, Ealing Hospital, London North West University Healthcare NHS Trust, London, United Kingdom
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8
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Face and Neck Lift Options in Patients of Ethnic Descent. Facial Plast Surg Clin North Am 2022. [DOI: 10.1016/j.fsc.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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9
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Solish N, Burgess CM, Weinkle SH, Ablon G, Brown J, Kooken K, Rubio RG. Efficacy and Safety of DaxibotulinumtoxinA for Injection in the Treatment of Glabellar Lines by Age and Race: Subgroup Analysis of the SAKURA Clinical Trials. Aesthet Surg J 2022; 43:205-214. [PMID: 36087303 PMCID: PMC9896135 DOI: 10.1093/asj/sjac246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND DaxibotulinumtoxinA for Injection (DAXI) is a novel botulinum toxin type A formulation approved for the treatment of glabellar lines. The efficacy, safety, and extended duration of response of DAXI 40 U for glabellar lines were demonstrated in 2 Phase 3, randomized, double-blind studies (SAKURA 1 and 2) and a Phase 3 open-label trial (SAKURA 3). OBJECTIVES The aim of this study was to evaluate the efficacy and safety of the first DAXI 40 U treatment received in SAKURA 1, 2, or 3 across age and race subgroups. METHODS Adults with moderate-to-severe glabellar lines (Investigator Global Assessment-Frown Wrinkle Severity [IGA-FWS] and Patient FWS [PFWS] scales) were evaluated for glabellar line severity for ≤36 weeks after the first DAXI treatment. Efficacy and safety were analyzed by age (18-45, >45-55, and >55 years) and race (Asian, Black and African American, and White). RESULTS Overall, 2785 patients were included in the efficacy analysis. The proportion of patients achieving none or mild glabellar line severity at maximum frown (IGA-FWS) after DAXI treatment was high in all age and race subgroups (>96% at Week 4). Glabellar line severity of none or mild by composite IGA-FWS and PFWS rating was maintained for a median of 24.0 weeks in all age subgroups, and for 27.0, 25.3, and 24.0 weeks in the Asian, Black and African American, and White subgroups, respectively. Treatment-emergent adverse events were similar across all subgroups. CONCLUSIONS Consistent with the overall study population, DAXI 40 U demonstrated a high response rate and duration of effect of ≥24 weeks across all age and race subgroups.
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Affiliation(s)
- Nowell Solish
- Corresponding Author: Dr Nowell Solish, Division of Dermatology, University of Toronto, ON M5S 3H2, Canada E-mail:
| | - Cheryl M Burgess
- Center for Dermatology and Dermatologic Surgery, Washington, DC, USA
| | | | - Glynis Ablon
- University of California Los Angeles (UCLA), Los Angeles, CA, USA
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10
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Facial Rejuvenation in Patients of Color. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-022-00407-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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11
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Quiñonez RL, Agbai ON, Burgess CM, Taylor SC. An update on cosmetic procedures in people of color. Part 1: Scientific background, assessment, preprocedure preparation. J Am Acad Dermatol 2022; 86:715-725. [PMID: 35189254 DOI: 10.1016/j.jaad.2021.07.081] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 11/28/2022]
Abstract
Increased life expectancy, focus on appearance, and readily available and accessible cosmetic procedures have served to drive an increase in the number of nonsurgical cosmetic procedures performed in the last 20 years. Demographic shifts in the United States, with increases in diverse populations that seek nonsurgical cosmetic procedures, have resulted in the need for a better understanding of cultural preferences as well as structural and biological differences in the skin of people of color (POC). Although many advances in the form of cosmeceuticals, cosmetics, and photoprotection have been made to address the aesthetic needs of and minimize complications in POC, nonsurgical cosmetic procedures are required to address common aesthetic concerns. Gaps remain in the education of dermatologists regarding the appropriate selection and execution of nonsurgical cosmetic procedures in POC. This educational initiative will facilitate a favorable outcome and optimal cosmetic results for POC.
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Affiliation(s)
- Rebecca L Quiñonez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Oma N Agbai
- Department of Dermatology, University of California, Davis School of Medicine, Sacramento, California.
| | - Cheryl M Burgess
- Center for Dermatology and Dermatologic Surgery, Washington, District of Columbia
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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12
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Xie Y, Li Q, Gao Z, Sun J, Li D, Harvey C, Qu J, Snow S, Li Q. Juvéderm Volift (VYC-17.5L), a Hyaluronic Acid Filler with Lidocaine, is Safe and Effective for Correcting Nasolabial Folds in Chinese Subjects. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:237-245. [PMID: 35210801 PMCID: PMC8859541 DOI: 10.2147/ccid.s344350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/27/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE Hyaluronic acid injectable gels are commonly used to treat nasolabial folds (NLFs). We evaluated the safety and effectiveness of VYC-17.5L for correcting NLFs in Chinese subjects. PATIENTS AND METHODS This prospective, multicenter, double-blind, within-subject‒controlled study randomized adults with moderate-to-severe NLFs to VYC-17.5L treatment (initial and touch-up) in 1 NLF and control (without lidocaine) in the contralateral NLF. Effectiveness endpoints at 6 months included noninferiority of VYC-17.5L to control in NLF Severity Scale response rate (primary endpoint), subject-reported procedural pain (11-point scale), and investigator and subject assessments using the Global Aesthetic Improvement Scale (GAIS). RESULTS A total of 175 subjects were included. The primary endpoint was met, with response rates of 84.2% for VYC-17.5L and 82.5% for control. Mean pain scores after initial and touch-up treatments were 2.4 for VYC-17.5L versus 5.2 for control (P < 0.001) and 2.0 versus 3.3 (P < 0.001), respectively. Investigator-rated GAIS scores were 86.5% for VYC-17.5L versus 86.0% for control. There were no between-group differences in subject-rated GAIS scores. Safety profiles were comparable for VYC-17.5L and control. CONCLUSION VYC-17.5L was noninferior to control without lidocaine for correcting moderate-to-severe NLFs in Chinese subjects and was superior to control in reducing procedural pain.
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Affiliation(s)
- Yun Xie
- Plastic Surgery Department of Shanghai 9th People's Hospital, Shanghai, People's Republic of China
| | - Qin Li
- Plastic Surgery Department of General Hospital of Guangzhou Military Command of PLA, Guangzhou, Guangdong, People's Republic of China
| | - Zhanwei Gao
- Plastic Surgery Department of Japan Friendship Hospital, Chaoyang, Beijing, People's Republic of China
| | - Jiaming Sun
- Plastic Surgery Department of Union Hospital Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Dong Li
- Plastic Surgery Department of Peking University Third Hospital, Haidian, Beijing, People's Republic of China
| | | | - Jiazhi Qu
- Allergan Aesthetics, an AbbVie Company, Beijing, People's Republic of China
| | - Sean Snow
- Allergan Aesthetics, an AbbVie Company, Irvine, CA, USA
| | - Qingfeng Li
- Plastic Surgery Department of Shanghai 9th People's Hospital, Shanghai, People's Republic of China
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13
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Shape Prediction of Nasal Bones by Digital 2D-Photogrammetry of the Nose Based on Convolution and Back-Propagation Neural Network. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:5938493. [PMID: 35069786 PMCID: PMC8767378 DOI: 10.1155/2022/5938493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/27/2021] [Indexed: 11/25/2022]
Abstract
In rhinoplasty, it is necessary to consider the correlation between the anthropometric indicators of the nasal bone, so that it prevents surgical complications and enhances the patient's satisfaction. The penetrating form of high-energy electromagnetic radiation is highly impacted on human health, which has often raised concerns of alternative method for facial analysis. The critical stage to assess nasal morphology is the nasal analysis on its anthropology that is highly reliant on the understanding of the structural features of the nasal radix. For example, the shape and size of nasal bone features, skin thickness, and also body factors aggregated from different facial anthropology values. In medical diagnosis, however, the morphology of the nasal bone is determined manually and significantly relies on the clinician's expertise. Furthermore, the evaluation anthropological keypoint of the nasal bone is nonrepeatable and laborious, also finding widely differ and intralaboratory variability in the results because of facial soft tissue and equipment defects. In order to overcome these problems, we propose specialized convolutional neural network (CNN) architecture to accurately predict nasal measurement based on digital 2D photogrammetry. To boost performance and efficacy, it is deliberately constructed with many layers and different filter sizes, with less filters and optimizing parameters. Through its result, the back-propagation neural network (BPNN) indicated the correlation between differences in human body factors mentioned are height, weight known as body mass index (BMI), age, gender, and the nasal bone dimension of the participant. With full of parameters could the nasal morphology be diagnostic continuously. The model's performance is evaluated on various newest architecture models such as DenseNet, ConvNet, Inception, VGG, and MobileNet. Experiments were directly conducted on different facials. The results show the proposed architecture worked well in terms of nasal properties achieved which utilize four statistical criteria named mean average precision (mAP), mean absolute error (MAE), R-square (R2), and T-test analyzed. Data has also shown that the nasal shape of Southeast Asians, especially Vietnamese, could be divided into different types in two perspective views. From cadavers for bony datasets, nasal bones can be classified into 2 morphological types in the lateral view which “V” shape was presented by 78.8% and the remains were “S” shape evaluated based on Lazovic (2015). With 2 angular dimension averages are 136.41 ± 7.99 and 104.25 ± 5.95 represented by the nasofrontal angle (g-n-prn) and the nasomental angle (n-prn-sn), respectively. For frontal view, classified by Hwang, Tae-Sun, et al. (2005), nasal morphology of Vietnamese participants could be divided into three types: type A was present in 57.6% and type B was present in 30.3% of the noses. In particular, types C, D, and E were not a common form of Vietnamese which includes the remaining number of participants. In conclusion, the proposed model performed the potential hybrid of CNN and BPNN with its application to give expected accuracy in terms of keypoint localization and nasal morphology regression. Nasal analysis can replace MRI imaging diagnostics that are reflected by the risk to human body.
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14
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Swift A, Liew S, Weinkle S, Garcia JK, Silberberg MB. The Facial Aging Process From the "Inside Out". Aesthet Surg J 2021; 41:1107-1119. [PMID: 33325497 PMCID: PMC8438644 DOI: 10.1093/asj/sjaa339] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The normal course of aging alters the harmonious, symmetrical, and balanced facial features found in youth, not only impacting physical attractiveness but also influencing self-esteem and causing miscommunication of affect based on facial miscues. With this evidence-based paper, the authors aim to provide a comprehensive overview of the latest research on the etiology and progression of facial aging by explaining the aging process from the “inside out,” that is, from the bony platform to the skin envelope. A general overview of the changes occurring within each of the main layers of the facial anatomy is presented, including facial skeleton remodeling, fat pad atrophy or repositioning, changes in muscle tone and thickness, and weakening and thinning of the skin. This is followed by an in-depth analysis of specific aging regions by facial thirds (upper, middle, and lower thirds). This review may help aesthetic physicians in the interpretation of the aging process and in prioritizing and rationalizing treatment decisions to establish harmonious facial balance in younger patients or to restore balance lost with age in older patients.
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Affiliation(s)
- Arthur Swift
- Westmount Institute of Plastic Surgery in Montréal, QC, Canada
| | - Steven Liew
- Shape Clinic in Darlinghurst, NSW, Australia
| | - Susan Weinkle
- Dermatology at the University of South Florida, Tampa, FL, USA
| | - Julie K Garcia
- Health Economics Outcomes Research at Allergan plc, an AbbVie Company, Irvine, CA, USA
| | - Michael B Silberberg
- Allergan Ltd, an AbbVie Company, Parkway, Marlow, Buckinghamshire, United Kingdom
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Voegeli R, Schoop R, Prestat-Marquis E, Rawlings AV, Shackelford TK, Fink B. Differences between perceived age and chronological age in women: A multi-ethnic and multi-centre study. Int J Cosmet Sci 2021; 43:547-560. [PMID: 34293190 PMCID: PMC9291153 DOI: 10.1111/ics.12727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/13/2022]
Abstract
Objective Accuracy in assessing age from facial cues is important in social perception given reports of strong negative correlations between perceived age and assessments of health and attractiveness. In a multi‐ethnic and multi‐centre study, we previously documented similar patterns of female facial age assessments across ethnicities, influenced by gender and ethnicity of assessors. Methods Here we extend these findings by examining differences between estimated age from digital portraits and chronological age (Δ age) for 180 women from three age groups (20–34, 35–49, 50–66 years) and five ethnicities (36 images of each ethnicity, assessed for age on a continuous scale by 120 female and male raters of each ethnicity). Results Across ethnicities, Δ age was smallest in French assessors and largest in South African assessors. Numerically, French women were judged oldest and Chinese women youngest relative to chronological age. In younger women, Δ age was larger than in middle‐aged and older women. This effect was particularly evident when considering the interaction of women's age with assessor gender and ethnicity, independently and together, on Δ age. Conclusion Collectively, our findings suggest that accuracy in assessments of female age from digital portraits depends on the chronological age and ethnicity of the photographed women and the ethnicity and gender of the assessor. We discuss the findings concerning ethnic variation in skin pigmentation and visible signs of ageing and comment on implications for cosmetic science.
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Affiliation(s)
| | | | | | | | | | - Bernhard Fink
- Biosocial Science Information, Biedermannsdorf, Austria.,Department of Evolutionary Anthropology, University of Vienna, Vienna, Austria
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Abstract
ABSTRACT Implicit bias can lead to discrimination of certain populations within healthcare. Representation in medical literature is no exception and it is hypothesized that images with lighter skin tone are more prevalent than darker skin tones in craniofacial literature. Clinical photographs and figure graphics from 5 journals were examined for pre-defined years. Annals of Plastic Surgery, Aesthetic Surgery Journal, Journal of Craniofacial Surgery, Journal of Plastic, Reconstructive and Aesthetic Surgery, and Plastic and Reconstructive Surgery journals were reviewed. All craniofacial-focused articles containing at least one color image depicting human skin were included. 10,477 images and 627 graphics were evaluated using the Fitzpatrick scale as a guide. Most journals trended toward broader inclusion of nonwhite photographs and graphics over time. In 2016, 47% of articles published in Journal of Craniofacial Surgery included nonwhite images compared to Annals of Plastic Surgery (16%), Aesthetic Surgery Journal (40%), Journal of Plastic, Reconstructive and Aesthetic Surgery (25%), and Plastic and Reconstructive Surgery (7%). Comparison of domestic and international publications demonstrated that author's country of origin impacted the percentage of nonwhite clinical photographs for most journals. Comparisons of publications by country demonstrated increased diversity in Asia and the Middle East for clinical photographs but not graphics. The frequency of nonwhite figure graphics was staggeringly low, identified in only 18 articles across all journals and years. Craniofacial literature more commonly reflects white skin tones. The trend over time suggests increasing inclusion of racial diversity in clinical photographs; however, figure graphics remain less racially diverse. Time, country of origin, and publishing journal appear to play a role.
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OnabotulinumtoxinA Treatment for Moderate to Severe Forehead Lines: A Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2669. [PMID: 32537333 PMCID: PMC7253259 DOI: 10.1097/gox.0000000000002669] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 01/08/2020] [Indexed: 11/25/2022]
Abstract
Background: With onabotulinumtoxinA approved for the treatment of glabellar and crow’s feet lines and, most recently, for forehead lines (FHL), it is possible to simultaneously treat multiple areas of the upper face that are of high concern and treatment priority for aesthetically oriented individuals. This review aims to present key insights on the use of onabotulinumtoxinA for the treatment of moderate to severe FHL. Methods: Double-blind, placebo-controlled registration trials of onabotulinumtoxinA for the treatment of FHL were included. Using findings from 3 such published studies, we discuss key concepts and clinical experience for the treatment of moderate to severe FHL with onabotulinumtoxinA (20 U in the frontalis and 20 U in the glabellar complex, with/without 24 U in crow’s feet lines), including injection pattern, dose selection, efficacy and safety data, and considerations for patient selection. Results: Across the 2 pivotal phase 3 studies, responder rates on investigator- and subject-assessed measures of appearance of FHL severity were significantly higher with onabotulinumtoxinA versus placebo for the treatment of FHL at day 30 (P < 0.0001), and results were maintained through 3 cycles of onabotulinumtoxinA. Conclusions: OnabotulinumtoxinA treatment also resulted in high patient satisfaction rates. The incidence of eyebrow and of eyelid ptosis was low, and no new safety signals were detected. OnabotulinumtoxinA is safe and effective and an appropriate option for patients with moderate to severe FHL encountered in clinical practice.
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