Experiences and attitudes toward aesthetic procedures in East Asia: a cross-sectional survey of five geographical regions

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.

Facial Rejuvenation: A Global Trend of Dermatological Procedures in the Last Decade

Background

We aimed to track the global trend of cosmetic treatment outcomes for facial rejuvenation and the differences in modalities used in East Asian and Western populations.

Methods

Articles reporting on facial rejuvenation procedures (invasive/noninvasive) were identified in PubMed from 2013 to March 2023 and bibliometrically analyzed for type of published document, citation frequency, authors with most articles, author's affiliation, and frequency distribution of keywords.

Results

From 553 articles, most were published in 2021 (n = 86, 15.6%). Western countries (n = 323, 58.4%) contributed more than East Asian (n = 230, 41.6%), with more invasive interventions (n = 355, 64.2%) than noninvasive techniques (n = 198, 35.8%). Numbers of invasive techniques in West versus East Asian countries were 225 (40.7%) versus 135 (24.4%). Main indications were the reduction of facial wrinkles and antiageing treatments. Hyaluronic acid, fillers, and botulinum toxin were the main hotspots for invasive treatments, whereas laser, platelet-rich plasma, and radiofrequency were for noninvasive treatments. Nasolabial folds (13.4%) and glabellar lines (12.4%) were the top research hotspots in the East Asian and Western regions. Common adverse events were pain, erythema, swelling, and bruising. Approximately, 89.3% of publications were from single countries, whereas 10.7% of publications were from international collaborations. Most articles (n = 387; 69.95%) presented their findings using level II evidence. Dermatological surgery (IF = 2.914) had the greatest number of publications (n = 109; 19.71%).

Conclusions

The main hotspots were antiaging and youthfulness. This study provides a trend and a new perspective on the future research directions in the field of facial rejuvenation.

A Systematic Review on the Reinforcement Loop in Aesthetic Medicine and Surgery: The Interplay of Social Media, Self-Perception, and Repeat Procedures

INTRODUCTION

This systematic review delves into the impact of social media on self-perception and the escalating interest in clinical aesthetic procedures, proposing that social media significantly influences beauty standards and increases demand for aesthetic enhancements.

METHOD

Following PRISMA guidelines, a mixed-method analysis of 34 articles was conducted, sourced from various databases, focusing on social media's psychological effects on clinical aesthetics decisions. The studies encompassed a broad spectrum, including qualitative, quantitative, and mixed methodologies, reflecting diverse geographical and cultural perspectives.

RESULTS

The quantitative analysis demonstrated a strong positive correlation between social media usage and the consideration of aesthetic procedures (r=0.45, p<0.001), indicating a significant impact. Specific findings included a large effect size (Cohen's d=0.8) for the relationship between time spent on social media and the desire for aesthetic enhancements. Individuals spending more than 3 hours per day on social media platforms were twice as likely to consider aesthetic procedures compared to those with less usage, with a 95% confidence interval indicating robustness in these findings.

CONCLUSION

Confirming the reinforcing effect of social media on aesthetic decision-making, this study highlights the complex interplay between digital media exposure, altered self-perception, and the increased inclination towards aesthetic procedures. It suggests a critical need for practitioners to carefully navigate the digital influence on patient's desires, reinforcing the significance of understanding psychological motivations and societal pressures in clinical aesthetics. This comprehensive analysis offers pivotal insights for clinical practice and ongoing research into social media's role in contemporary beauty standards.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Updates in the Management of Congenital Melanocytic Nevi

Congenital melanocytic nevi (CMN) carry an increased risk of melanoma and may be disfiguring, and consensus regarding treatment recommendations is lacking. While clinical monitoring is the standard of care, many caregivers are interested in its removal to prevent psychosocial burden or to decrease risk. Although melanoma can occur regardless of CMN removal, there are a variety of treatments that may offer improved cosmesis or local symptom control, including surgical excision, laser therapy, and other superficially destructive techniques. Regardless of the selected management, these patients are monitored for ongoing melanoma risk. An extensive discussion with families regarding the risks and benefits of observation versus active intervention is essential. To facilitate these discussions, we herein summarize current CMN management strategies and considerations.

A Novel, Deep Learning-Based, Automatic Photometric Analysis Software for Breast Aesthetic Scoring

Background  Breast aesthetics evaluation often relies on subjective assessments, leading to the need for objective, automated tools. We developed the Seoul Breast Esthetic Scoring Tool (S-BEST), a photometric analysis software that utilizes a DenseNet-264 deep learning model to automatically evaluate breast landmarks and asymmetry indices. Methods  S-BEST was trained on a dataset of frontal breast photographs annotated with 30 specific landmarks, divided into an 80-20 training-validation split. The software requires the distances of sternal notch to nipple or nipple-to-nipple as input and performs image preprocessing steps, including ratio correction and 8-bit normalization. Breast asymmetry indices and centimeter-based measurements are provided as the output. The accuracy of S-BEST was validated using a paired t -test and Bland-Altman plots, comparing its measurements to those obtained from physical examinations of 100 females diagnosed with breast cancer. Results  S-BEST demonstrated high accuracy in automatic landmark localization, with most distances showing no statistically significant difference compared with physical measurements. However, the nipple to inframammary fold distance showed a significant bias, with a coefficient of determination ranging from 0.3787 to 0.4234 for the left and right sides, respectively. Conclusion  S-BEST provides a fast, reliable, and automated approach for breast aesthetic evaluation based on 2D frontal photographs. While limited by its inability to capture volumetric attributes or multiple viewpoints, it serves as an accessible tool for both clinical and research applications.

Cosmetic augmentation of lower-lid pretarsal roll with injection of autologous fat for Asians

BACKGROUND

Autologous fat has the advantages of regeneration, rejuvenation, homology, and support. There are currently no reports indicating that injecting autologous fat enhances the fullness of the lower-lid pretarsal roll.

OBJECTIVES

In this retrospective, non-randomized study, the effects of injecting autologous fat to cosmetically enlarge the lower-lid pretarsal roll were evaluated by comparison of preoperative and postoperative photographs and patient satisfaction during the follow-up.

METHODS

First, fat tissues were manually sucked with a 20-ml syringe connected to a 2.5-mm three-hole liposuction cannula. The treated fat tissues were transferred to a 10-ml syringe and centrifuged at 2000 rpm for 2 min, and then the fibrous tissues were manually removed. Finally, autologous fat was injected using a 1-ml syringe linked to a sharp needle.

RESULTS

Forty-seven patients who underwent surgery between 2018 and 2021 were retrospectively evaluated. Only three patients showed obvious asymmetry or uneven outlines after surgery and underwent a second fat injection. During recovery, bruising and minor contouring irregularities obviously improved after 1 or 2 weeks. Eight patients, who had severe bruising, were able to make a full recovery in more than 2 weeks. No patients experienced serious complications. All patients ultimately displayed pretarsal fullness in their lower eyelids and were satisfied with their outcomes.

CONCLUSION

The effects of injecting autologous fat to cosmetically enlarge the lower-lid pretarsal roll are long-lasting, esthetic, and safe.

Patient Satisfaction and Scar Quality Following Upper Blepharoplasty Using a Simplified Preoperative Marking Technique

One of the most popular plastic surgical interventions both abroad and in Kazakhstan is blepharoplasty. Plastic surgeons continue to debate various methods for performing this operation; however, some of the methods used by plastic surgeons for preoperative marking of the upper eyelid skin may not be suited to the type of incision that should be used on the eyelids of individuals from Kazakhstan. For this reason, the surgery may not achieve the desired results. We conducted a study of patients from Kazakhstan who underwent upper blepharoplasty using a simplified technique for eyelid marking that we developed at our plastic surgery center. We used the Patient-Reported Outcome Measure Questionnaire (PROM-Q) to measure patient satisfaction and the Patient and Observer Scar Assessment Scale (POSAS) to measure scar quality. The results of our study showed that the majority of patients who underwent upper blepharoplasty performed by surgeons using our method of preoperative marking were extremely satisfied with the effect. The patients noted rapid tissue repair and minimal scarring. We concluded that the use of a simplified marking technique can significantly help aesthetic surgeons performing upper blepharoplasty by reducing the risk for negative postoperative effects.

Cosmetic Surgery and the Diversity of Cultural and Ethnic Perceptions of Facial, Breast, and Gluteal Aesthetics in Women: A Comprehensive Review

An increasing number of people are opting for cosmetic surgeries. For many years, the physical and aesthetic appearance of Caucasians has been considered to be ideal. However, it is now commonly acknowledged that attractiveness and aesthetic standards vary among cultural backgrounds and ethnic groups and that Western attractiveness criteria no longer apply to all. Herein, we conducted a comprehensive review of studies that examined cultural and ethnic variations in preferences for facial, breast, and gluteal aesthetics, as well as reviewed studies that investigated ethnic disparities in attitudes and motivations for cosmetic surgery. A total of 4532 references were identified, 66 of which met the inclusion criteria. Several studies have reported that facial golden ratios are invalid for representing perceived attractiveness standards among different ethnicities. The majority of studies also indicated that facial aesthetic interventions should not aim to Westernize but to optimize ethnic traits. Significant ethnic differences in preferences for upper- and lower-pole breast proportions have been reported. The size of the buttocks and waist-to-hip ratio were identified as the main factors of buttock aesthetics, with buttock size preferences having a high ethnic diversity. Interest in cosmetic surgical procedures while maintaining ethnic identity continues to grow among young women worldwide. This comprehensive review strongly suggests that accommodating cultural and ethnic differences in aesthetic standards in cosmetic surgery planning can lead to more acceptable cosmetic outcomes.

Direct and Indirect Roles of Men in Determining Women Decision to Use Laser Procedures for Skin Care

Laser procedures for skin care is becoming increasingly popular and used by the global community and affect many aspects of human life. However, there is very little research on the role of men in women's decision to follow this dermatological procedure. This study aimed to identify the role of men in motivating women to choose laser-based procedure. A systematic literature review research design was applied in this study. A total of 27 papers were obtained by searching PubMed Central for the 2013-2022 editions. The extraction of samples and the motivation of patients or research respondents in choosing laser procedures for cosmetic treatments were conducted to obtain clues about the role of men in making these decisions. Only six studies explicitly reveal the role of men as motivators of women to perform laser-based dermatological procedures. Four of these six studies were conducted in Asia in countries with a high degree of collectivism. The remaining two studies reveal a minor role for men in women's motivation to choose dermatological procedures. Other studies only indirectly implicate the role of men through intrasexual competition, increased self-esteem, and the needs of the world of work. Limitations of the study lies in the non-specificity of the study sample in the female population, laser-based treatments, and the role of men in motivating women. The role of men in motivating women to perform laser-based skin care procedures is stated explicitly in collectivist cultures while only implicitly in individualist cultures. These findings indicate that the strategy of utilizing the added value of men to laser treatment procedures should be directed at the relationship between men and women in real terms in collective cultured countries.