Perceived Effects of Orthognathic Surgery versus Orthodontic Camouflage Treatment of Convex Facial Profile Patients

Increased facial profile convexity has a common occurrence in the population and is a primary reason for seeking orthodontic treatment. The present study aimed to compare the perceived changes in facial profile appearance between patients treated with combined orthognathic/orthodontic treatment versus only orthodontic camouflage treatment. For this reason, 18 pairs of before- and after-treatment facial profile photos per treatment group (n = 36 patients) were presented to four types of assessors (surgeons, orthodontists, patients, laypeople). Ratings were recorded on 100 mm visual analogue scales depicted in previously validated questionnaires. All rater groups identified minor positive changes in the facial profile appearance after exclusively orthodontic treatment, in contrast to substantial positive changes (14% to 18%) following combined orthodontic and orthognathic surgery. The differences between the two treatment approaches were slightly larger in the lower face and the chin than in the lips. The combined orthodontic and orthognathic surgery interventions were efficient in improving the facial appearance of patients with convex profile, whereas orthodontic treatment alone was not. Given the significant influence of facial aesthetics on various life aspects and its pivotal role in treatment demand and patient satisfaction, healthcare providers should take these findings into account when consulting adult patients with a convex facial profile.

A Comparison of Self-Perceived Oral and Facial Esthetics in Patients After Lip Repositioning Surgery With Modified and Conventional Techniques

BACKGROUND

Patients with excessive gingival display (EGD) are treated with lip repositioning surgeries (LRS). This study used a questionnaire to analyze and evaluate how patients who received LRS with modified and traditional techniques perceived their own oral and facial esthetics at various timelines after their surgeries.

METHODS

An orofacial esthetic questionnaire (OEQ) was used in this cross-sectional study. The participants were patients who underwent LRS for the treatment of their EGD. They were divided into control (n=100) and test (n=100) groups. For the control group, LRS were performed using traditional/conventional techniques, and for the test group, LRS were performed using a modified approach. An OEQ was used to record responses. The scale comprised eight questions targeted to capture participating patients' perceptions about their own oral and facial esthetics at four timelines (baseline and one-month, six-month, and one-year follow-up). Patients responded to each question on a 10-point Likert scale (0: very dissatisfied, 10: very satisfied). Data was analyzed by independent samples T-tests using Statistical Package for the Social Sciences (SPSS) version 21.0 software (IBM SPSS Statistics, Armonk, NY).

RESULTS

Seven (3.5%) out of the total (N=200) patients were unable to take part in the study's OEQ. At one-year follow-up, the mean and standard deviation (SD) for the test group's gingival display (GD) were 2.48±0.86 mm and 3.77±1.76 mm, respectively, and comparisons revealed that the test group's GD was significantly lower (p=0.000) than the control group. Results from the participant responses to OEQ using the Likert scale at one-year follow-up revealed significant differences between the control and test groups for all questions, except question 5 (p=0.06), as the shape of the teeth will not be affected by LRS. Patients in the test group who underwent LRS with a modified approach have a high level of satisfaction (satisfaction score: >9). Patients in the control group scored their satisfaction less favorably, with certain questions (question 3) receiving scores as low as 0.31. Perception of oral and facial esthetics was significantly higher for the test group at different time points. At one-year follow-up, the mean difference was 4.46, which was the greatest (p=0.000).

CONCLUSIONS

EGD improved significantly at one year with the modified lip repositioning technique. The satisfaction level of patients with outcomes of the modified lip repositioning was significantly higher as compared to the satisfaction level of patients who underwent the conventional technique.

Postoperative facial appearance of patients with extensive oral squamous cell carcinoma can be adequately preserved with in‑house virtually planned mandibular reconstruction

The present study aimed to assess the concordance of preoperative and postoperative hard and soft tissues in patients with advanced oral squamous cell carcinoma (OSCC) following virtual surgical planning (VSP) mandibular reconstruction. In the present study, a cohort of 32 patients with OSCC underwent in-house VSP, followed by guided mandibular reconstruction utilizing vascularized free tissue grafts sourced from the fibula or scapula. A morphometric analysis was conducted comparing preoperative and postoperative three-dimensional virtual models to evaluate discrepancies and identify potential risk factors associated with poor reconstruction outcomes. The outcome variables were the differences in root mean square (RMS) and mean surface distance (MSD) resulting from the application of an iterative closest point algorithm to the virtual data. The validity of soft tissue comparison data is limited due to its susceptibility to various confounding variables. The present study conducted a comprehensive re-evaluation of these variables. High tumor stage, positive N status and the use of adjuvant therapy contributed to more noticeable differences in preoperative and postoperative facial soft tissue appearance. The accuracy of postoperative bone reconstruction results was higher in patients who underwent neomandibular formation using a fibular graft compared with those who received a scapular graft. Preoperative and postoperative soft tissue analyses were conducted for comparison. The MSD showed a deviation of 3.2 mm (± 2.0 mm SD; range 1.3-9.5 mm), whereas the RMS was 5.3 (± 2.9 SD; range 2.1-14). In conclusion, in-house VSP and guided mandibular reconstructions can yield clinically accurate results, preserving patient appearance and offering the advantage of rapid feasibility.

Facial aesthetic minimally invasive procedure: More than just vanity, a social-psychological approach

BACKGROUND

Due to the great importance of the face in social interaction, minimally invasive treatments can-besides their ability to rejuvenate and enhance beauty-also change the way facial impressions of a person are perceived. In recent literature, three main character traits (attractiveness, trustworthiness, and competence) and subdomains essential for facial perception were described.

OBJECTIVE

To investigate whether minimally invasive procedures truly influence different character traits when evaluated by independent, objective observers.

METHODS

Photographs of n = 34 female faces before and after treatment with injectable fillers and botulinum toxin were rated by 393 individuals without aesthetic background with regards to different character traits on a 7-point Likert scale. Tests for dimensionality were performed, and composite scores of the impressions underlying each of the three dimensions were created and compared using within-subjects t tests.

RESULTS

Treatments statistically significantly improved the overarching character trait domains attractiveness, trustworthiness, and competence in posttreatment photographs compared with pretreatment. Posttreatment ratings of the respective subdomains also showed a statistically significant difference compared with pretreatment photographs, with the exception of the subdomain dominance which failed to reach statistical significance.

CONCLUSION

Impressions of facial attractiveness, trustworthiness, and competence can be improved by injectables while the naturalness of the face is left intact. An implication is that the improvement of traits highly relevant to social interaction will accommodate the patient's desires for beautification and rejuvenation.

Parental influence in orthodontic treatment: a systematic review

The reasons for searching orthodontic treatment in pediatric/adolescent patients are multifactorial. The aim of this systematic review was to study the parental influence in this process. This study comprises a systematic review of the literature, based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. We analyzed 41 articles related to the study hypothesis, 29 of which followed the general inclusion criteria, and 21 specific studied the parental influence in orthodontic treatment. The results demonstrated that dental aesthetics and facial appearance were the main triggering factors related to the search for orthodontic treatment. Pair influence also plays an important role. The perception of malocclusion and the motivation are factors that emphasize the importance of parents in this process. Parental support was identified as a positive factor in orthodontic success reported in most of the studies. Parental influence has a positive effect on orthodontic treatment and should be understood by clinicians as a central factor in achieving the desired treatment plans.

The Effect of Moral Behavior on Facial Attractiveness

Purpose

Evaluating face attractiveness is a core aspect of face perception, which plays an important role in impression formation. A more reliable source of information in impression formation is moral behavior, which forms the primary basis for the comprehensive evaluation of others. Previous studies have found that one can easily form an association when faces and moral behaviors are presented together, which in turn affects facial attractiveness evaluation. However, little is known of the extent to which these learned associations affect facial attractiveness and whether the influence of moral behavior on facial attractiveness was related to facial appearance.

Methods

We used the associative learning paradigm and manipulated face presentation duration (Experiment 1 and Experiment 2) and response deadline (Experiment 2) to investigate these issues. Under these conditions, the association information was difficult to be retrieved. Participants learned associations between faces and scenes of moral behavior, and then evaluated facial attractiveness.

Results

We found that both moral behavior and facial appearance influence facial attractiveness under conditions where associated information was difficult to retrieve, and their effects increased with the increase of face presentation time. With increasing response deadlines, the effect of moral behavior on facial attractiveness increased. The influence of moral behavior on facial attractiveness was associated with facial appearance.

Conclusion

These results suggest that moral behavior continuously affects facial attractiveness. Our findings expand previous research by showing a robust influence of moral behavior on facial attractiveness evaluation, and highlight the important role of moral character in impression formation.

Chronic Beneficial Effect of Makeup Therapy on Cognitive Function of Dementia and Facial Appearance Analyzed by Artificial Intelligence Software

BACKGROUND

Makeup greatly impacts normal social lives but can also be a non-pharmacological form of therapy for dementia.

OBJECTIVE

To evaluate the therapeutic effect of makeup therapy.

METHODS

We carried out a prospective interventional study on female nursing home residents with dementia, focusing on the chronic therapeutic effect of makeup therapy. Thirty-four patients who received either only skin care (control group, n = 16) or skin care plus makeup therapy (makeup therapy group, n = 18) once every 2 weeks for 3 months were assessed.

RESULTS

Three months of makeup therapy significantly improved the Mini-Mental State Examination (MMSE) score compared with control patients ( *p <  0.05). Artificial intelligence (AI) software revealed that the appearance of age decreased significantly in the makeup group compared with the control, especially among patients without depression ( *p <  0.05). Furthermore, a larger AI happiness score was significantly correlated with a greater improvement of ADL in the makeup therapy group (r = 0.43,  *p <  0.05).

CONCLUSION

Makeup therapy had a chronic beneficial effect on the cognitive function of female dementia patients, while the chronic effect of makeup therapy on facial appearance was successfully detected by the present AI software.

Immediate Beneficial Effect of Makeup Therapy on Behavioral and Psychological Symptoms of Dementia and Facial Appearance Analyzed by Artificial Intelligence Software

BACKGROUND

Possible benefits of makeup therapy, in terms of immediate and late effects on cognitive and affective functions, have not been fully proved for dementia patients.

OBJECTIVE

To evaluate the immediate effect of makeup therapy on dementia patients.

METHODS

Female nursing home residents with dementia received either only skin care treatment (control group, n = 17) or skin care plus makeup therapy treatment (makeup therapy group, n = 19). Cognitive, affective, and activity of daily living (ADL) scores were evaluated before and just after treatments. Apparent age and emotion were also evaluated with artificial intelligence (AI) software.

RESULTS

Makeup therapy significantly improved Abe's behavioral and psychological symptoms of dementia (BPSD) score (ABS, *p < 0.05). AI software judged that makeup therapy significantly made the apparent age younger (*p < 0.05). In particular, patients with moderate ADL scores had a significantly higher happiness score in makeup therapy (*p < 0.05), with a modest correlation to the Mini-Mental State Examination (MMSE, r = 0.42, *p < 0.05). The severe baseline MMSE group reported a greater feeling of satisfaction following makeup therapy (*p < 0.05).

CONCLUSION

The present makeup therapy is a promising non-pharmacological approach to immediately alleviate BPSD in female dementia patients, and the present AI software quickly and quantitatively evaluated the beneficial effects of makeup therapy on facial appearance.

Evaluation of Facial Appearance-Related Quality of Life in Young Japanese Patients With Cleft Lip and/or Palate

OBJECTIVE

(1) To confirm the reliability of a Japanese version of the Youth Quality of Life Instrument-Facial Differences Module (YQOL-FD); (2) to assess the quality of life (QoL) related to facial difference in Japanese youths with cleft lip and/or palate (CL/P) using this instrument; and (3) to examine the QoL differences according to age, sex, and cleft type.

DESIGN

A cross-sectional study.

SETTING

Japanese youths with CL/P were recruited through our hospital and asked to complete the YQOL-FD.

PARTICIPANTS

Sixty-nine Japanese youths (age, 11-18 years) with CL/P.

OUTCOME MEASURES

The domain scores of stigma, negative consequences, negative self-image, positive consequences, and coping in the YQOL-FD, and the reliability of such scores were evaluated.

RESULTS

The instrument showed an acceptable internal consistency (Cronbach α = 0.74-0.92) and test-retest reliability (intraclass correlation coefficient = 0.94-0.98), except for the coping domain. The individual's domain scores were spread out from the lowest score to the high scores among all domains, thus indicating the negative and positive impacts of living with facial differences regarding their QoL may vary among individuals with CL/P. All domain scores in the 15- to 18-year-old group were significantly higher than those in 11- to 14-year-old group; there were no significant differences according to sex or cleft type.

CONCLUSIONS

The instrument showed acceptable reliability, except for the coping domain. There were individual variations in QoL concerning the facial difference among Japanese youths with CL/P as measured by the YQOL-FD, suggesting the importance of individual evaluations. Perceptions were influenced by age, but not sex or cleft type.

Developing an Artificial Intelligence (A.I)-based descriptor of facial appearance that fits with the assessments of makeup experts

OBJECTIVE

To develop an A.I-based automatic descriptor that detects and grades, from selfie pictures, 23 facial signs, hairs included, as a help to making-up procedures.

MATERIAL AND METHODS

The selfie images taken in very different conditions by 3326 women and men were used to create (90% of dataset) and validate (10% of dataset) a new algorithm architecture to appraise and grade 23 different facial signs such as lips, nose, eye color, eyebrows, eyelashes, and hair color as defined by makeup artists. Each selfie image was annotated by 12 experts and defined references to train Artificial Intelligence (A.I)-based algorithm.

RESULTS

As some the 23 signs present a continuous or discontinuous feature, these were analyzed by two different statistical approaches. The results provided by the automatic descriptor system were not only in good agreement with the expert's assessments but were even found of a better precision and reproducibility. This automatic descriptor system has proven a good and robust accuracy despite the very variable conditions in the acquisition of selfie pictures.

CONCLUSION

Such automatic descriptor system seems providing a valuable help in making-up procedures and may extend to other activities such as Skincare or Haircare. As such it should allow large investigations to better evaluate the consumers' needs of esthetical improvements.

Professional framing and emotional stability modulate facial appearance biases in nursing students

AIM

Providing the same standard of care to all patients alike, regardless of race, gender, age or any other irrelevant characteristic is imperative in the healthcare profession. In this study we examined whether and to what extent unintentional evaluations based on facial appearance of others affect nursing students' readiness to approach them and provide nursing care.

METHOD

A cross-sectional study was conducted from November 2018 to July 2019. Nursing students (N = 160) enrolled in the Nursing Degree Course of School of Medicine of Bologna University, completed a self-report questionnaire assessing personality traits and evaluated photographs of trustworthy, untrustworthy and neutral-looking male and female faces, while indicating their own approach behavior in a series of social interaction and caretaking scenarios.

RESULTS

Trustworthy faces elicited a higher approach readiness than untrustworthy and neutral ones across scenarios. Nonetheless, the nursing care scenario facilitated the approach toward others perceived as untrustworthy. Emotional stability trait further enhanced the approach of untrustworthy-looking others and provision of impartial care.

CONCLUSION

Present findings suggest that facial appearance bias among nursing students may be downregulated by activating cognitive representations of their professional role as future caretakers and their caretaking motivation. This speaks of the need to integrate as early as possible into existing nursing education programs simulation scenarios aimed to increase emotional awareness and model nursing students' future relational and caring skills.

Safety and Efficacy of a Novel Antiaging Skin Care Regimen Containing Neutraceuticals and Growth Factors on the Facial Skin of Women: A 12-Week Open-label Study

BACKGROUND: Due to both intrinsic and extrinsic damage, the skin is where easily noticable signs of aging manifest. OBJECTIVE: We sought to assess the effects of two complex novel topical formulations, L'Unique Miracular Facial Serum (LMFS) and L'Unique Skin Essence (LSE) (Nourishing Biologicals LLC, St. Augustine, Florida) on hydration, firmness, elasticity, wrinkling, and pore size of facial skin after initial application and then after four, eight, and 12 weeks of use. METHODS: An open-label study was conducted on subjects (N=32) between the ages of 45 and 65 years (mean: 57 years). Subjects were treated with a twice-daily application of LMFS and LSE for a total of 12 weeks following a one-week washout period. The test products were gently applied in a circular motion to the face each morning and evening. Measurements of skin hydration, transepidermal water loss (TEWL), and skin elasticity and firmness and three-dimensional skin surface evaluations were performed at each visit. Skin lift and pore size assessments were also completed using clinical photography. Subjective outcomes were assessed by a posttreatment product efficiency survey at the end of each visit. RESULTS: Objective instrumental measurements showed statistically significant improvements in skin hydration (20.19%), TEWL (25.96% at 15 minutes), firmness (24.77%), skin elasticity (11.40%), and skin lift (5.41%) with product use. Improvements in pore size and wrinkle depth were not statistically significant. CONCLUSION: Use of the test products produced significant improvements in skin hydration, TEWL, firmness, and skin elasticity with associated improvements in facial skin appearance.

Cancer and changes in facial appearance: A meta-ethnography of qualitative studies

INTRODUCTION

Living with an altered facial appearance as a result of treatment for cancer requires considerable psychological adjustment. As such it is essential that health care professionals understand the lived experience of people affected. This systematic review provides a meta-ethnography of studies that have explored the experience of changed facial appearance as a result of cancer.

METHODS

A search of four databases (Web of Science, CINAHL, PsycInfo, and Scopus) took place using terms relating to qualitative research, cancer, and changed facial appearance. Thirteen studies were identified, appraised, and included in the synthesis. The findings and interpretations within the studies were subject to meta-ethnography procedures so as to elicit novel cross-cutting themes.

FINDINGS

The experience of changed facial appearance after cancer was clustered into three contexts. In the context of the disease, subthemes were the primacy of survival, the changing relationship with the disease, and the impact of the care team on the experience of changed appearance. In the context of the social world, subthemes were positive reactions, negative reactions, and coping strategies. In the context of the self, subthemes were the self under attack, self-to-self relating, the self in the world, and rebuilding the self.

CONCLUSIONS

The findings indicate that health care professionals must conduct holistic assessments, so as to fully recognize and where necessary address the impact upon self. The meta-ethnography shows that the experience of facial appearance change following cancer is complex and requires awareness of a number of theoretical areas including identity construction, social support, stigmatization, and the specific literature on visible difference. Statement of contribution What is already known on this subject? Changed facial appearance after cancer can cause significant social difficulties and impact on the sense of self. The experience of managing the specific dual challenges of cancer and altered facial appearance is not clearly understood. Recent studies that have focused specifically on the experience of changes in appearance after cancer have been limited in scope and transferability. What does this study add? To our knowledge, this is the first meta-ethnography to bring together the literature on the impact of altered facial appearance following cancer. Patients may feel unable to talk about appearance with health care professionals because it is seen as a frivolous issue. Clinicians should facilitate open, person-centred opportunities for patients to discuss the impact of changed appearance and where necessary facilitate access to support.

Evaluation of Patient and Parent Satisfaction After Orthodontic Treatment/Orthognathic Surgery for Cleft Lip and Palate Deformity

Objectives:

The objectives of this study were to evaluate the satisfaction of patients, parents, and individuals other than health professionals (neighbors or relatives), regarding the quality of care, and to evaluate the patients general care, facial appearance, dental changes, and psychological assessment by social outlook and emotional quotient.

Materials and Methods:

Sixty patients with cleft lip and palate reporting to a dental institution were divided into two age groups, 0–15 years (G1) and 15–30 years (G2), their parents (P1 and P2) and a group comprising their neighbour’s or relatives (T1 and T2) were also divided according to G1 and G2. To evaluate their satisfaction toward the treatment received, three separate questionnaires were given to the three groups and their responses were subjected to statistical analysis.

Results:

The results showed that majority of patients (74%) and their parents (60%) were satisfied with the orthodontic treatment they received to align the teeth. But they were not satisfied with the appearance of lip (61.6% and 56.6%), nose (60% and 53.3%), and speech (62%). This study showed that cleft-affected individuals were teased mainly for speech (60%) followed by lip and teeth. Sixty percent of the patients admitted that their self-confidence was quite affected because of cleft and 36.6% expressed that their school/college results have been affected.

Conclusion:

Majority of cleft lip and palate patients as well as their parents were satisfied with their child’s dental appearance; they were unsatisfied with the appearance of nose, lip, smile, and speech.

Applying artificial intelligence to assess the impact of orthognathic treatment on facial attractiveness and estimated age

This observational study aimed to use artificial intelligence to describe the impact of orthognathic treatment on facial attractiveness and age appearance. Pre- and post-treatment photographs (n=2164) of 146 consecutive orthognathic patients were collected for this longitudinal retrospective single-centre study. Every image was annotated with patient-related data (age; sex; malocclusion; performed surgery). For every image, facial attractiveness (score: 0-100) and apparent age were established with dedicated convolutional neural networks trained on >0.5million images for age estimation and with >17million ratings for attractiveness. Results for pre- and post-treatment photographs were averaged for every patient separately, and apparent age compared to real age (appearance). Changes in appearance and facial attractiveness were statistically examined. Analyses were performed on the entire sample and subgroups (sex; malocclusion; performed surgery). According to the algorithms, most patients' appearance improved with treatment (66.4%), resulting in younger appearance of nearly 1year [mean change: -0.93years (95% confidence interval (CI): -1.50; -0.36); p=0.002), especially after profile-altering surgery. Orthognathic treatment had similarly a beneficial effect on attractiveness in 74.7% [mean difference: 1.22 (95% CI: 0.81; 1.63); p<0.001], especially after lower jaw surgery. This investigation illustrates that artificial intelligence might be considered to score facial attractiveness and apparent age in orthognathic patients.

Voting for a Male Warrior or Female Peacekeeper? Testing the Evolutionary Contingency Hypothesis in the 2016 U.S. Presidential Elections

The present research replicates and extends previous literature on the evolutionary contingency hypothesis of leadership emergence. Using artificially masculinized versus feminized versions of the faces of the candidates for the 2016 U.S. presidential elections, we demonstrated that different contextual cues produced systematic variation in both preferences for and personality impressions of leadership. We describe results of an online study ( N = 298), demonstrating that followers who perceived a match between the contextual prime ( intergroup conflict or cooperation) and a leader candidate's relevant physical cues ( masculinized or feminized versions of their faces) both (a) preferred them as leaders and (b) rated them more positively on personality attributes commonly associated with effective leadership such as trustworthiness, warmth, competence, and charisma.

Facial Shape Analysis Identifies Valid Cues to Aspects of Physiological Health in Caucasian, Asian, and African Populations

Facial cues contribute to attractiveness, including shape cues such as symmetry, averageness, and sexual dimorphism. These cues may represent cues to objective aspects of physiological health, thereby conferring an evolutionary advantage to individuals who find them attractive. The link between facial cues and aspects of physiological health is therefore central to evolutionary explanations of attractiveness. Previously, studies linking facial cues to aspects of physiological health have been infrequent, have had mixed results, and have tended to focus on individual facial cues in isolation. Geometric morphometric methodology (GMM) allows a bottom–up approach to identifying shape correlates of aspects of physiological health. Here, we apply GMM to facial shape data, producing models that successfully predict aspects of physiological health in 272 Asian, African, and Caucasian faces – percentage body fat (21.0% of variance explained), body mass index (BMI; 31.9%) and blood pressure (BP; 21.3%). Models successfully predict percentage body fat and blood pressure even when controlling for BMI, suggesting that they are not simply measuring body size. Predicted values of BMI and BP, but not percentage body fat, correlate with health ratings. When asked to manipulate the shape of faces along the physiological health variable axes (as determined by the models), participants reduced predicted BMI, body fat and (marginally) BP, suggesting that facial shape provides a valid cue to aspects of physiological health.

Social Vision: Applying a Social-Functional Approach to Face and Expression Perception

A social-functional approach to face processing comes with a number of assumptions. First, given that humans possess limited cognitive resources, it assumes that we naturally allocate attention to processing and integrating the most adaptively relevant social cues. Second, from these cues, we make behavioral forecasts about others in order to respond in an efficient and adaptive manner. This assumption aligns with broader ecological accounts of vision that highlight a direct action-perception link, even for nonsocial vision. Third, humans are naturally predisposed to process faces in this functionally adaptive manner. This latter contention is implied by our attraction to dynamic aspects of the face, including looking behavior and facial expressions, from which we tend to overgeneralize inferences, even when forming impressions of stable traits. The functional approach helps to address how and why observers are able to integrate functionally related compound social cues in a manner that is ecologically relevant and thus adaptive.

Parent satisfaction with primary repair of paediatric cleft lip in Southwest China

The purpose of this study was to investigate the key factors in relation to parent satisfaction with the primary repair of paediatric cleft lip. One hundred and ninety-five children born with cleft lip and/or palate aged between 3 months and 1 year were recruited, along with their caregivers. All patients underwent primary cleft lip repair, and a telephone interview was held with their main caregivers at 3 months postoperative. The level of satisfaction with each item included in a simplified Cleft Evaluation Profile was ascertained and recorded. Patient clinical data were obtained from the medical records. One hundred and thirty-eight (71%) parents reported satisfaction with the general outcome of surgery. Parents were satisfied with the appearance of the lip and profile of the face, but were dissatisfied with the appearance of the nose and teeth. Mothers of patients showed lower satisfaction levels than fathers and grandparents. Parental satisfaction with the appearance of the lip was lower for patients without a cleft palate than for those with a cleft palate. The results of this study suggest that most Chinese parents of children who undergo primary cleft lip repair express satisfaction with the surgical outcomes. Satisfaction with the appearance of the nose and teeth is low and this needs to be improved. Other factors are likely to influence expressions of satisfaction.

The influence of political candidates' facial appearance on older and younger adults' voting choices and actual electoral success

Younger adults (YA) judgments of political candidates' competence from facial appearance accurately predict electoral success. Whether this is true for older adults (OA) has not been investigated despite the fact that OA are more likely to vote than YA and may respond differently to particular facial qualities. We examined whether OA and YA ratings of competence, trustworthiness, attractiveness, and babyfaceness of opposing candidates in US Senate elections independently predicted their own vote choices and actual election outcomes. OA and YA ratings of attractiveness, competence, and trustworthiness positively predicted their choices, but the effect of competence was weaker for OA. Babyfaceness negatively predicted OA, but not YA, choices. OA and YA competence ratings equally predicted the actual election winners, while OA, but not YA, attractiveness ratings did so. Trustworthy and babyface ratings did not predict actual winners. These findings have implications for understanding age differences in candidate preferences and the prediction of election outcomes.

Personality at Face Value: Facial Appearance Predicts Self and Other Personality Judgments among Strangers and Spouses

Character judgments, based on facial appearance, impact both perceivers' and targets' interpersonal decisions and behaviors. Nonetheless, the resilience of such effects in the face of longer acquaintanceship duration is yet to be determined. To address this question, we had 51 elderly long-term married couples complete self and informant versions of a Big Five Inventory. Participants were also photographed, while they were requested to maintain an emotionally neutral expression. A subset of the initial sample completed a shortened version of the Big Five Inventory in response to the pictures of other opposite sex participants (with whom they were unacquainted). Oosterhof and Todorov's (2008) computer-based model of face evaluation was used to generate facial trait scores on trustworthiness, dominance, and attractiveness, based on participants' photographs. Results revealed that structural facial characteristics, suggestive of greater trustworthiness, predicted positively biased, global informant evaluations of a target's personality, among both spouses and strangers. Among spouses, this effect was impervious to marriage length. There was also evidence suggestive of a Dorian Gray effect on personality, since facial trustworthiness predicted not only spousal and stranger, but also self-ratings of extraversion. Unexpectedly, though, follow-up analyses revealed that (low) facial dominance, rather than (high) trustworthiness, was the strongest predictor of self-rated extraversion. Our present findings suggest that subtle emotional cues, embedded in the structure of emotionally neutral faces, exert long-lasting effects on personality judgments even among very well-acquainted targets and perceivers.

The face is not an empty canvas: how facial expressions interact with facial appearance

Faces are not simply blank canvases upon which facial expressions write their emotional messages. In fact, facial appearance and facial movement are both important social signalling systems in their own right. We here provide multiple lines of evidence for the notion that the social signals derived from facial appearance on the one hand and facial movement on the other interact in a complex manner, sometimes reinforcing and sometimes contradicting one another. Faces provide information on who a person is. Sex, age, ethnicity, personality and other characteristics that can define a person and the social group the person belongs to can all be derived from the face alone. The present article argues that faces interact with the perception of emotion expressions because this information informs a decoder's expectations regarding an expresser's probable emotional reactions. Facial appearance also interacts more directly with the interpretation of facial movement because some of the features that are used to derive personality or sex information are also features that closely resemble certain emotional expressions, thereby enhancing or diluting the perceived strength of particular expressions.