Comparing Lateral Rhytidectomy With and Without Neck Suture Suspension

Background: Characteristic aesthetic changes of the aging neck include skin laxity and rhytid formation, submental fat deposition, plastysmal banding, and ptosis of underlying structures that lead to the development of an obtuse cervicomental angle (CMA). Cervical rejuvenation techniques that aim to restore the CMA are widely discussed in the literature, and share variable outcomes. The aim of this study is to compare the restoration of the CMA in patients undergoing the addition of midline platysmal plication using a modified Giampapa stitch with absorbable PDS suture, to those patients undergoing standard deep plane lateral rhytidectomy alone. Methods: A retrospective cohort study was performed by a single surgeon in a private facial plastics practice. 264 patients undergoing rhytidectomy were included in the study. Pre and postoperative measurement differences in CMA degree and depth were compared in patients undergoing only traditional deep plane lateral rhytidectomy (TDPLR) in isolation, with those who also had modified suture suspension and platysma plication (MSSPP). The primary outcome in the study was the change in the degree of the CMA taken from standardized preoperative and postoperative surgical photos in the Frankfort profile view. Secondary outcomes include the change in the depth of the CMA as determined by the hyomental distance between study and control groups. Results: A total of 264 patients were identified who met the study criteria. A total of 134 (123 female; 11 male; average age, 62.66 ± 8.19) underwent TDPLR with MSSPP, and 130 (127 female; 3 male; average age, 63.09 ± 7.75) underwent TDPLR alone. All patients in the study underwent preoperative photographic evaluation in Frankfurt profile view and the same postoperative photographic evaluation at an average of 436.56 days (14.4 months) after surgery. Patients in the cohort study group were found to have a statistically significant increase in the depth of the CMA by an average of 13.9 degrees ± 6.26 and increase in the hyomental distance of 1.38 cm ± 0.87, compared to the control group who underwent traditional lateral rhytidectomy with an average CMA change of 6.87 degrees ± 6.7 ( P = .00146) and hyomental distance increase of 0.75 ± 0.68 ( P = .00031), respectively. Statistical significance was taken at P < .05. Conclusions: The results from this study indicate that the addition of a relatively minimally invasive approach to neck rejuvenation using a modified Giampapa stitch with absorbable PDS suture is helpful in restoring the CMA in an aging neck.

Role of barium enema examination for the diagnosis of submucosal invasion depth in T1 colorectal cancers

Background The indication for endoscopic resection for submucosally invasive colorectal cancer (T1-CRC) depends on the preoperative diagnosis of invasion depth. The aim of this investigation was to evaluate the association between barium enema examination (BE) profile views and depth of submucosal (SM) invasion in CRCs. Methods We reviewed the radiographic and endoscopic findings of 145 T1-CRCs diagnosed from 2008 to 2019. We measured the widths of horizontal and vertical rigidity under a BE profile view corresponding to CRC and compared the values with SM invasion depth. Horizontal rigidity was defined as the horizontal length and vertical rigidity as the vertical width of the barium defect corresponding to each target lesion. The most appropriate cut-off values for predicting SM invasion ≥1.8 mm were calculated by receiver operating characteristic curve analysis. Results Values of horizontal rigidity (r = 0.626, P < 0.05) and vertical rigidity (r = 0.482, P < 0.05) correlated significantly with SM invasion depth. The most appropriate cut-off values for the prediction of SM invasion depth ≥ 1.8 mm were 4.5 mm for horizontal rigidity, with an accuracy of 80.7%; and 0.7 mm for vertical rigidity, with an accuracy of 77.9%. The prevalence of lympho-vascular invasion was significantly different when those cut-off values were applied (43.2% vs. 17.5% for horizontal rigidity, P < 0.005). Conclusions In T1-CRC, values of horizontal and vertical rigidities under a BE profile view were correlated with SM invasion depth. While the accuracy of the rigidities for the prediction of SM invasion depth ≥ 1.8 mm was not high, horizontal rigidity may be predictive of lympho-vascular invasion, thus aiding in therapeutic decision-making.

Emotion Recognition of Facial Expressions Presented in Profile

Aim of the research The literature on emotion recognition from facial expressions shows significant differences in recognition ability depending on the proposed stimulus. Indeed, affective information is not distributed uniformly in the face and recent studies showed the importance of the mouth and the eye regions for a correct recognition. However, previous studies used mainly facial expressions presented frontally and studies which used facial expressions in profile view used a between-subjects design or children faces as stimuli. The present research aims to investigate differences in emotion recognition between faces presented in frontal and in profile views by using a within subjects experimental design. Method The sample comprised 132 Italian university students (88 female, Mage = 24.27 years, SD = 5.89). Face stimuli displayed both frontally and in profile were selected from the KDEF set. Two emotion-specific recognition accuracy scores, viz., frontal and in profile, were computed from the average of correct responses for each emotional expression. In addition, viewing times and response times (RT) were registered. Results Frontally presented facial expressions of fear, anger, and sadness were significantly better recognized than facial expressions of the same emotions in profile while no differences were found in the recognition of the other emotions. Longer viewing times were also found when faces expressing fear and anger were presented in profile. In the present study, an impairment in recognition accuracy was observed only for those emotions which rely mostly on the eye regions.

A Novel Device to Measure the Optimal Position of Central Incisors in Anteroposterior Dimension Clinically: “P” Device

Facial esthetic has always been a concern for humans for ages. The anteroposterior (AP) position of central incisors plays a key role in building facial esthetic in a smiling profile view. There have been various cephalometric, profilometric, and photographic methods used in the past to assess and predict the AP position of maxillary incisors in their optimal esthetic position. Our new device will help to predict, assess, and measure the optimal AP position of maxillary central incisors clinically using the glabella as a landmark.

Within-person variability can improve the identification of unfamiliar faces across changes in viewpoint

Unfamiliar face identification is concerningly error prone, especially across changes in viewing conditions. Within-person variability has been shown to improve matching performance for unfamiliar faces, but this has only been demonstrated using images of a front view. In this study, we test whether the advantage of within-person variability from front views extends to matching to target images of a face rotated in view. Participants completed either a simultaneous matching task (Experiment 1) or a sequential matching task (Experiment 2) in which they were tested on their ability to match the identity of a face shown in an array of either one or three ambient front-view images, with a target image shown in front, three-quarter, or profile view. While the effect was stronger in Experiment 2, we found a consistent pattern in match trials across both experiments in that there was a multiple image matching benefit for front, three-quarter, and profile-view targets. We found multiple image effects for match trials only, indicating that providing observers with multiple ambient images confers an advantage for recognising different images of the same identity but not for discriminating between images of different identities. Signal detection measures also indicate a multiple image advantage despite a more liberal response bias for multiple image trials. Our results show that within-person variability information for unfamiliar faces can be generalised across views and can provide insights into the initial processes involved in the representation of familiar faces.

Effects of deviations in the nose and chin prominence on facial attractiveness

Objective: To assess the effects of deviations in the nose and chin prominence on facial attractiveness. Methods: In this study, a reference digital photograph was taken from the facial profile view of an adult female model. Some changes were made in the nose and chin prominence in Photoshop software using the Crumley’s analysis. Changes made in the nose prominence yielded a prominent nose (2:11 ratio), a normal nose (3:53 ratio) and a small nose (4:61 ratio). Changes made in the chin prominence were protrusion by +2 and 0 mm and retrusion by −2, −4 and −6 mm (distance from the pogonion to the vertical reference line). In total, 18 orthodontists, 18 oral and maxillofacial surgeons, 18 art students and 18 laypeople evaluated the photographs (n = 15) and expressed their opinion regarding the facial profile attractiveness using a visual analogue scale (0−100). Data were analysed using SPSS version 18. Results: A significant difference was noted in the ratings of photographs (Greenhouse-Geisser, P < 0.001). Orthodontists gave a significantly higher score than laypeople to photographs with a small nose and deviations of the chin prominence ( P = 0.015). Art students gave a significantly higher score than laypeople to photographs with a prominent chin and deviations in the nose prominence ( P = 0.012). Conclusions: Facial profile with a normal (3:53 ratio) or small (4:61 ratio) nose and chin protrusion/retrusion by 2 mm (pogonion-vertical line) is considered attractive.

Diagnosis and Planning in Orthognathic Surgery

The clinical evaluation of the face is the most important aspect of evaluating patients with dentofacial deformities. The clinical examination is the primary determinant in making a diagnosis and developing a treatment plan. The basic treatment goals are: establishment of orofacial function, ensure stability of results, achieve facial esthetics and to consider the patency of the airway. The systematic clinical examination is divided into five basic evaluations: the frontal view, the profile view, three quarter view, an occlusal assessment and the temporomandibular joint evaluation. The clinical diagnosis is then confirmed with special investigations such as panoramic, lateral and anteroposterior cephalometric radiographs and other investigations as required. A dental, skeletal and soft tissue problem list is then noted and orthodontic and surgical solutions integrated into a final treatment plan. A cephalometric radiographic tracing or a 3D virtual treatment planning system is finally used to measure the planned surgical movements and to visualize the expected treatment results.

Eye tracking study of frontal and profile face image observation and recognition

Facial images are an important element of nonverbal communication. Eye-tracking systems enable us to objectively measure and analyse the way we look at facial images and thus to study the behaviour of observers. Different ways of looking at facial images influence the process of remembering faces and recognition performance. In the real world we are dealing with different representations of faces, especially when we look at them from different angles. Memory and recognition performance are different when test subjects look at the face from the frontal or from a profile view. We studied crossobservation and recognition, so we performed two tests. In the first test, subjects observed facial images shown in the frontal view and recognized them in the profile view. In the second test, the faces were observed from the profile and recognized in the frontal view. The presentation time in the observation test was four seconds, which was found to be an adequate time for sufficient recognition in some previous tests. The results were analysed with the well-known time and spatial method based on fixations and saccades and with the new area method using heatmaps of the eye tracking results. We found that the recognition success (correct and incorrect recognition) was better when the combination of frontal view and profile recognition was used. The results were then confirmed by measuring the fixation duration and saccade length. More visible facial features resulted in a shorter fixation duration and shorter saccade length, which led to a better memory. We also confirmed the results of observation and recognition by area analysis, where we measured the area, perimeter and circularity of heatmaps. Here we found that larger areas and perimeter and smaller circularity of heatmaps resulted in better memory of facial images and therefore better recognition.