The Rejuvenation of the Aged Central Lower Face: A Contemporary Perspective

Fedok, Fred G.

doi:10.1055/s-0039-1683857

Cited by 10 publications

(10 citation statements)

References 31 publications

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“…35 Recent studies have also begun to highlight the role of the lower central face (upper and lower lips, chin) in one's apparent age. 36,37 To be clear, these results do not mean that the eyes are less significant in determining facial age. On the contrary, the time spent on the eyes still constituted a relative majority as compared with the nose or mouth.…”

Section: Age-tasked Eye-tracking Study 39mentioning

confidence: 94%

“…Perhaps the mouth and central lower face deserve more attention in facial rejuvenation as Fedok suggests. 36 Alas, one must also consider facial age from different perspectives. Our study participants viewed faces in frontal plane at a conversational distance of 60 cm, allowing them to see salient facial features in detail.…”

Section: Age-tasked Eye-tracking Study 39mentioning

confidence: 99%

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How Old Do I Look? Exploring the Facial Cues of Age in a Tasked Eye-Tracking Study

Liao

Ishii

Chen

et al. 2020

Facial Plastic Surgery & Aesthetic Medicine

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Importance: This is the first eye-tracking study to use a tasked age estimation paradigm to explore the facial cues of age as seen by casual observers. Objectives: Determine where observers gaze on faces when tasked with estimating an individual's age. Design, Setting, and Participants: This was a prospective controlled experiment, which took place at an academic tertiary referral center. In total, 220 casual observers (80 untasked, 140 tasked) viewed frontal facial images of women while an infrared eye-tracking monitor recorded their eye movements and fixations in real time. Main Outcomes and Measures: Multivariate Hotelling's analysis followed by planned posthypothesis testing was used to compare fixation durations for predefined regions of interest, including the central triangle, upper face, midface, lower face, and neck between tasked and untasked observers. Results: A total of 80 observers (mean age 23.6 years, 53% female) successfully completed the first untasked eyetracking experiment. A total of 140 observers (mean age 26.1 years, 60% female) successfully completed the second age estimation experiment. On multivariate analysis, there were significant differences in the distribution of attention between observers in the two experiments (T 2 = 99.70; F(5,2084) = 19.9012, p < 0.0001). On planned posthypothesis testing, observers attended significantly more to the lower third of the face (0.20 s, p < 0.0001, 95% confidence interval (CI) 0.14-0.27 s) and neck (0.05 s, p = 0.0074, 95% CI 0.01-0.08 s) and less to the upper third of the face (À0.27 s, p < 0.0001, 95% CI À0.40 to À0.14 s) when tasked. There was no significant difference in time spent on the whole face in the two experiments, suggesting that peripheral elements such as hair color or jewelry did not significantly influence gaze patterns. Conclusions and Relevance: Humans form judgments about others every day of their lives, and age perception colors their every interaction. To our knowledge, this study is the first to use eye tracking to investigate facial cues of age. The results showed that when tasked with estimating age, casual observer visual attention was shifted toward the lower face when compared with those who were untasked. These data inform our understanding of facial age perception and potential areas to target for facial rejuvenation.

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Section: Age-tasked Eye-tracking Study 39mentioning

confidence: 94%

Section: Age-tasked Eye-tracking Study 39mentioning

confidence: 99%

How Old Do I Look? Exploring the Facial Cues of Age in a Tasked Eye-Tracking Study

Liao

Ishii

Chen

et al. 2020

Facial Plastic Surgery & Aesthetic Medicine

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show abstract

“…The lower mandible contributes to the morphology of the lower face and accentuates the jawline. Aesthetic surgeons refer to a youthful jawline as one characterized by a straight line from the chin to the mandibular angle [ 137 , 138 ]. Excess subcutaneous fat in the region may cause certain skinfolds and disrupt this angular definition of the jawline, which can lead to the lower face becoming more squarish than oval [ 84 , 89 ].…”

Section: Facial Features With Clinical Significancementioning

confidence: 99%

Use of Facial Morphology to Determine Nutritional Status in Older Adults: Opportunities and Challenges

Tay¹,

Quek²,

Kaur³

et al. 2022

JMIR Public Health Surveill

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Undiagnosed malnutrition is a significant problem in high-income countries, which can reduce the quality of life of many individuals, particularly of older adults. Moreover, it can also inflate the costs of existing health care systems because of the many metabolic complications that it can cause. The current methods for assessing malnutrition can be cumbersome. A trained practitioner must be present to conduct an assessment, or patients must travel to facilities with specialized equipment to obtain their measurements. Therefore, digital health care is a possible way of closing this gap as it is rapidly gaining traction as a scalable means of improving efficiency in the health care system. It allows for the remote monitoring of nutritional status without requiring the physical presence of practitioners or the use of advanced medical equipment. As such, there is an increasing interest in expanding the range of digital applications to facilitate remote monitoring and management of health issues. In this study, we discuss the feasibility of a novel digital remote method for diagnosing malnutrition using facial morphometrics. Many malnutrition screening assessments include subjective assessments of the head and the face. Facial appearance is often used by clinicians as the first point of qualitative indication of health status. Hence, there may be merit in quantifying these subtle but observable changes using facial morphometrics. Modern advancements in artificial intelligence, data science, sensors, and computing technologies allow facial features to be accurately digitized, which could potentially allow these previously intuitive assessments to be quantified. This study aims to stimulate further discussion and discourse on how this emerging technology can be used to provide real-time access to nutritional status. The use of facial morphometrics extends the use of currently available technology and may provide a scalable, easily deployable solution for nutritional status to be monitored in real time. This will enable clinicians and dietitians to keep track of patients remotely and provide the necessary intervention measures as required, as well as providing health care institutions and policy makers with essential information that can be used to inform and enable targeted public health approaches within affected populations.

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“…Involutional processes will degrade the graceful youthful mandibular contour as muscular attachments change and there is actual wasting of the mandibular bone itself. 5 The ptosis of the submandibular glands and visible anterior bellies of the digastric muscle will further diminish the aesthetic appearance.…”

Section: Aesthetic Challenges Of the Aging Neckmentioning

confidence: 99%

Another Look at Platysmaplasty in Facelifting

Fedok

2020

Facial Plast Surg

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Over the history of facial rejuvenation surgery there has been a progressive assimilation of knowledge about the anatomy of neck structures that are central to the manifestations of the aging neck. These advances in knowledge have been accompanied by the innovation and introduction of several surgical techniques to restore the neck to a more youthful appearance. The rejuvenation of the aging neck frequently incorporates a consideration and execution of accepted methods to restore the platysma muscles to a more aesthetic form. Lasting and dependable surgical techniques remain somewhat elusive and late failures in the neck continue to be a frustration for both patients and surgeons.In this manuscript, the author reviews some of the more enduring and innovative methods to manage the platysma in facelifting and cites the rationale and limitations of the various techniques. The concept of the restoration of an effective platysma “sling” in the upper neck to eliminate platysma bands and recreate a defined jawline is highlighted. A framework of patient evaluation and decision making is presented, and a suggested individualized application of accepted surgical maneuvers is suggested.

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The Rejuvenation of the Aged Central Lower Face: A Contemporary Perspective

Cited by 10 publications

References 31 publications

How Old Do I Look? Exploring the Facial Cues of Age in a Tasked Eye-Tracking Study

How Old Do I Look? Exploring the Facial Cues of Age in a Tasked Eye-Tracking Study

Use of Facial Morphology to Determine Nutritional Status in Older Adults: Opportunities and Challenges

Another Look at Platysmaplasty in Facelifting

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