Fold Depth Research Articles

EN FACE IMAGE–BASED ANALYSIS OF RETINAL TRACTION CAUSED BY EPIRETINAL MEMBRANE AND ITS RELATIONSHIP WITH VISUAL FUNCTIONS

To evaluate the relationship between retinal traction caused by epiretinal membrane and visual functions. In this institutional study, en face swept-source optical coherence tomography images of 141 eyes of 130 patients with epiretinal membrane were analyzed to investigate maximum depth of retinal folds, which represents retinal traction strength and the distribution pattern of retinal folds. We investigated the relationships between the maximum depth and distribution pattern of retinal folds and visual functions as well as the effects of membrane peeling. Maximum retinal fold depth was significantly correlated with the metamorphopsia score (P < 0.001). Fifteen eyes showed retinal folds radially extending from the macular epiretinal membrane (radiating folds group), whereas 126 eyes showed a multidirectional pattern of retinal folds (multidirectional folds group). The radiating folds group showed a significantly lower metamorphopsia score (P = 0.014). Multiple regression analysis revealed that the metamorphopsia score was significantly related to maximum retinal fold depth (P = 0.003), distribution pattern (P = 0.015), and central retinal thickness (P < 0.001). One month after membrane peeling, parafoveal retinal folds resolved completely in all cases, and both visual acuity (P < 0.001) and average metamorphopsia score (P = 0.036) were significantly improved. Both the strength and the distribution pattern of retinal traction are significantly related to metamorphopsia in epiretinal membrane patients.

Lateral Superficial Muscular Aponeurotic System Stacking/Superficial Muscular Aponeurotic Systemectomy With Orbicularis-Malar Fat Repositioning: A Procedure Tailored for Female Asian Patients.

Important differences in facial anatomy and how faces age must be considered when performing facelifts in Asian populations. Few facelift methods are specifically designed for Asian patients. This study evaluated the efficacy of lateral superficial muscular aponeurotic system (SMAS)-stacking/SMAS-ectomy with orbicularis-malar fat repositioning. Between February 2013 and December 2016, 62 women underwent the evaluated technique and completed the follow-up (15 months, ranging from 3 to 38.5 months). Three blinded, independent observers graded wrinkles, laxity, nasolabial fold depth, malar prominence, and tear trough deformity using quantitative comprehensive grading scales. FACE-Q scale items were assessed, and complications were recorded. The mean postoperative scores for wrinkles, laxity, nasolabial fold depth, malar prominence, and tear trough deformity decreased from 2.64, 2.62, 2.01, 2.06, and 2.40 to 1.48, 1.34, 0.93, 1.21, and 1.27, respectively. The preoperative and postoperative scores differed significantly for all parameters (p < .05). The FACE-Q results showed that the patients were highly satisfied with their appearance, quality of life, adverse effects, and care. The authors' technique allows midfacial and periorbital rejuvenation and offers dual benefits by correcting individual facial asymmetries and reshaping the jowls and neck contour in Asian patients.

Preparation and evaluation of anti-wrinkle cream containing saffron extract and avocado oil.

Recently, many compounds or extracts from natural sources are used for reducing facial aging and wrinkles. This study investigates the preparation and evaluation of the safety and efficacy of saffron extract and avocado oil used for anti-wrinkle topical cream. Oil in water cream was prepared containing avocado oil and the saffron extract. Accelerated stability tests were carried out due to 6months accordingly through the International Council for Harmonization (ICH) guideline. For clinical studies, topical cream was applied by twenty healthy volunteers daily, for 12weeks. Improvement in wrinkle grading by a Global Aesthetic Improvement Scale (GIAS), depth and volume of the nasolabial fold, thickness, and density of dermis, and determination of the skin biophysical parameters were evaluated at the baseline, 6th and 12th week. During the period of storage, the formulation showed no variation in physicochemical properties. The clinical evaluation showed at least one-grade improvement in GIAS in 30% and 45% of participants, after 6 and 12weeks, respectively. Subjects were "moderately satisfied" with the treatment. In addition, the area and volume of nasolabial folds were significantly reduced. Moreover, net elasticity (R5) and gross elasticity (R2) showed a significant increase after 12weeks of treatment. There was no report of allergic reactions, and no changes in skin hydration occurred during the treatment. The results of this study showed that saffron extract and avocado oil anti-wrinkle topical cream is an efficient and safe treatment for facial skin rejuvenation.

Effect of Vocal Fold Implant Placement on Depth of Vibration and Vocal Output.

Most type 1 thyroplasty implants and some common injectable materials are mechanically stiff. Placing them close to the supple vocal fold mucosa can potentially dampen vibration and adversely impact phonation, yet this effect has not been systematically investigated. This study aims to examine the effect of implant depth on vocal fold vibration and vocal output. Computational simulation. Voice production was simulated with a fiber-gel finite element computational model that incorporates a three-layer vocal fold composition (superficial lamina propria, vocal ligament, thyroarytenoid muscle). Implants of various depths were simulated, with a "deeper" or more medial implant positioned closer to the vocal fold mucosa and replacing more muscle elements. Trajectories of surface and within-tissue nodal points during vibration were produced. Outcome measures were the trajectory radii, fundamental frequency (F0 ), sound pressure level (SPL), and smoothed cepstral peak prominence (CPPS) as a function of implant depth. Amplitude of vibration at the vocal fold medial surface was reduced by an implant depth of as little as 14% of the total transverse vocal fold depth. Increase in F0 and decrease in CPPS were noted beyond 30% to 40% implant depth, and SPL decreased beyond 40% to 60% implant depth. Commonly used implants can dampen vibration "from a distance," ie, even without being immediately adjacent to vocal fold mucosa. Since implants are typically placed at depths examined in this study, stiff implants likely have a negative vocal impact in a subset of patients. Softer materials may be preferable, especially in bilateral medialization procedures. N/A Laryngoscope, 130:2192-2198, 2020.

Topical Nanofat Biocrème Improves Aesthetic Outcomes of Nonablative Fractionated Laser Treatment: A Preliminary Report.

Improvements in skin erythema and elasticity have been observed with topical application of platelet-rich plasma after fractional laser (FXD) treatment. Injections of nanofat via small needles into the dermis improves tissue thickness, discoloration and wrinkle depth. The aim of this study was to evaluate improvements in skin following a nonablative FXD treatment combined with the application of a novel topical nanofat biocrème, called neo-U. Fifty patients were treated with a nonablative FXD followed by application of a topical nanofat biocrème. Harvested fat was processed into nanofat, which was compounded with a transdermal liposomal delivery vector to produce a topical biocrème. In 2 patients, postauricular skin punch biopsies were performed before and after treatment and examined for histologic changes. Photographs of a historical group treated with only the FXD were compared with photographs of patients treated with a combination of topical nanofat biocrème and FXD. Skin types were evaluated for improvements in nasolabial folds, wrinkles, and skin texture. Findings from postauricular skin biopsies show the skin exposed to FXD with nanofat biocrème had more elastin fibers and a slight increase in the thickness of the epidermis. Patients treated with FXD plus nanofat biocrème had a statistically significant improvement in the degree of wrinkles, nasolabial fold depth, and texture compared with historical controls. Transdermal delivery of nanofat topical biocrème applied after FXD treatment can serve as a delivery system to improve fine lines, nasolabial fold depth, and overall texture of the tissue to a greater degree than laser resurfacing alone.

Intraglottal Pressure: A Comparison Between Male and Female Larynxes

Acoustic differences in the phonated sounds made by men and women are related to laryngeal and vocal tract structural differences. This model-based study explored how typical vocal fold differences between males and females affect intraglottal pressure distributions under conditions of different glottal angles and transglottal pressures, and thus how they may affect phonation. The computational code ANSYS Fluent 6.3 was used to obtain the pressure distributions and other aerodynamic parameters for laminar, incompressible flow. Typical values of the vocal fold length, the vertical glottal duct length, and the lateral vocal fold tissue depth were selected both for males and females under conditions of nine typical convergent/divergent glottal angles and three transglottal pressures. There was no coupling of the upstream or downstream vocal tracts, and also no vocal fold contact in these two-dimensional static glottal geometries. Results suggest that males tend to have greater intraglottal pressures for the convergent glottal shape that occurs during glottal opening, and the male glottis offers less flow resistance than the female glottis. These results suggest that the male vocal folds may vibrate more easily (ie, with lower transglottal pressure) but the tissue differences may nullify such an hypothesis. Also, the peak velocities in the glottis were dependent on the transglottal pressure driving the flow and the minimal glottal diameter, which were the same for both the male and female larynxes, rather than on the inferior-superior length of the glottis or the anterior-posterior glottal length. In addition, the tangential forces for larger glottal convergent angles was significantly greater in the female larynx. The entrance loss coefficients, however, were similar between the male and female larynxes, except for the uniform glottis for which the values were larger for the male larynx. The results suggest that the structural differences between male and female vocal folds should be well specified when building computational and physical models of the larynx.

Altered cortical folding and reduced sulcal depth in adults with anorexia nervosa.

Previous studies on anorexia nervosa (AN) focused on cortical volume and mainly reported grey matter reduction. They also investigated cortical surface parameters, for example, absolute mean curvature (AMC) providing information on cortical folding or sulcal depth (SD). For the first time, we also analysed cortical complexity using fractal dimension (FD) in AN. In a cross-sectional study, we performed surface analyses (AMC, SD, and FD) on 34 women with AN, 24 recovered from AN (REC), and 41 healthy controls (HC). Structural MR data was processed using the Computational Anatomy Toolbox and statistically compared across groups on a vertex- and region-of-interest-wise level using statistical parametric mapping. We found a lower AMC and SD in AN, especially in temporal areas. FD was increased in the left precentral gyrus in AN. No differences of the parameters AMC, SD, or FD were evident between REC and HC participants. Alterations in AMC, SD, and FD in AN patients, but not between the REC and HC groups, suggest that these alterations are state related. The findings concur with other structural AN studies that suggest restitution with clinical recovery. The changes may be due to malnutrition, dehydration, osmotic dysregulation, or hormonal aberrations during the acute stage.

Balcony genioplasty: a novel technique for better esthetic results in patients with deep mentolabial fold

BackgroundTo introduce a novel technique for advancement genioplasty helping surgeons to avoid soft tissue difficulties especially in short-faced patients with deep mentolabial fold and everted lower lip.Case presentationIn a trapezius-shaped, osteotomy was performed in the chin region. The mobilized segment was advanced, and the existing gap was grafted using interpositional allograft materials. Each side had been fixated by three-hole plates and two screws. The outcomes revealed no change in lower anterior teeth vitality. The patients did not report any changes of sensation in lower lip and chin either. The measurements indicated no increase in depth of mentolabial fold in patients undergoing this surgical technique. The postoperative evaluation showed a successful esthetic outcome for the patient and the surgeon concurrently.ConclusionBased on our experience, the authors concluded that the Balcony technique is a simple and reliable procedure for patients with a deep mentolabial fold.

A novel technique for large and ptotic breast reconstruction using a latissimus dorsi myocutaneous flap set at the posterior aspect, combined with a silicone implant, following tissue expander surgery.

Large and ptotic breast reconstruction in patients who are not candidates for a transverse rectus abdominalis myocutaneous flap and revision surgery for the contralateral breast remains challenging. We developed a novel breast reconstruction technique using a latissimus dorsi myocutaneous (LD m-c) flap set at the posterior aspect of the reconstructed breast, combined with an anatomical silicone breast implant (SBI), following tissue expander surgery. We performed the proposed technique in four patients, in whom the weight of the resected tissue during mastectomy was >500 g and the depth of the inframammary fold (IMF) was >3 cm. After over-expansion of the lower portion of the skin envelope by a tissue expander, the LD m-c flap was transferred to cover the lower portion of the breast defect and to achieve a ptotic contour, with the skin paddle set at the posterior aspect of the reconstructed breast. An SBI was then placed in the rest of the breast defect after setting the LD m-c flap. No major complications were observed during the follow-up period. The proposed technique resulted in symmetrical and aesthetically satisfactory breasts with deep IMFs, which allowed proper fitting of the brassiere, following large and ptotic breast reconstruction.

A computational method for longitudinal mapping of orientation-specific expansion of cortical surface in infants.

The cortical surface of the human brain expands dynamically and regionally heterogeneously during the first postnatal year. As all primary and secondary cortical folds as well as many tertiary cortical folds are well established at term birth, the cortical surface area expansion during this stage is largely driven by the increase of surface area in two orthogonal orientations in the tangent plane: 1) the expansion parallel to the folding orientation (i.e., increasing the lengths of folds) and 2) the expansion perpendicular to the folding orientation (i.e., increasing the depths of folds). This information would help us better understand the mechanisms of cortical development and provide important insights into neurodevelopmental disorders, but still remains largely unknown due to lack of dedicated computational methods. To address this issue, we propose a novel method for longitudinal mapping of orientation-specific expansion of cortical surface area in these two orthogonal orientations during early infancy. First, to derive the two orientation fields perpendicular and parallel to cortical folds, we propose to adaptively and smoothly fuse the gradient field of sulcal depth and also the maximum principal direction field, by leveraging their region-specific reliability. Specifically, we formulate this task as a discrete labeling problem, in which each vertex is assigned to an orientation label, and solve it by graph cuts. Then, based on the computed longitudinal deformation of the cortical surface, we estimate the Jacobian matrix at each vertex by solving a least-squares problem and derive its corresponding stretch tensor. Finally, to obtain the orientation-specific cortical surface expansion, we project the stretch tensor into the two orthogonal orientations separately. We have applied the proposed method to 30 healthy infants, and for the first time we revealed the orientation-specific longitudinal cortical surface expansion maps during the first postnatal year.

Case 3: Newborn with Asymmetric Crying Face

A 35-week-gestation male infant is delivered by cesarean section in the setting of maternal premature rupture of membrane and fetal nonreassuring heart tracing during the process of labor induction. The mother is a 30-year-old, gravida 2, para 1, healthy woman without significant medical history. Maternal antenatal testing results are normal with unremarkable prenatal complications. The neonate is the product of a nonconsanguineous marriage. At birth, the infant’s head is delivered without instrumental assistance or birth trauma. He is vigorous and cries immediately after birth. Resuscitation efforts include a brief period of continuous positive airway pressure and oxygen support for increased work of breathing and desaturation; however, the infant recovers quickly and is transferred to the sick newborn unit in room air. His Apgar scores are 8 and 9 at 1 and 5 minutes, respectively. Physical examination reveals a nondistressed premature infant with normal vital parameters. His birthweight, length, and occipitofrontal circumference are 1,840 g, 39 cm, and 31.5 cm, respectively. He is found to have an asymmetric crying face. When he is quiet or sleeping, his face appears symmetric. However, when he cries, the left corner of the mouth is drawn to the left and downward while the right corner does not move. The forehead wrinkling, nasolabial fold depth, and eye closure remain intact and equal on both sides (Fig 1). All extraocular muscle movements are intact. He has an overfolded helix with squared superior portion of helix of bilateral ears and microretrognathia (Fig 2). Other physical examination findings are unremarkable. There is no history of a similar condition on both sides of the family. Figure 1. When the infant is at rest, the face appears symmetrical (left). When the …

Evaluation of selected skin parameters following the application of 5% vitamin C concentrate.

Ascorbic acid is a substance with confirmed anti-free-radical properties. It triggers the collagen synthesis, has a depigmenting effect and seals blood vessels. All these properties have a significant effect of the skin's appearance. The characteristic traits of capillary skin include telangiectasias as well as erythema, which might consolidate in the future, along with the feeling of burning and increased skin sensitivity. Study and evaluation of selected parameters of capillary skin after the application of 5% vitamin C concentrate throughout the period of 6weeks with the use of instrumental tests and questionnaires. The research was conducted on a group of 30 women ranging from 30 to 60years of age with capillary skin indicating visible signs of erythematous plaques. The concentrate was applied once a day. Analyses of skin conditions were conducted four times: before the launch of the research D(0), after two 2D(14), after four 4D(28), and after 6 D(42) weeks of application. The research was conducted with the use of Mexameter MPA equipment, which was used to measure changes in the intensity of erythematous plaques. The depth of wrinkles was measured by PRIMOS system (two times D0 and 6D(42). The research also used VISIA system which allowed to perform visual and numeral skin analyses. Each research was finalized with a questionnaire which provided a subjective evaluation of the examined product among participants. Significant reduction in erythema has been widely recorded. After 2weeks, erythema dropped by 9%. After 4weeks, it decreased by 16% and by 21% after 6weeks. The concentrate's efficiency in diminishing erythematous plaques was confirmed by photographs generated by VISIA photograph system. Thanks to PRIMOS, decrease in both depth and volume of nasolabial folds was recorded in 87% of participants after 6weeks of research. 5% vitamin C concentrate is effective in treating capillary and photograph-aging skin. It decreases erythema and telangiectasias as well as triggers the shallowing of skin wrinkles.

Suppression of epithelial folding at actomyosin-enriched compartment boundaries downstream of Wingless signalling in Drosophila.

ABSTRACTEpithelial folding shapes embryos and tissues during development. Here, we investigate the coupling between epithelial folding and actomyosin-enriched compartmental boundaries. The mechanistic relationship between the two is unclear, because actomyosin-enriched boundaries are not necessarily associated with folds. Also, some cases of epithelial folding occur independently of actomyosin contractility. We investigated the shallow folds called parasegment grooves that form at boundaries between anterior and posterior compartments in the early Drosophila embryo. We demonstrate that formation of these folds requires the presence of an actomyosin enrichment along the boundary cell-cell contacts. These enrichments, which require Wingless signalling, increase interfacial tension not only at the level of the adherens junctions but also along the lateral surfaces. We find that epithelial folding is normally under inhibitory control because different genetic manipulations, including depletion of the Myosin II phosphatase Flapwing, increase the depth of folds at boundaries. Fold depth correlates with the levels of Bazooka (Baz), the Par-3 homologue, along the boundary cell-cell contacts. Moreover, Wingless and Hedgehog signalling have opposite effects on fold depth at the boundary that correlate with changes in Baz planar polarity.

A COMPUTATIONAL METHOD FOR LONGITUDINAL MAPPING OF ORIENTATION-SPECIFIC EXPANSION OF CORTICAL SURFACE AREA IN INFANTS.

The dynamic expansion of the human cortical surface during infancy is largely driven by the increase of surface area in two orthogonal directions: 1) the expansion parallel to the folding orientation (i.e., increasing the lengths of folds) and 2) the expansion perpendicular to the folding orientation (i.e., increasing the depths of folds). The knowledge on this would help us better understand the cortical growth mechanisms and provide important insights into neurodevelopmental disorders, but still remains scarce, due to the lack of dedicated computational methods. To address this issue, we propose a novel method for longitudinal mapping of orientation-specific expansion of cortical surface area in these two orthogonal directions during early infancy. We apply our method to 30 healthy infants, and for the first time reveal the orientation-specific longitudinal cortical surface expansion maps during the first postnatal year.

Assessment of Lamellar Macular Hole and Macular Pseudohole With a Combination of En Face and Radial B-scan Optical Coherence Tomography Imaging

To investigate lamellar macular hole (LMH) and macular pseudohole (MPH) using a combination of en face and radial B-scan OCT. Retrospective observational case series. Setting: Institutional study. En face and radial B-scan OCT images of 63 eyes of 60 patients diagnosed with LMH or MPH based on an international classification were reviewed. Cases were classified using en face images based on the presence/absence of epiretinal membrane (ERM), retinal folds, parafoveal epicenter of contractile ERM (PEC-ERM), and retinal cleavage. We compared the en face imaging-based classification system with the international classification system using radial B-scan images. We quantitatively evaluated visual function and macular morphology. Characterization of multimodal OCT-based subtypes of LMH and MPH. All cases showed ERM and were classified into 4 groups. In the first group, which lacked retinal folds and showed significantly lower visual acuity than the other groups, 81% of eyes had degenerative LMH. In the second group, which lacked PEC-ERM and retinal cleavage and showed significantly lower retinal fold depth, all eyes had MPH. The third group, in which 95% of eyes had symmetric tractional LMH, included eyes with retinal cleavage but without PEC-ERM, and this group showed higher circularity of the foveal aperture and cleavage area than the group with both these features, in which all eyes had asymmetric tractional LMH. Multimodal OCT enables classification of LMH and MPH based on pathologic conditions. Retinal traction in particular may be useful for determining treatment methods.

Cohesive Polydensified Matrix® hyaluronic acid volumizer injected for cheek augmentation has additional positive effect on nasolabial folds.

PurposeCohesive Polydensified Matrix® hyaluronic acid (CPM-HA) volumizer has been used successfully for several years to reverse biometric volume loss during facial aging. This observational study explored the additive effect on nasolabial folds when CPM-HA volumizer is injected into the neighboring cheek area.Patients and methodsIn this open-label, prospective, postmarketing noninterventional study, 18 adult patients seeking esthetic enhancement of the lateral cheek hollows and cheekbone area were injected with CPM-HA volumizer integrated with lidocaine (CPM-HA-VL) in the upper or lower cheek area. Safety and performance of CPM-HA-VL up to 12 months after injection with follow-up visits at week 4 and month 3, 6, and 12 were assessed. The primary endpoint was improvement of cheek fullness on the validated Merz Aesthetics Scales. Additionally, changes in nasolabial folds were quantified using a phaseshift rapid in vivo measurement of skin optical three-dimensional (3D) in vivo measurement device.ResultsPatients (94.4% female, median age 52 years, age range 39–69 years) were injected with a mean volume of 2.5±1.1 mL CPM-HA-VL per side. Immediately after injection, mean severity for upper and lower cheek fullness assessed on the validated MAS improved from 2.5±0.6 and 2.8±0.5, respectively, to 1.0±0.0, and remained unchanged through month 12. Improvement in relation to baseline was attested on the Global Aesthetics Improvement Scale for all assessments. Compared with baseline, the following assessments offered a statistical significance in the reduction of wrinkle depth of nasolabial folds (maximum depth reduction by 30.4% at 3 months) according to optical 3D in vivo measurements. Pain during injection was minimal and abated within 30 minutes. Treatment was well tolerated and led to great patient satisfaction.ConclusionCPM-HA-VL injected into the upper and lower cheeks led to long-lasting satisfactory cosmetic results in cheek augmentation as well as in reducing depth of nasolabial folds adjacent to the injection site.

Characterization of drape profile using Fuzzy-C-Mean (FCM) method

The overall objective of this study is to predict the behavior of the fabrics in details overlooked the drape phenomenon using Fuzzy-C-Mean (FCM) method. In this paper, the fabric properties which are the weight, the bending rigidity B in three direction: warp, weft and skew direction and the shear rigidity G were preselected according to their influence on the drape parameters (the drape coefficient DC, the node number NN, the fold depth index FDI and the drape distance ratio DDR). The result showed that the drape phenomenon was classified into three classes: low drape, average drape and high drape. The values of drape parameters were discussed in this work.

Summertime tropospheric ozone enhancement associated with a cold front passage due to stratosphere‐to‐troposphere transport and biomass burning: Simultaneous ground‐based lidar and airborne measurements

AbstractStratosphere‐to‐troposphere transport (STT) and biomass burning (BB) are two important natural sources for tropospheric ozone that can result in elevated ozone and air‐quality episode events. High‐resolution observations of multiple related species are critical for complex ozone source attribution. In this article, we present an analysis of coinciding ground‐based and airborne observations, including ozone lidar, ozonesonde, high spectral resolution lidar (HSRL), and multiple airborne in situ measurements, made on 28 and 29 June 2013 during the Southeast Nexus field campaign. The ozone lidar and HSRL reveal detailed ozone and aerosol structures as well as the temporal evolution associated with a cold front passage. The observations also captured two enhanced (+30 ppbv) ozone layers in the free troposphere (FT), which were determined from this study to be caused by a mixture of BB and stratospheric sources. The mechanism for this STT is tropopause folding associated with a cutoff upper level low‐pressure system according to the analysis of its potential vorticity structure. The depth of the tropopause fold appears to be shallow for this case compared to events observed in other seasons; however, the impact on lower tropospheric ozone was clearly observed. This event suggests that strong STT may occur in the southeast United States during the summer and can potentially impact lower troposphere during these times. Statistical analysis of the airborne observations of trace gases suggests a coincident influence of BB transport in the FT impacting the vertical structure of ozone during this case study.

Abstract: Filling Prominent Nasolabial Fold Appliying Platelet Rich Plasma(PRP) Gel

INTRODUCTION: PRP gels has been used for a few years in facial plastic surgery to decrease hematoma formation, seroma formation, postoperative swelling, and healing time.1 Despite having a volume itself, PRP gel hasn’t ever used as a filling material in aesthetic plastic surgery practice. The gel has not only volume advantage but also the benefits of PDGF and cytokines. Due to this, we used the PRP gel as a filling material for nasolabial folds. MATERIALS AND METHODS: 3,W patients were refered to our clinic with prominent nasolabial fold due to aging. Mean age was 46 (42- 48). We obtained PRP gel from their own blood without anesthesia by embryologists. Blood was centrifuged, and the platelet and fibrinogen rich plasma component were harvested. It was applied in policlinic doing injection with 18 G canule about 2 cc. Patients were visited at 1th week, 1th, 3th and 6th months. Photos and videos were taken. For one patient MR imaging was performed. RESULT: In one patient PRP gel was seen at MR imaging at nasolabial fold area at 1th month.In physical examination, gel was perceivable. Nasolabial fold depth was reduced at static and dynamic visualization and their face were looked younger. CONCLUSION: Prominent nasolabial folds due to ageing are a major aesthetic concern among women. There are many treatments like injection of artificial fillers, fat grafting operations, facelift procedures. And the most popular is fat graft. We shared our patients whom we used PRP gel for filling the nasolabial fold. PRP gels has been used for a few years in facial plastic surgery to decrease hematoma formation, seroma formation, postoperative swelling, and healing time. Their use as a biological dressing after laser resurfacing has demonstrated faster healing and decreased erythema. The application of platelet gels to fat grafts enhances the longevity when injected for contour augmentation. When platelet gel is used in conjunction with sutures it provides for greater tensile strength. PRP gel hasn’t ever used as a filling material in aesthetic plastic surgery practice. In this study we used PRP gel as a tissue fiiler. It an easy harventing, cost effective method and the main advantage is restoring the problem with autologous tissue even easier than fat graft. DISCLOSURE/FINANCIAL SUPPORT:None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. REFERENCES 1 Edward P. Melmed, MD, Autologous Platelet Gel in Plastic Surgery. Aesthetic Surgery Journal. 2001:21:377–379

Weighting of Facial Grading Variables to Disfigurement in Facial Palsy.

A universal, health care professional-graded scale for facial assessment would be a useful tool for reporting, comparing, and assessing facial function among patients with facial paralysis. To correlate scores of an assessment tool, the eFACE scale, with expert-rated facial disfigurement and to determine the relative contributions of facial features to facial palsy-related disfigurement. The eFACE scale yields 15 individual variable scores, in addition to subscores for static, dynamic, and synkinesis elements, and a total score that is based on 100-point scales. Two hundred patients with varying degrees of unilateral facial palsy underwent independent eFACE assessment and assignment of a disfigurement score by 2 facial nerve surgeons. The mean scores were determined, and multivariate regression analysis was performed to fit eFACE subset scores (static, dynamic, and synkinesis) to disfigurement ratings. A hybrid regression model was then used to weight each of the 15 eFACE variables, using stepwise regression to control for the effect of the other variables. Scoring was performed during an 8-week period from March 16 to May 8, 2015. Use of the 100-point eFACE variables, together with a 100-point visual analog scale of disfigurement, with 0 representing the most extreme disfigurement possible from a facial nerve disorder and 100 representing no discernible facial disfigurement. In the 200 patients included in analysis (126 [63.0% female]; mean [SD] age, 46.5 [16.4] years]), predicted disfigurement scores based on eFACE subset scores demonstrated excellent agreement with surgeon-graded disfigurement severity (r2 = 0.79). Variable weighting demonstrated that the 6 key contributors to overall disfigurement were (in order of importance) nasolabial fold depth at rest (normalized coefficient [NC], 0.18; P < .001), oral commissure position at rest (NC, 0.15; P < .001), lower lip asymmetry while pronouncing the long /ē/ (NC, 0.09; P < .001), palpebral fissure width at rest (NC, 0.09; P < .001), nasolabial fold orientation with smiling (NC, 0.08; P = .001), and palpebral fissure width during attempts at full eye closure (NC, 0.06; P = .03). A mathematical association between eFACE-measured facial features and overall expert-graded disfigurement in facial paralysis has been established. For those using the eFACE grading scale, predictions of the specific effects of various interventions on expert-rated disfigurement are now possible and may guide therapy. NA.