Face Shape Research Articles

Analyzing 3D facial morphology: Insights from a comparative European and South African study on population affinity, sex, age, and allometry

Variable growth patterns and multifactorial mechanisms cause variation in facial shape. These differences in facial morphology pose challenges for craniofacial reconstruction. Three-dimensional (3D) imaging modalities are a valuable resource for examining these variations. In this study, we used geometric morphometric methods to evaluate the effects of population affinity, sex, age, and allometry on the variation and covariation of hard and soft tissue facial morphology matrices in a sample of French and white South African individuals. Seventy-six and 108 cone-beam computed tomography scans of white South African and French nationals, respectively, were retrospectively acquired. Three-dimensional anatomical structures (hard and soft tissue matrices) were extracted using MeVisLab© v. 2.7.1 software for dense landmarking of 43 craniometric, 50 capulometric, and 559 sliding landmarks. Geometric morphometric analyses were used to quantify shape differences attributed to population affinity, sex, age, and allometry and assess the covariation between hard tissue structures and soft facial tissues. Hard and soft tissue facial matrices were influenced by population differences, sexual dimorphism, and aging. Compared to sex and age, population affinity had the strongest influence on variation. In French individuals, all hard and soft tissue matrices were sexually dimorphic, except for the eyes and left external auditory meatus (EAM). In white South Africans, sexual dimorphism was observed for the mouth, midface, and left EAM. Significant shape differences were also observed for specific age groups. The underlying skull and overlying soft tissues were strongly associated with the nose and anterior nasal aperture (correlation, r2-PLS = 0.976), followed by the right ear and right EAM (r2-PLS = 0.875) and the left ear and left EAM (r2-PLS = 0.871) in white South Africans. For French individuals, relatively weak to moderate correlations were observed, and the covariation between matrices was nonsignificant, except for the association between the right ear and right EAM (r2-PLS = 0.499). The smallest covariation was observed between the mouth and midfacial matrix in both populations (South African: r2-PLS = 0.464; French: r2-PLS = 0.367), which was also nonsignificant. This study revealed that 3D imaging technology and geometric morphometric methods can accurately quantify and visualize facial morphology differences. These methods can also evaluate the association between skull structure and soft facial features.

Shape analysis of the craniofacial skeleton in children prenatally exposed to anticonvulsant medications using geometric morphometrics.

Children exposed prenatally to antiepileptic drugs may have a typical facies characterized by midfacial retrusion, a short nose, and anteverted nares. Our aim was to determine whether the shape of the maxilla was altered in its sagittal displacement, or whether the defect in the underlying articulation with the cranial base was responsible for the appearance of midface retrusion. Our hypothesis was that the sphenoid bone as well as the maxilla and other bones in the cranial base were affected by the anticonvulsant medication. The lateral cephalograms of 65 children exposed prenatally to monotherapy (phenobarbital, phenytoin, or carbamazepine) were evaluated using various analyses derived from geometric morphometrics (GM) on different studied areas (maxilla, entire cranial base, spheno-occipital region, and the total study area) and the resulting configurations compared with those of control children. Procrustes ANOVA suggested that shape variation for all the regions correlated significantly (p < 0.0001) with exposure to antiepileptic drugs, and principal component analysis revealed a noticeable separation between the means of the two groups when PC1 was plotted against PC2 for all the areas studied. The cross-validation resulting from the discriminant function analysis accurately classified between 79.5% and 88.6% of the control group and between 73.8% and 90.7% of the study group when looking at the different anatomic regions. Canonical variate analysis, applied to the sample after its separation following biological sex and stratification into two age groups, showed unequal results between males and females as well as during circumpubertal growth of the cranial base. Thus, in the exposed subjects, while the glabella was projected forward with a similar prominence in males and females, the rhinion, which is relocated more posteriorly, was more severely displaced in females as opposed to the sella, where the most important displacement occurred in males. Regarding the age groups, it revealed that patients in the younger group of both sexes exhibited a facial shape difference very early (p < 0.0001) when the comparison was performed between exposed and non-exposed subjects. This difference was maintained in females at older ages but not in males. These details may help isolate the mechanism for the anomalies because of GM's use of shape instead of traditional linear and angular cephalometric measurements.

Three-dimensional facial morphology in patients with craniofacial microsomia and microtia.

Craniofacial microsomia (CFM) is classified using the subjective Orbit, Mandible, Ear, Nerve and Soft tissue (OMENS) tool. Digital stereophotogrammetry (i.e. three-dimensional [3D] photography) can be used to capture facial shape objectively. This case-control study assessed the applicability of 3D photography in distinguishing between patients with CFM and individuals without craniofacial conditions, as well as classifying the severity of facial involvement. 3D photographs of patients with CFM and/or microtia from the Amsterdam UMC, Radboudumc and the Great Ormond Street Hospital and of individuals without craniofacial conditions were assessed. Differences between patients and controls were explored through asymmetry index (ASI) and facial signature (FS) scores, as well as a principal components (PC) analysis of FS scores and logistic regression. Correlations between OMENS scores and ASI, FS and PC scores were evaluated. A total of 179 patients and 210 controls were analyzed. ASI and FS scores differed significantly between patients and controls (p<0.001), and were correlated with several OMENS subscales. The logistic regression model distinguishing between patients and controls showed increasing asymmetry of the mandible and orbits with increasing Pruzansky-Kaban score. Patients with isolated microtia deviated from controls in the midface. Clinically significant differences in the facial morphology of patients with CFM and microtia were found compared to controls, suggesting that 3D photography can be used to assess the severity of facial involvement in a novel, objective and safe way in these patients.

Facial and dental arch shape in individuals with different bite force levels : A pilot study using geometric morphometrics.

This pilot study aimed to assess the relationship between bite force variation and dental arch and facial shape using geometric morphometrics, an advanced method of statistical analysis that provides adetailed shape analysis of astructure considering the spatial relationship of its parts. The sample consisted of 16German adult men and women. For each individual, maximum bite force was recorded in four positions: maximum intercuspation, protrusion, laterotrusion to the right and to the left. Facial and three-dimensional (3D) dental reconstructions were obtained from 3D facial photographs and 3D scans of dental stone models. Atotal of 51landmarks were placed. General shape variation was assessed by principal component analysis. Partial least squares analyses were performed to evaluate the covariation between bite force, facial shape, and dental shape. There was no clear pattern or statistically significant covariation between our variables. Our results suggest aweak relationship between bite force, dental arch, and facial shape. Considering previous work in this field, we propose that low masticatory loads, characteristic in Western urban populations, may explain this. Further studies should, therefore, address this issue, taking into account effect size, the mechanical properties of the diet, and other relevant variables.

A.S.S.E.S.S. for Facial Fillers.

An in-depth and detailed facial assessment is critical in treating and achieving desirable dermal filler and neurotoxin results. An acronym called A.S.S.E.S.S. simplifies an often complex and overwhelming amount of data needed to assimilate when performing facial filler and neurotoxin injections. Applying this method to patients in six simple steps provides a starting point and offers a guideline to capture key details for a more comprehensive facial assessment. The A.S.S.E.S.S. acronym stands for animate, shape, side, external, symmetry, and shadows and is helpful in following a methodical approach in analyzing facial shape, profile, and natural facial curves in both static and dynamic states. Following a regimented A.S.S.E.S.S. approach prior to treating filler and neurotoxin patients allows providers a straightforward guide to achieve a desirable facial shape and profile. This stepwise facial assessment establishes a logical and detailed approach to ensure the important aspects of facial details are appreciated in creating reliable and pleasing filler and neurotoxin results.

Quantitative analysis of facial shape in children to support respirator design

The COVID-19 pandemic demonstrated the need for respiratory protection against airborne pathogens. Respirator options for children are limited, and existing designs do not consider differences in facial shape or size. We created a dataset of children's facial images from three cohorts, then used geometric morphometric analyses of dense and sparse facial landmark representations to quantify age, sex and ancestry-related variation in shape. We found facial shape and size in children vary significantly with age from ages 2 to 18, particularly in dimensions relevant to respirator design. Sex differences are small throughout most of the age range of our sample. Ancestry is associated with significant facial shape variation in dimensions that may affect respirator fit. We offer guidance on how to our results can be used for the appropriate design of devices such as respirators for pediatric populations. We also highlight the need to consider ancestry-related variation in facial morphology to promote equitable, inclusive products.

Augmented Reality for Exploring Solids: A Study on Improving Pre-Service Teachers

Applications of augmented reality are gradually being integrated into teaching at various levels and types of schools. Augmented reality has the potential to transform the training of future teachers in the context of developing their mathematical knowledge, digital skills, and teaching competencies. The paper focuses on researching the impact of augmented reality on the learning of future primary teachers. The aim was to investigate the impact of AR applications on the development of cognitive and psychomotor skills and on students' motivation to learn. The study had a mixed research design. Using a pedagogical experiment, we investigated the effectiveness of an educational intervention based on the use of applications Augmented Reality in combination with hands on activities in the training of future teachers. The educational intervention was a set of activities that were carried out in a mixed reality environment using the 3D solids construction kit, the Polyedres augmentes and GeoGebra applications. The content of the educational intervention was the exploration of significant elements and properties of solids. We tested students' knowledge and abilities in the following areas: identification of simple solids from a picture; identification of significant elements of solids (vertices, edges and faces); identification of the shapes of faces of solids; nets of solids; simple metric tasks with solids. The study was conducted in 2024 with 152 primary education students as part of geometry courses. In line with the results of previous research in this area, we found that AR has the potential to improve understanding of geometric concepts, increase interactivity and student motivation. Augmented reality opens up new possibilities for exploring solids and their properties, as it allows for transfer between planar and spatial representation of solids and helps to develop spatial imagination.

Effects of Spontaneous Curvature on Interfacial Adsorption and Collapse of Phospholipid Monolayers.

To function effectively, pulmonary surfactant must adsorb rapidly to the alveolar air/water interface, but avoid collapse from the interface when compressed to low surface tensions. Prior studies show that phospholipids in the cylindrical monolayers of the inverse hexagonal (HII) phase adsorb quickly. The monolayers have negative curvature, defined by the concave shape of the hydrophilic face. Formation of the HII structures, however, involves significant disruption of optimal chain-packing. Samples with significant spontaneous curvature, formed in the absence of applied force, may nonetheless have lamellar structures. The experiments here tested whether planar lamellar bilayers formed by phospholipids with negative spontaneous curvature might adsorb rapidly but collapse slowly. Prior studies have shown that binary mixtures of dioleoyl phosphatidylcholine-dioleoyl phosphatidylethanolamine (DOPC-DOPE) with higher mol fractions of DOPE (XPE) have more negative spontaneous curvature. Samples with higher XPE adsorbed more rapidly but also collapsed more quickly. Over that range of XPE, small angle X-ray scattering showed only lamellar structures. The HII phase was undetectable. The results suggest that the innate tendency of the phospholipids to form curved structures has primary importance for adsorption rather than the presence of HII structures. Planar structures are insufficient to minimize the tendency of spontaneous curvature to promote collapse. These findings are consistent with adsorption and collapse that occur via rate-limiting structures with significant negative curvature.

Object Detection Algorithms for Video Surveillance Applications

Abstract—Object Detection algorithms find applications in various fields, such as defense, security, and healthcare. In this paper, various Object Detection Algorithms, such as face detection, skin detection, color detection, shape detection, and target detection, are simulated and implemented using MATLAB 2017b to detect various types of objects with improved accuracy for video surveillance applications. Further, various challenges and applications of object detection methods are elaborated.

Parotid Gland Suspension Combined with Rhytidectomy to Recontour the Lower Face and Neck Enlargement Caused by Benign Parotid Hypertrophy.

Lower face and neck aging and facial shape changes are usually caused by soft tissue descent. During lower face and neck enlargement, parotid hypertrophy is an important influence factor of morphologic changes in the periauricular regions. Most plastic surgery techniques greatly improve the shape of the lower face and neck, but ignore the manipulation of the parotid gland. We aimed to resolve the lower face and neck enlargement caused by parotid hypertrophy. Thus, we performed parotid gland suspension combined with rhytidectomy to improve the lower face and neck contour. This retrospective study recruited 22 patients who underwent parotid gland suspension combined with rhytidectomy from 2012 to 2020. The evaluation of patient outcomes was performed by selecting items from the FACE-Q scale. Surgical procedures involved parotid gland exposure and parotid fascia suspension. Patient-perceived age appraisal indicated a younger appearance with follow-ups for approximately 3-10year after the surgery (mean ± standard deviation - 5.53 ± 3.67). Patients had a high satisfaction level for facial appearance (67.15 ± 16.84), lower face (74.69 ± 21.22), and contour of the parotid gland areas of the neck (65.76 ± 23.62). The lower face and neck contours were narrowed and tightened. The parotid gland area showed a remarkable improvement after surgery. Parotid gland suspension combined with rhytidectomy obtained an outstanding improvement. This method can achieve a better lower face and neck contour, especially in patients with benign parotid hypertrophy or lower face and neck enlargement in periauricular regions. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Midface Skeletal Sexual Dimorphism: Lessons Learned from Advanced Three-dimensional Imaging in the White Population.

Facial shape is significantly influenced by the underlying facial bony skeleton. Sexual dimorphisms in these structures are crucial for craniofacial, aesthetic, and gender-affirming surgery. Previous studies have examined the orbits and upper face, but less is known about the midface. This study aimed to elucidate the sexual dimorphism in the midface region, focusing on the maxilla and zygomatic bones. A retrospective review was conducted using facial computed tomography scans from 101 White patients aged 20-79 years, using Materialise Mimics and 3-Matics for segmentation and 3D reconstruction. Measurements and statistical shape modeling of the midfacial skeleton were performed. Our results show a distinct sexual dimorphism in the midfacial skeletal structure across all age groups. Women typically had a narrower bizygomatic width by 1.5 mm (P = 0.04), a shallower maxillary depth by 1.6 mm (P < 0.01), and a midfacial vertical height that was 4 mm shorter than that of men (P = 0.018). In contrast, men exhibited a greater distance between the frontozygomatic sutures by 5.4 mm (P < 0.01), a 3-mm greater interorbitale distance (P < 0.01), and a 2.1-mm wider infraorbital foramina distance (P = 0.007). There were no significant differences in the pyriform and maxillary angles (P = 0.15 and P = 0.52, respectively). Our analysis of midfacial skeletal anatomy revealed sexual dimorphism differences. Men exhibited more pronounced facial features than women, with a broader horizontal midfacial skeleton, a longer midfacial vertical height, and greater maxillary depths compared with women.

Charting facial growth and development for Bantu Africans: Central tendencies, variational properties and sexual dimorphisms.

Current studies on facial growth and development have been largely based on European populations. Less studied are African populations, who because of their distinct genetic makeup and environmental conditions, provide deeper insights into patterns of facial development. Patterns of facial shape development in African populations remain largely uncharacterised. Our study aimed to establish facial growth and development trajectories based on a cohort of 2874 Bantu Africans from Tanzania aged 6-18 years, with particular focus on identifying morphogenetic processes that lead to observed developmental shape changes. Procrustes ANCOVA suggested sexually dimorphic patterns of facial shape development (p = 0.0036). The forehead was relatively contracted during development in both sexes. The glabella region was more anteriorly displaced in females due to expansion in the region laterosuperior to the eyes. Nasal protrusion increased with development, which was found to arise from local expansion in the nasal alae and columella. Local expansion in the upper and lower labial regions resulted in forward displaced lips in both sexes, with the effect more pronounced in males. The mentum was displaced more anteriorly in females due to comparatively more expanded mental regions with development. The lateral facial region corresponding to the underlying body of the mandible were developmentally expanded but were posteriorly positioned due to protrusive growth of surrounding structures. Generalised additive modelling of Procrustes variance suggested that facial variation decreased non-linearly with age (p < 0.05). Relative principal component analysis suggested that variations in facial outline shape were developmentally constrained, whereas nasolabial and mental regions, where developmental changes were significant, became morphologically diversified with development. In contrast to simple descriptive illustration of facial shape development, we gained transformative insights into patterns of facial shape development by analysing morphogenetic processes and variational properties. Our analytical framework is broadly applicable to morphometric studies on ontogenetic shape changes.

Determining Chin Dimensions for Feminizing Genioplasty: An Anatomic Study.

Feminizing genioplasty warrants chin modification to achieve feminine characteristics. This study compared female and male facial skeletal dimensions and shape to guide feminizing genioplasty. Skulls stored at the Cleveland Museum of Natural History were analyzed. Sex, age, and race were documented. Heights and widths of the face and chin were measured, normalized, and compared. Forty-three male (43.58±12.52-y-old) and 43 female (40.48±12.04-y-old) skulls were included. Within each group, 25 skulls were of African American (AA) origin and 18 were of Caucasian (C) origin. Absolute chin heights were larger in AA and C males compared with females (P<0.05). After normalization to lower facial height, there was a trend toward greater chin height in AA males compared with females (P=0.07). Parasagittal chin width in AA males was significantly larger than AA females (P=0.0006). Interforaminal chin width in C males trended toward being significantly larger than females (P=0.08). Following normalization of chin widths, no significant sex-based differences were noted for AA skulls except for the interforaminal/intergonial ratio, which was smaller in AA males (P=0.04). For C skulls, most normalized ratios were significantly smaller in males (P<0.05). C females had wider angles at the point of maximum chin projection (P=0.007) and wider symphyseal inclinations (P<0.0001). These differences were not present in AA skulls (P>0.05). Regardless of race, male chins appeared square, whereas female chins were round. While chin width reduction is not needed for most patients, height reduction could be considered. Chin contouring is the most central component of feminizing genioplasty.

Forensic facial identification – reconstruction of facial geometry and shape from dental dimensions

Human identification has always remained as a main task of forensic anthropology and forensic science for various purposes. The purpose of human identification may vary from legal identity to disaster victim identification, from criminal identity to unidentified deceased identification. The condition, such as putrefaction, charring and mutilation of corpse always become an obstacle during the process of identification. Due to surviving nature of teeth, they may serve as evidence for identification in highly decomposed conditions. Therefore, a cross-sectional study was conducted on 207 participants (93 males and 114 females) in the age range of 21 to 45 years with the aim of two-dimensional facial reconstruction. Dental casts, anthropometric facial measurements and facial photographs were obtained from the participants. Dental measurements were taken on the cast in the laboratory. Statistical analysis revealed a weak but statistically significant correlation between the dental and facial parameters. The geometrical faces and the shapes were reconstructed based on the dental dimensions. The reconstructed facial geometry and shapes were very similar to the true facial geometry and facial shapes of the individual. By improving identification of disaster victims and unidentified deceased, the results of the study can have considerable implications in forensic and medico-legal case-works.

Smart filtering facepiece respirator with self-adaptive fit and wireless humidity monitoring

The widespread emergence of airborne diseases has transformed our lifestyle, and respirators have become an essential part of daily life. Nevertheless, finding respirators that fit well can be challenging due to the variety of human facial sizes and shapes, potentially compromising protection. In addition, the current respirators do not inform the user of the air quality in case of continuous long-term use. Here, we introduce a smart filtering facepiece respirator incorporating a humidity sensor and pressure sensory feedback for self-fit adjusting and maintaining an adequate fit. The humidity detection sensor uses laser-induced graphene, and the pressure sensor array based on the dielectric elastomeric sponge monitors the respirator contact on the user's face, providing real-time closed-loop feedback and the wearer's fitting status. Those membrane sensors show outstanding performance, such as a low humidity hysteresis of 0.131 % and a precise pressure detection limit of 0.23 ± 0.02 kPa. As a result of the self-fit adjusting mode, the overall fit factor is increased by 10 % on average compared to the commercial respirator. This significant improvement in fit factor, coupled with the innovative design, has the potential to develop next-generation facepiece respirators as essential personal protective equipment.

The impact of breastfeeding on facial appearance in adolescent children.

Evidence that breastfeeding impacts the facial features of children is conflicting. Most studies to date have focused on dental and skeletal malocclusion. It currently remains unclear whether such effects are of sufficient magnitude to be detectable on outward facial appearance. Here, we evaluate the extent to which maternally reported breastfeeding is associated with 3D facial shape in a large adolescent cohort. After extracting 3D facial surfaces from MR scans in 2275 9- and 10-year-old children and aligning the surfaces in dense correspondence, we analyzed the effect of breastfeeding on shape as a dichotomous (no/yes) and semi-quantitative (to assess duration in months) variable using partial least squares regression. Our results showed no effect (p = 0.532) when breastfeeding was dichotomized. However, when treated as a semi-quantitative variable, breastfeeding duration was associated with statistically significant changes in shape (p = 3.61x 10-4). The most prominent facial changes included relative retrusion of the central midface, zygomatic arches, and orbital regions along with relative protrusion of forehead, cheek, and mandible. The net effect was that as breastfeeding duration increased, the facial profile in children became flatter (less convex). The observed effects on the face, however, were subtle and likely not conspicuous enough to be noticed by most observers. This was true even when comparing the faces of children breastfed for 19-24 months to children with no reported breastfeeding. Thus, breastfeeding does appear to have detectable effect on outward facial appearance in adolescent children, but its practical impact appears to be minimal.

Associations of Facial Shape With Physical Strength and 2D:4D in a Turkish Male and Female Sample.

Human sexual dimorphism in physical strength manifests itself in men having a greater muscle mass than women, reflecting ancestral roles in competition, protection, and provisioning. Prenatal testosterone exposure, approximated via the second-to-fourth digit ratio (2D:4D), is linked to increased muscular strength in both sexes, indicating a developmental influence. Previous research has shown that both physical strength and 2D:4D have facial shape correlates, especially in men, but most studies have focused on Western populations and one trait. We therefore hypothesized a broader relationship between facial shape and both physical strength and 2D:4D. In this study, we quantified the association between facial shape, handgrip strength (HGS), and 2D:4D in a non-Western Turkish sample (72 men, 55 women; Md = 22 y, SIR = 1.8 y) using two dimensional geometric morphometrics. Thirty-eight somatometric and 32 semi-landmarks were digitized on facial photographs taken in frontal view. Physical strength was assessed via handgrip strength (HGS), and the second digit length was divided by the fourth digit length to calculate 2D:4D. Both HGS and 2D:4D were significantly associated with shape in both sexes, but only in men did they explain a significant amount of facial variation. Thin-plates spline deformation grids and geometric morphometric morphs visualized the facial shape changes related to variations in handgrip strength, 2D:4D, and sexual dimorphism, enabling trait comparisons. This study contributes a comparative sample from the Middle East, which is indispensable to discern universalities from Western peculiarities. It provides evidence to better understand the biological basis of facial traits, which can potentially serve as increasingly relevant social cues in today's online and digital environments.

Face shape transfer via semantic warping

Face reshaping aims to adjust the shape of a face in a portrait image to make the face aesthetically beautiful, which has many potential applications. Existing methods 1) operate on the pre-defined facial landmarks, leading to artifacts and distortions due to the limited number of landmarks, 2) synthesize new faces based on segmentation masks or sketches, causing generated faces to look dissatisfied due to the losses of skin details and difficulties in dealing with hair and background blurring, and 3) project the positions of the deformed feature points from the 3D face model to the 2D image, making the results unrealistic because of the misalignment between feature points. In this paper, we propose a novel method named face shape transfer (FST) via semantic warping, which can transfer both the overall face and individual components (e.g., eyes, nose, and mouth) of a reference image to the source image. To achieve controllability at the component level, we introduce five encoding networks, which are designed to learn feature embedding specific to different face components. To effectively exploit the features obtained from semantic parsing maps at different scales, we employ a straightforward method of directly connecting all layers within the global dense network. This direct connection facilitates maximum information flow between layers, efficiently utilizing diverse scale semantic parsing information. To avoid deformation artifacts, we introduce a spatial transformer network, allowing the network to handle different types of semantic warping effectively. To facilitate extensive evaluation, we construct a large-scale high-resolution face dataset, which contains 14,000 images with a resolution of 1024 × 1024. Superior performance of our method is demonstrated by qualitative and quantitative experiments on the benchmark dataset.

A Novel Hybrid Injectable for Soft-tissue Augmentation: Analysis of Data and Practical Experience

Background: HA/CaHa (HArmonyCa, Allergan Aesthetics, an AbbVie Company) is a hybrid injectable filler developed for aesthetic purposes that contains calcium hydroxyapatite microspheres suspended in a hyaluronic acid gel. This review describes preclinical and clinical data, recommendations for use based on the primary author’s clinical experience, and case studies that illustrate implementation of product use recommendations and patient outcomes. Methods: Preclinical data on the lift capacity and tissue integration of the HA/CaHa hybrid injectable and clinical data on its safety, efficacy, and real-world use were extracted from poster presentations, published literature, manufacturer instructions for use, and proprietary data files. Case studies were presented based on clinical experience. Results: The HA component of HA/CaHa provides an immediate and noticeable filling and lifting effect, whereas CaHa microspheres result in neocollagenesis. In preclinical studies, HA/CaHa demonstrated higher lift capacity (P &lt; 0.05) and faster tissue integration than a CaHa filler and led to collagen I gene and protein expression. Clinical studies showed clinical safety and effectiveness with high patient satisfaction. The most common adverse event was injection-site response. Clinician recommendations for achieving desired aesthetic results while minimizing or preventing adverse events are reviewed, including patient selection and assessment, treatment approaches based on face shape, injection technique, and postprocedure care. Conclusion: The novel hybrid injectable consisting of HA with incorporated CaHa microspheres in a single marketed product may help achieve aesthetic goals by immediately restoring volume and potentially improving skin architecture and soft-tissue quality over time.

The Concept of Ideal Lips of Caucasian Female: An Anthropometric Analysis of the Lower Third of the Face.

The demand for lip-redefining procedures has been rising in recent years, thus creating the need for reliable and detailed reference sources on aesthetic female lips. This study investigates the morphology of the lower third of the face, including the lips and jawline, of attractive young Caucasian females. A semi-automatic photogrammetric analysis of the faces of professional female photograph models (n=400) of the Caucasian race aged 18-39 was performed. Angular, linear, and surface area parameters were evaluated. A graphical summarization of the average facial shape of all analyzed attractive females was generated as an average body contours (ABC) image. The height of the lower third of the face equaled 0.32 ± 0.02 of the total facial height. The average lip width was 48.06 ± 3.34mm. The upper vermilion height was found to be significantly lower than the lower vermilion height (6.47 ± 1.36 vs. 11.64 ± 1.46mm, p < 0.01). The lip obliquity angle was found to be 1.05° ± 0.79°. The area surface of the upper lip vermilion was considerably smaller than the vermilion of the lower lip (p < 0.01). This is one of the largest studies on attractive Caucasian females' lips and lower face morphology. The data it provides, including the graphical presentation of the aesthetic lower face as an ABC image, may provide physicians with valuable guidelines for lips rejuvenation and reconstruction procedures. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .