Facial Appearance Research Articles

Examining attitudes about the virtual workplace: Associations between zoom fatigue, impression management, and virtual meeting adoption intent.

Impression management is a crucial tactic within the workplace milieu. This study establishes a connection between impression management and the negative self-evaluation stemming from heightened self-monitoring during virtual meetings (VM), which manifests in the form of Zoom (VM) fatigue. We conducted a cross-sectional survey, by recruiting 2,448 U.S.-based workers. Our survey results revealed that facial appearance dissatisfaction is associated with VM fatigue, resulting in lower intention to adopt VM technologies due to decreased perceived usefulness of VM technologies. Furthermore, building upon the Uses and Gratification (UG) perspective and the assumptions of the Social Information Processing (SIP) theory and the Hyperpersonal Model, our findings illuminate that VM fatigue prompts the use of impression management behaviors by using VM features closely linked to dissatisfaction with one's facial appearance. The results suggest that utilization of impression management features in VMs is driven by needs related to facial appearance concerns, which is associated with impression management. This study extends the concept of impression management to VM environments in the workplace, underscoring the importance of addressing workers' needs and well-being to foster worker-friendly VM communication environments and promote VM acceptance. This study identifies external factors within the Technology Acceptance Model by integrating the UG perspective, the SIP theory, and the Hyperpersonal Model to understand the mechanisms underlying VM fatigue and adoption in the emerging virtual workplace.

An evaluation of the scapular osseous free flap in maxillary reconstruction using the FACE-Q Head and Neck Cancer Module for patient-reported outcome measures.

Health-related quality of life (HR-QoL) outcomes following maxillary reconstruction with the scapular osseous free flap (SOFF) are lacking. Material and Methods: To determine these outcomes, a study of patients who completed maxillary reconstruction with flap survival of the SOFF between 2016 and 2023 was conducted, using Face-Q Head and Neck Cancer Module (FACE-Q). Eligible patients had at least six months of follow-up. Twenty questionnaires were completed (100% response rate). Median age was 59 years, 80% were male, and 90% were being treated for malignant disease. Overall, best scores were reported in the facial appearance and experience of care domain. Furthermore, the worst scores were reported in the facial function domain. Subgroup analysis focused on the following three specific surgical outcomes; dental rehabilitation, oronasal fistula and eye-related problems. A better score, though non-significant, in facial function was recorded in the dental rehabilitation group, (70±23 vs. 40±34, p = 0.089). A tendency towards worse facial function regarding eating and drinking was noted in the fistula group (49±14 vs. 56±23, p = 0.468). Patients suffering from eye-related problems reported marginally worse facial appearance scores, (79±21 vs. 68±19, p = 0.289). In 20 patients who completed maxillary reconstruction with flap survival of the SOFF, the group reported the best scores in the facial appearance and experience of care domain.

O-12 A CASE OF DIABETES ASSOCIATED WITH A DE NOVO PAX4 MUTATION AND CONCURRENT SMAD6 GENE MUTATION

Abstract Introduction Monogenic diabetes constitutes approximately 1-5 % of all diabetes cases. While there is substantial information available about the more common MODY subtypes, the rarer subtypes remain much less understood. In this report, we present a rare case of diabetes with no family history, characterized by a pathogenic mutation in the PAX4 gene, which has been previously linked to MODY 9, along with a concurrent SMAD6 mutation. Clinical Case A 24-year-old male patient presented to our clinic for the management of diabetes mellitus. He was initially diagnosed with diabetes at the age of 17 and was initially managed with metformin alone. However, due to inadequate blood sugar control, basal insulin was later added to his treatment regimen. At his most recent visit, his treatment included a combination of sitagliptin+metformin (50/1000 mg, BID) and insulin glargine (16 units per day). His medical history revealed a childhood operation for congenital heart disease. Physical examination revealed nasal speech, a syndromic facial appearance (with downward-pointing ears and a flattened nasal root), and a limitation of internal rotation in the forearms. His BMI was 27.8 kg/m², and he had maintained a stable weight since the time of diagnosis. Laboratory evaluations revealed that anti-GAD was negative, with a C-peptide level of 0.6 ng/mL, HbA1c of 10.1%, and fasting blood glucose of 118 mg/dL. Kidney function tests and liver enzyme tests were within normal limits. Since diagnosis, HbA1c values have generally not been within the target range, fluctuating widely between 6.6% and 14%. The patient exhibited no microalbuminuria, no neuropathic findings, and no signs of retinopathy. Additionally, there was no family history of diabetes. Given the patient’s atypical diabetes history and syndromic findings, genetic analysis was undertaken. Whole exome sequencing, performed using next-generation sequencing, identified a PAX4 (c.1013C>T) mutation, which is potentially pathogenic (Figure 1 and Figure 2) and a homozygous pathogenic mutation in the SMAD6 gene. The patient’s diabetes history was attributed to the PAX4 gene mutation, which has been previously associated with MODY9, while the cardiac and extremity abnormalities were believed to be linked to the SMAD6 gene mutation. The 3D structures of the wild-type and mutant protein for PAX4 variant was predicted (Figure 2). Conclusion Diabetes cases resulting from PAX4 gene mutations are quite rare and often involve a form of diabetes that requires insulin. While most cases reported in the literature include a family history, there are instances, such as in our case, where a de novo mutation is identified. The presence of the SMAD6 gene mutation has contributed to the additional syndromic findings. Increasing the reporting of monogenic forms of diabetes, will enhance the recognition of diabetes-related genes and contribute to advances in understanding its etiopathogenesis.Figure 1-a:Visualization of the PAX4 c.1013C>T;p.A338V variant region using VarSome Figure 1-b:3D structures of PAX4 created using Swiss-Model and visualized with Chimera. A) Presents the mutated protein (Purple) superimposed on the WT protein (Pink). (B) The amino acid substitution is shown, with the wild-type amino acid in pink and the mutant amino acid in purple

Diagnosis and Management of Patients with Neglected Fractures of The Mandibular Parasymphysis : Case Report.

Introduction: Neglected mandibular fractures can interfere with mastication, swallowing, speech, and facial appearance. Neglected fractures also make treatment procedures difficult. Correct diagnosis and treatment are essential to prevent complications. Case report: A 22-year-old male patient came with a complaint of a fracture of the mandible, which was caused by a traffic accident about three weeks previously and had not been treated. The diagnosis, in this case, was a neglected fracture in the left mandibular parasymphysis region, with clinical symptoms of malocclusion characterized by an edge-to-edge incisor relationship and a cusp-to-cusp relationship of the right posterior teeth. The treatment carried out was ORIF with the installation of 2 titanium plates which had previously been refractured at the fracture line. Conclusion: Neglected mandibular fractures can occur due to slow or inappropriate treatment. In treating neglected fractures, refracturing is necessary to obtain optimal occlusion and function. ORIF treatment, in this case, is the treatment of choice with optimal results and minimal complications Keywords: mandibular fracture, parasymphysis, open reduction, neglected fracture

A Validated Cultural Adaptation and Translation of the CLEFT-Q Patient Reported Outcome Measure (PROM) from English into Italian

Cleft lip and/or palate (CL/P) is a prevalent congenital malformation, affecting approximately 1 to 7 children per 1000 live births, with consequences impacting both appearance and functional abilities such as speech, hearing, and orodental health. These factors contribute to significant psychological challenges and reduced quality of life (QoL) in affected individuals. Treatment typically involves a multidisciplinary approach that begins during pregnancy and continues into young adulthood, ideally managed by specialized centers with dedicated cleft teams. In Italy, the Cleft Center of Milan, part of the European Reference Network (ERN CRANIO), is a leading facility providing care for CL/P. International collaboration and standardized outcome measures, like Patient-Reported Outcome Measures (PROMs), are essential in ensuring high-quality patient-centered care. The CLEFT-Q is a widely used, CL/P-specific PROM developed to assess aspects of facial appearance, psychosocial well-being, and functional abilities. Though originally developed in English, the Cleft Center of Milan, along with ERN CRANIO, undertook the translation and validation of the CLEFT-Q into Italian to enable its implementation in Italy. The translation process adhered to the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines and included expert review, patient interviews, and adjustments based on participant feedback. The study confirmed the effectiveness of the CLEFT-Q in capturing relevant patient-reported outcomes in Italian-speaking populations. It also highlighted the importance of standardized PROMs in improving CL/P treatment outcomes and facilitating international research collaboration. The paper concludes with recommendations for the integration of PROMs in CL/P care and explores alternative PROMs, such as the Pediatric Quality of Life Inventory (PedsQL) and the Cleft Hearing, Appearance, and Speech Questionnaire (CHASQ), which could complement the CLEFT-Q for more comprehensive patient assessments.

Endoscopic-Assisted Mandibular Angle Revision Using Patient-Specific PEEK Implants: Surgical Accuracy and Aesthetic Outcomes in Over-Resected Mandibles.

Mandibular angle osteotomy (MAO) is a popular procedure to improve facial aesthetics, however, over-resection of the mandibular angle can lead to both functional and aesthetic challenges. Precision is essential in restoring these over-resected mandibles to achieve balanced outcomes. Polyetheretherketone (PEEK) implants offer biocompatibility, durability, and customization potential, making them valuable for achieving precise and predictable results. This study examines the efficacy of PEEK patient-specific implants (PSIs) in endoscopic-assisted mandibular angle revision (MAR) surgery, assessing improvements in surgical accuracy and aesthetic outcomes. We retrospectively analyzed 24 patients (39 mandibles) who underwent MAR from January 2019 to December 2023. Surgical accuracy was measured by comparing planned and achieved PSI positions using root mean square error (RMSE) and maximum deviation (MaxD). Patient satisfaction was assessed using the FACE-Q questionnaire, administered preoperatively and at least six months postoperatively, with correlations drawn between implant fit accuracy and FACE-Q scores changes. The average RMSE ranged from 0.1166 to 0.3149mm, with 96% of PSIs showing deviations under 0.3 mm. FACE-Q scores for lower facial appearance and psychological well-being improved significantly, form 42.50 ± 5.28 to 56.08 ± 4.58 and 61.50±4.31 to 70.58 ± 6.46, respectively. A strong negative correlation was observed between implant fit accuracy (RMSE, MaxD) and FACE-Q score improvements related to appearance. Endoscopic-assisted MAR with PEEK PSIs offers precise correction and significant aesthetic improvements for patients with over-resected mandibles. This technique demonstrated high surgical accuracy and favorable patient-reported outcomes. Future studies on a larger scale are recommended to validate these findings. 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.

Early menarche is associated with disordered eating-results from a National Youth Survey.

Disordered eating (DE) is highly prevalent among adolescents, though its definition varies. The association between DE and early pubertal maturation (EPM) remains underexplored in Israel, and has not been sufficiently examined using the widely-used SCOFF questionnaire. This study examines these associations in adolescents. Participants (n = 2415 girls, 2095 boys; ages 12-18 years) in a nationally-representative, cross-sectional Youth Health and Nutrition Survey (2015-2016) completed self-administered questionnaires, including the SCOFF questionnaire, and underwent anthropometric measurements. EPM was determined by menarcheal age <11.5 years in girls, and facial hair appearance <12.5 years in boys. Respondents affirming ≥2 SCOFF items were classified as DE cases. Multivariable logistic regression analyses examined the associations between EPM and DE. Among the participants, 12.7% of the girls and 20.4% of the boys met EPM criteria; 55.5% and 33.7%, respectively, were categorized as having DE. Following adjustment for age, socioeconomic status, ethnic background, and weight status, EPM was significantly associated with DE in girls (OR 1.47, 95%CI: 1.12-1.93) and with 3/5 SCOFF items. No such association was found in boys (OR 1.00, 95%CI: 0.77-1.28). EPM in girls was associated with DE. Identifying high risk groups for DE in adolescents is crucial for early intervention and prevention. This study included a large, nationally representative sample of Israeli adolescents and utilized the SCOFF questionnaire, a widely used screening measure for disordered eating (DE). Following comprehensive analyses, a significant association between early pubertal maturation (EPM), defined as early menarche, and DE was documented in Israeli adolescent girls. Identifying girls with EPM and screening for disordered eating will allow for early interventions, potentially improving physical and mental health, and preventing progression to eating disorders.

Posterior lateral perforator flap in lower limb combined with free fibula for maxillary tissue defect repair

To investigate the effectiveness of posterior lateral perforator flap in lower limb combined with free fibula for maxillary tissue defect repair. Between December 2018 and December 2023, 16 patients with the maxillary malignant tumors were admitted. There were 10 males and 6 females, with an average age of 64.3 years (range, 54-75 years). There were 7 cases of maxillary gingival cancer, 5 cases of hard palate cancer, and 4 cases of maxillary sinus cancer. According to the 2017 American Joint Committee on Cancer (AJCC) TNM stage, there were 8 cases of stage Ⅲ, 6 cases of stage Ⅳa, and 2 cases of stage Ⅳb. After resection of the lesion, the remaining maxillary defects were classified into class Ⅱa in 3 cases, class Ⅱb in 5 cases, and class Ⅲb in 8 cases according to Brown's classification. The size of soft tissue defects ranged from 4 cm×3 cm to 8 cm×6 cm. The posterior lateral perforator flap in lower limb in size of 5 cm×4 cm-9 cm×7 cm were harvested to repair soft tissue defects, and free fibula in length of 6-11 cm were used to repair bone defects. The donor sites of the lower limb were sutured directly (6 cases) or repaired with free skin grafting (10 cases). Six patients with positive lymph node pathology were treated with radiotherapy after operation. At 6 and 12 months after operation, the self-assessment was performed by the University of Washington Quality of Survival Questionnaire Form (QUW-4) in five dimensions (facial appearance, swallowing function, chewing function, speech function, and mouth opening), and swallowing function was evaluated by using the Kubota water swallowing test. Postoperative pathological examination showed that all patients were squamous cell carcinoma. One patient who was treated with radiotherapy developed osteomyelitis and 1 patient developed venous crisis of skin flap. The rest of the flaps and all skin grafts survived, and the wounds healed by first intention. All patients were followed up 1-5 years (mean, 2.8 years). Two patients died of local recurrence of the tumor at the 4th and 5th years after operation, respectively. Except for the chewing function score and total score at 6 months after operation, which showed significant differences compared to preoperative scores ( P<0.05), there was no significant difference in other QUW-4 scale scores between different time points ( P>0.05). The patients' swallowing function evaluated by Kubota water swallowing test reached normal in 4 cases, suspicious in 9 cases, and abnormal in 3 cases at 6 months after operation, and 10, 6, and 0 cases at 12 months after operation, respectively. The swallowing function at 12 months was significantly better than that at 6 months ( Z=-2.382, P=0.017). The posterior lateral perforator flap in the lower limb combined with free fibula to repair maxillary tissue defects can repair soft and hard tissue defects at the same time, so that the patient's facial appearance, swallowing function, chewing function, speech function, and mouth opening are satisfactorily restored and the mid-term effectiveness is good.

A Prospective Comparison of Patient Reported Outcomes After Facial Laser Resurfacing.

Laser resurfacing provides a minimally invasive method for addressing facial/neck skin rejuvenation neglected by modern surgical approaches. Despite its popularity, there is a paucity of outcome data. Herein, we present patient reported outcomes (PROs) to assess the effectiveness of a single surgeon's approach to skin rejuvenation. Adult patients undergoing first-time facial laser resurfacing (with broadband light and hybrid Er:YAG/thulium laser or hybrid thulium fractional laser alone) between March 2023 - February 2024, performed by the senior author (GG) and laser specialist (Registered Nurse: RN (LS)), were prospectively analyzed. Patient demographics, laser technique/settings, prophylactic medication, and post-procedure management were collected. PROs were assessed during early and late recovery periods, using 10 FACE-Q surveys related to appearance, health-related quality of life (HRQOL), and adverse effects. A paired student's t-test compared pre- and post-treatment responses. A total of 71 (69 female, two male) patients were identified. The mean age was 56 years [40-78]. Most (>50%) patients experienced tightness, swelling, tenderness, discomfort, and burning in the early recovery period, that dissipated over time. Post-procedure facial (p < 0.001) and skin (p < 0.001) appearance scores improved significantly, whereas that of facial lines insignificantly improved (p = 0.053). Overall, most patients were satisfied with the treatment outcome and their decision to undergo laser resurfacing. Patients were highly satisfied with both the decision to undergo the procedure and the outcome, particularly in facial appearance and HRQOL. They experienced minimal adverse effects in the early recovery period that dissipated over time.

Improvement in Temple Hollowing with VYC-20L Hyaluronic Acid Filler: A Multicenter, Randomized Controlled Trial of Safety and Effectiveness.

Temple hollowing is characterized by the reduction of volume in the temporal fossa, which can result in a skeletonized look and contribute to an aged appearance. This study aimed to evaluate the safety and effectiveness of the VYC-20L injectable gel for improvement of temple hollowing. Adults with minimal, moderate, or severe temple hollows were randomized 2:1 to receive VYC-20L or no treatment. Participants were followed for 13 months for safety and effectiveness assessments. Treatment effectiveness was assessed by blinded evaluating investigators using the validated Allergan Temple Hollowing Scale (ATHS) and the Global Aesthetic Improvement Scale (GAIS), and by participants using GAIS, FACE-Q scales, and patient satisfaction questionnaires. Adverse events and injection site responses (ISRs) were monitored. At Month 3, 80.4% of the treatment group vs 13.5% of the untreated control group achieved a ≥1-grade improvement in both temples on the ATHS (P < 0.0001). The ATHS responder rate remained high throughout Month 13. The GAIS responder rates at Month 3 (responses of Improved or Much improved) were high in the treatment group, as assessed by the blinded evaluating investigator (83.8%) and participants (92.9%). Furthermore, satisfaction with Facial Appearance and Temples on the FACE-Q questionnaires increased significantly from baseline (both P < 0.0001). Adverse events and ISRs were mostly mild and consistent with the known safety profile of fillers. VYC-20L treatment showed favorable safety and effectiveness results in restoring temple volume, with significant aesthetic improvement and high participant satisfaction. Treatment effects lasted for over a year.

Canada HARMONY Study: Improvements in Patient Satisfaction With Facial Appearance and Psychological Impact of Combined Aesthetic Treatment

Abstract Background Panfacial treatment has the potential to positively impact psychosocial and emotional well-being. Objectives The Canada HARMONY study evaluated the satisfaction and psychosocial impact of comprehensive, multimodal aesthetic treatment of the face and submental area from the patient perspective. Methods Over 12 months, all patients (N=58) sequentially received treatment with hyaluronic acid (HA) fillers, onabotulinumtoxinA, and medical-grade skincare products, and eligible patients (n=13) also received ATX-101. The primary endpoint was the change from baseline on the FACE-Q Satisfaction with Facial Appearance Scale. Secondary endpoints included the following assessments: FACE-Q Expectations of Life Change, Psychological Function, Social Function, Satisfaction with Skin, and Aging Appraisal Scales; Global Aesthetic Improvement Scale (GAIS); and the Periorbital Aesthetic Appearance Questionnaire (PAAQ). Safety was monitored throughout the study. Results Baseline FACE-Q Expectations of Life Change scores indicated realistic treatment expectations. Significant improvements from baseline were observed on the FACE-Q Satisfaction with Facial Appearance, Psychological Function, Social Function, Satisfaction with Skin, and Aging Appraisal Scales (P &amp;lt; 0.0001 for all endpoints). Most patients rated “Much Improved” on the GAIS. The mean PAAQ total score significantly improved from baseline by 32.6 (P &amp;lt; 0.0001). Most patients reported mild to moderate injection site responses, which had a mean time to resolution of &amp;lt;14 days. Conclusions Panfacial aesthetic treatment consisting of HA fillers, onabotulinumtoxinA, and ATX-101 improved patient-reported satisfaction, psychological function, social function, and aging appraisal across validated measures.

The influence of repeated frowning and smiling on corrugator muscle activity and wrinkles between eyebrows

Like the lines themselves, concerns about facial wrinkles, particularly glabellar lines - the prominent furrows between the eyebrows - intensify with age. These lines can inadvertently convey negative emotions due to their association with negative facial expressions. We investigated the effects of repeated frowning on the development of temporary glabellar lines through the activation of the corrugator muscle. In addition, as communication via facial expressions requires precise control over the muscles of the face in such a way as to avoid contradictory signals, we hypothesized that smiling and activation of the zygomatic major may inhibit the corrugator. Our findings reveal that repeated frowning creates temporary wrinkles between the eyebrows, caused by the slight but cumulative activation of the corrugator muscle. Further we found that the act of smiling activates zygomatic major and suppresses the corrugator reducing the appearance of glabellar lines. The results offer a novel perspective on smiling and suggests that smiling not only facilitates positive emotional exchanges but may also help maintain a youthful facial appearance.

Face Boundary Formulation for Harmonic Models: Face Image Resembling.

This paper is devoted to numerical algorithms based on harmonic transformations with two goals: (1) face boundary formulation by blending techniques based on the known characteristic nodes and (2) some challenging examples of face resembling. The formulation of the face boundary is imperative for face recognition, transformation, and combination. Mapping between the source and target face boundaries with constituent pixels is explored by two approaches: cubic spline interpolation and ordinary differential equation (ODE) using Hermite interpolation. The ODE approach is more flexible and suitable for handling different boundary conditions, such as the clamped and simple support conditions. The intrinsic relations between the cubic spline and ODE methods are explored for different face boundaries, and their combinations are developed. Face combination and resembling are performed by employing blending curves for generating the face boundary, and face images are converted by numerical methods for harmonic models, such as the finite difference method (FDM), the finite element method (FEM) and the finite volume method (FVM) for harmonic models, and the splitting-integrating method (SIM) for the resampling of constituent pixels. For the second goal, the age effects of facial appearance are explored to discover that different ages of face images can be produced by integrating the photos and images of the old and the young. Then, the following challenging task is targeted. Based on the photos and images of parents and their children, can we obtain an integrated image to resemble his/her current image as closely as possible? Amazing examples of face combination and resembling are reported in this paper to give a positive answer. Furthermore, an optimal combination of face images of parents and their children in the least-squares sense is introduced to greatly facilitate face resembling. Face combination and resembling may also be used for plastic surgery, finding missing children, and identifying criminals. The boundary and numerical techniques of face images in this paper can be used not only for pattern recognition but also for face morphing, morphing attack detection (MAD), and computer animation as Sora to greatly enhance further developments in AI.

Clinical and patient-reported outcomes between full-endoscopic and conventional parotidectomy: a prospective cohort study.

This study investigates the clinical and patient-reported outcomes of full-endoscopic parotidectomy compared to the conventional approach. Between July 2021 and December 2023, patients who underwent parotidectomy were prospectively enrolled and assigned to either the full-endoscopic parotidectomy group (Group I) or the conventional surgery group (Group II). Clinical outcomes were evaluated, and patient-reported outcomes were assessed using a Visual Analogue Scale and five FACE-Q scales. A total of 293 patients were prospectively included, with 146 in the full-endoscopic group and 147 in the conventional group. Blood loss was significantly lower in the full-endoscopic group (regression coefficient, 0.61; 95% CI, 0.15 to 1.07), as was the rate of immediate facial paralysis (0.76; 95% CI, 0.25 to 1.27). The full-endoscopic group also showed superior outcomes on the Visual Analogue Scale (- 0.14; 95% CI, - 0.23 to - 0.05) and FACE-Q scales for Appearance-Related Psychosocial Distress (1.15; 95% CI, 0.59 to 1.71), Social Function (- 0.37; 95% CI, - 0.59 to - 0.15), Satisfaction with Facial Appearance (- 0.44; 95% CI, - 0.64 to - 0.23), Psychological Function (- 0.39; 95% CI, - 0.58 to - 0.20), and Satisfaction With Outcome (- 0.42; 95% CI, - 0.66 to - 0.19). Full-endoscopic parotidectomy yields less blood loss and a reduced incidence of immediate facial paralysis compared to conventional surgery. Patients undergoing full-endoscopic parotidectomy reported better aesthetic and psychological outcomes. The combined analysis of clinical and patient-reported outcomes is valuable in guiding surgical planning. These findings provide valuable insights for patients considering full-endoscopic parotidectomy and underscore the importance of addressing functional, aesthetic, and psychological aspects for both patients and healthcare providers.

Fear in Beauty: Sylvia Plath’s Reflections in Mirror

This research aims to explore the role of fear and its outcome in the quest for beauty in Sylvia Plath’s poem “Mirror”. Beauty has been defined as the source of power as well as the cause of the annihilation of the entire civilization. Internal beauty has a superior role to external beauty. The persona of the poem has been found engaged in the quest for external beauty even in her old age which is unnatural and worthless. Extreme fear has acted negatively and devastatingly to ruin the life of the persona of the poem. It has led the speaker of the poem hopelessness of life and depersonalized condition which compelled her to commit suicide. The role of fear must be focused on the balance form of fear to maintain and achieve the goal in life. Otherwise, fear’s role and its effect tend to be detrimental and destructive to reaching the destination of keeping beauty, peace, and harmony in life. It has been analyzed how fear has acted and affected the life of Sylvia Plath due to extreme fear in beauty’s quest in old age.The original lines of the poem have been adopted as the primary data and analyzed with the support of secondary articles and journals produced on the poem. The speaker’s fear in the poem “Mirror” has been explored in various forms and such fears have been found to be acting actively in the psyche of the speaker in losing her charming facial appearance of her own youth.

Ultrasonographic study and anatomical guidelines for botulinum neurotoxin injection into the parotid gland.

Benign enlargement of the parotid gland hypertrophy results in a bulky lateral facial contour and esthetic appearance. This study aimed to determine the depth from the skin surface to the parotid fascia, which encompasses the parotid gland. The anatomical properties of the parotid glands were evaluated in 40 patients using ultrasonography. An up-to-date understanding of the localization of botulinum neurotoxin (BoNT) injection based on anatomy could lead to better localization of the injection into the parotid gland through morphological measurements using data previously published from cadaveric studies. Measurement using the otobasion inferius as a landmark revealed parotideomasseteric fascia thickness averaging 4-6 mm from the skin surface, with the parotid gland extending approximately 15 mm anteriorly. Analysis showed a 3-7 mm thickness range, indicating an optimal injection depth for safety and efficacy in BoNT procedures. Utilizing the otobasion inferius as an anatomical landmark offers a practical approach for measuring parotideomasseteric fascia thickness, addressing cadaveric study limitations. These guidelines aim to maximize the effects of BoNT therapy, which can be useful in clinical settings, by minimizing its deleterious effects.

Delivering an Inclusive Experience for Patients of All Genders in the Aesthetics Practice: A Roundtable Discussion

Abstract Background Transgender, nonbinary, and gender diverse individuals represent a growing proportion of patients desiring minimally invasive aesthetic treatments to enhance facial appearance. While awareness of the need for gender-affirming care is increasing and resources are available on approaches to injection in gender-diverse individuals, guidance on how to best provide this care is lacking. Objectives To share recommended practices for aesthetic clinicians who wish to treat transgender, nonbinary, and gender diverse individuals or wish to improve gender inclusivity within their aesthetic practices. Methods As part of a continuing medical education activity, the authors participated in a roundtable discussion on how individual practices can support inclusive care for transgender, nonbinary, and cisgender patients. Results A thorough understanding of vocabulary in support of gender diversity can help to improve clinician confidence and the patient experience. Consideration of clinic design, including the use of gender-neutral bathrooms and the display of gender diversity in advertisements or clinic artwork, can also support a gender-inclusive and welcoming environment. The use of correct pronouns and gender-neutral language by all clinic staff and clinicians as well as a thoughtful approach to language used on intake forms may also help to provide an inclusive and safe space for the transgender, nonbinary, and gender-diverse community. Conclusions Inclusive and gender-affirming healthcare improves the mental health and wellbeing of transgender, nonbinary, and gender-diverse populations. Individual aesthetic clinicians can improve inclusivity by considering their advertising, clinic design, intake forms as well as their consultation, treatment, and follow-up practices.

Literature review of indirect veneers as an esthetic alternative in worn anterior teeth

Veneers are reconstructive and esthetic procedures designed to improve dental harmony and facial appearance, mainly in the anterior area of the oral cavity. A wide variety of veneers and treatment methods are available on the market, with indirect veneers being the most common. Among these are ceramic veneers, such as the so-called “contact lenses” and “micro veneers,” which are minimally invasive treatments due to their reduced thickness, ranging from 0.3 mm to 0.8 mm. This article, based on a literature review with a qualitative, descriptive and cross-sectional approach, aims to identify the optimal treatment using veneers, analyzing their benefits for patients with dental alterations that negatively impact on their emotional state and self-esteem

Novel Plating System Designed Specifically for Chin Narrowing Surgery.

Chin narrowing surgery also described as T-shape genioplasty is a procedure commonly performed in South Korean females, as well as, transgender females as it provides more triangle and feminine appearance of the lower face. It requires segmentation of the chin and that is more challenging than classic sliding genioplasty, which is commonly performed in the correction of retro or progenia. This article describes the utility of the new concept of a t-shape genioplasty plate that reduces the time of operation and minimizes typical complications of this procedure such as postoperative chin asymmetry or inadequate adhesion between bone segments.

Phase 1 study of AYP-101 (soybean phosphatidylcholine): safety, pharmacokinetics, and lipid profile effects for reducing submental fat

BackgroundExcessive submental fat under the chin is a known aesthetic concern because of its negative impact on facial appearance and psychological well-being. AYP-101 is a newly developed injectable agent containing 93% soybean phosphatidylcholine (SPC) designed to reduce submental fat. We conducted a phase 1 study to evaluate the safety, pharmacokinetic (PK), and lipid profile effects of AYP-101.MethodsThis study was a randomized, double-blind, placebo-controlled, single-dose, two-cohort trial. Participants were randomized into groups receiving 250 mg of AYP-101, 500 mg of AYP-101, or placebo at a 9:9:8 ratio across both cohorts. Safety was assessed through standard clinical evaluations. Blood samples were collected up to 144 h postdose in cohort 1 and up to 48 h postdose in cohort 2. The PK parameters were calculated via noncompartmental analysis.ResultsAll 26 randomized subjects completed the study. A total of 72 solicited adverse drug reactions (ADRs) were reported by 24 subjects, all of which were mild. The most common ADRs were injection site pain and bruising. There were 29 ADR cases in the 250 mg group; 26 cases in the 500 mg group; and 18 cases in the placebo group, indicating that there were no clinically significant differences in the safety profiles between the groups. All the dose groups presented similar PK profiles, with Cmax values of 12.86, 13.44, and 13.61 µg/L and AUC0−24 h values of 278.06, 274.79, and 267.63 µg*h/L, respectively. No clinically significant differences in PK or lipid profiles were observed between the postdose group and the baseline group for any of the dose groups.ConclusionsAYP-101 appears to be a safe candidate for treating submental fat, with localized reactions and no systemic exposure at single subcutaneous doses of up to 500 mg.Trial registrationClinicalTrials.gov NCT05476094.