Minor Asymmetries Research Articles

Exploring Nasal Wall Cartilage Asymmetry in Rhinoplasty: Implications for Postoperative Symmetry.

Facial symmetry is prized for its association with health, genetic quality, and attractiveness, but minor asymmetries are common. Human asymmetry tends to favor the left side and is noticeable in various nose parts. However, the discrepancy in cartilage thickness between the nose's right and left sides remains understudied. This cross-sectional study involved 60 patients undergoing primary open rhinoplasty. During routine rhinoplasty Procedure, upper and lower lateral cartilage strips were excised from each patient, yielding four tissue samples. Tissue thickness and width were measured using a microscope stage calibration slide. This approach systematically assessed left and right cartilage thickness differences in primary open rhinoplasty patients, offering insights into nasal asymmetry and potential surgical implications. Out of 60 patients, 43 were female (72%) and 17 were male (28%). The mean thickness of upper lateral (UL) cartilage was 0.53mm on the right and 0.54mm on the left side (P value= 0.52). For lower lateral (LL) cartilage, the mean thickness was 0.50mm on the right and 0.54mm on the left side (P value < 0.001), indicating significant left-sided dominance. This dominance was consistent across both sexes. Our study highlights the significance of addressing subtle nasal cartilage asymmetries to improve postoperative symmetry. Modifying nasal cartilage microstructures during rhinoplasty can enhance both aesthetic and functional outcomes. 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 .

Composite Sling: A Strategy for Enhancing Inferolateral Support in Mastopexy with Implant.

Augmentation mastopexy has attracted the attention of numerous authors seeking to improve surgical outcomes and ensure breast implant stability. The utilization of the dual plane technique with a lateral sling, pioneered by Ono and Karner, has demonstrated effectiveness in providing long-term implant support. However, challenges arise in cases of anatomical variations, such as a short pectoralis major (PM) muscle or chest, necessitating alternative approaches like the composite sling. This study presents a technique designed to elongate and broaden the lateral sling to enhance implant support. The composite sling incorporates components from the abdominal part of the PM muscle, the aponeurotic/muscular part of the external oblique muscle, and the cranial part of the rectus abdominis. Procedures were performed on 29 patients using the composite sling technique from July 2022 to October 2023. The follow-up period ranged from 6 to 18 months (average of 11.89 months). The lateral sling approach was successfully extended to cases with a short PM muscle or chest, previously managed using the dual plane technique without inferolateral support. No increase in complications or implant displacements was observed compared with the original lateral sling approach. However, four reoperations addressed issues such as dog ears, scarring, and minor asymmetries. Consistent results were observed throughout the follow-up period, particularly in maintaining upper pole fullness and preventing lower pole ptosis. The composite sling approach provides a viable solution for cases where the original sling technique is impractical. Its implementation could broaden surgical options and optimize results, particularly in cases of unfavorable anatomy.

Dual-Plane Midface Lift Through Transoral and Transtemporal Approach.

The surge in the popularity of midface and temporal lifting procedures can be attributed to evolving social media trends and heightened patient expectations, particularly among younger individuals seeking "beautification" rather than traditional rejuvenation. Scarless techniques, such as transtemporal/transoral approaches, are increasingly preferred. This study aimed to combine the advantages of both superficial and deep dissection planes in midface and temporal lifting procedures. This retrospective study included 184 patients who underwent surgery using a dual-plane midface and temporal lift technique. Preoperative and postoperative assessments, including P1/P2 ratio calculations, were performed to evaluate volumetric distribution in the midface. The study cohort exhibited a significant improvement in the P1/P2 ratio postoperatively (p < 0.05), indicating successful volume redistribution. Complications, including hypoesthesia, bruising, and infection, were managed effectively. Minor asymmetries were observed, with revisions offered, but declined by the patient. This technique offers hidden incisions and reduces the risk of scar-related complications, making it suitable for patients seeking facial enhancement. Addressing the tear trough area and the lateral canthus provides comprehensive facial rejuvenation. The dual-plane approach facilitates both skin mobilization and volume shift, yielding favorable aesthetic outcomes. The dual-plane midface and temporal lift technique presented in this study offers a bi-vectoral approach to midfacial lifting, suitable for both beautification and rejuvenation goals. Despite the potential limitations, including infection risk, this method is an effective option for facial enhancement. 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 .

Asymmetries of foot strike patterns during running in high-level female and male soccer players

BackroundFoot strike pattern (FSP) is defined by the way the foot makes initial ground contact and is influenced by intrinsic and extrinsic factors. This study investigated the effect of running speed on asymmetries of FSP.MethodsSeventeen female and nineteen male soccer players performed an incremental running test on an instrumented treadmill starting at 2.0 m/s until complete exhaustion. Force plate data were used to categorize foot strikes into rearfoot (RFS) and non-rearfoot strikes. Additionally, peak vertical ground reaction force (peakGRF) and stride time were calculated. The symmetry index (SI) was used to quantify lateral asymmetries between legs.ResultsThe SI indicated asymmetries of the rate of RFS (%RFS) of approximately 30% at slow running speed which decreased to 4.4% during faster running speed (p = 0.001). There were minor asymmetries in peakGRF and stride time at each running stage. Running speed influenced %RFS (p < 0.001), peakGRF (p < 0.001) and stride time (p < 0.001). Significant interaction effects between running speed and sex were shown for %RFS (p = 0.033), peakGRF (p < 0.001) and stride time (p = 0.041).ConclusionFSP of soccer players are asymmetric at slower running speed, but symmetry increases with increasing speed. Future studies should consider that FSP are non-stationary and influenced by running speed but also differ between legs.

Designing Ecological Auditory Feedback on Lower Limb Kinematics for Hemiparetic Gait Training.

Auditory feedback has earlier been explored as a tool to enhance patient awareness of gait kinematics during rehabilitation. In this study, we devised and tested a novel set of concurrent feedback paradigms on swing phase kinematics in hemiparetic gait training. We adopted a user-centered design approach, where kinematic data recorded from 15 hemiparetic patients was used to design three feedback algorithms (wading sounds, abstract, musical) based on filtered gyroscopic data from four inexpensive wireless inertial units. The algorithms were tested (hands-on) by a focus group of five physiotherapists. They recommended that the abstract and musical algorithms be discarded due to sound quality and informational ambiguity. After modifying the wading algorithm (as per their feedback), we conducted a feasibility test involving nine hemiparetic patients and seven physiotherapists, where variants of the algorithm were applied to a conventional overground training session. Most patients found the feedback meaningful, enjoyable to use, natural-sounding, and tolerable for the typical training duration. Three patients exhibited immediate improvements in gait quality when the feedback was applied. However, minor gait asymmetries were found to be difficult to perceive in the feedback, and there was variability in receptiveness and motor change among the patients. We believe that our findings can advance current research in inertial sensor-based auditory feedback for motor learning enhancement during neurorehabilitation.

The mediating role of oil price in the export-exchange rate nexus for selected African economies: Evidence from MATNARDL model

This research investigates the potential influence of extreme exchange rate asymmetry on export commerce using the instance of leading oil and non-oil exporting African economies, namely Nigeria, Ghana, Congo, Gabon, Algeria, and Morocco, within the context of MANTARDL. In addition, the analysis disentangled the positive (appreciation) and negative (depreciation) components of the exchange rate to explore if exchange rate considerations show a differential effect on the export trade. The findings for the six countries are different depending on whether the currency rate is flexible, fixed, or managed. According to MATNARDL's results, an inverted J-curve may be seen in both Nigeria and Ghana. As an additional note, (minor, moderate and major) asymmetries in exchange rate modeling nexus in oil-exporting countries in the African continent should not be neglected. Acceptable policy suggestions are provided in the main text of the work.

The Evolutionary Principles of the Attractiveness of Symmetry and Their Possible Sustainability in the Context of Research Ambiguities

Symmetry belongs to one of the basic principles of the beauty of human and non-human objects since antiquity. Even though its significance has been verified by numerous theories and research studies, there is a number of papers suggesting that this principle may be false. The study identifies five major evolutionary principles, in the context of new approaches and research ambiguities based mainly on neuroscience and evolutionary psychology, that support the thesis that highlights the significance of symmetry in the perception and assessment of attractiveness: 1. symmetry as an honest signal of various health characteristics; 2. symmetry as proof of developmental stability; 3. effectiveness; 4. comprehensibility; 5. predictability. In the context of the mechanisms described above it also seeks possible explanations for the existence of contradictory research results related to the attractiveness of symmetry. The outcome of the study is the postulation of three hypotheses: 1. the naturalness hypothesis (symmetry is only attractive to the same degree that it naturally occurs in the subject); 2. the accent hypothesis (minor asymmetries do not disprove the principles of symmetry, they make them more visible); 3. the ecology hypothesis (the attractiveness of symmetry is conditioned by the situation and depends on the type of subject assessed) that allow us to integrate both past and contemporary (and putatively contradictory) research findings. The paper also provides proposals for the verification of the postulated hypotheses.

Kinematics of molecular gas in star-forming galaxies with large-scale ionized outflows

ABSTRACT We investigate the kinematics of the molecular gas in a sample of seven edge-on (i &amp;gt; 60°) galaxies identified as hosting large-scale outflows of ionized gas, using ALMA CO(1–0) observations at ∼1 kpc resolution. We build on Hogarth et al., where we find that molecular gas is more centrally concentrated in galaxies which host winds than in control objects. We perform full three-dimensional kinematic modelling with multiple combinations of kinematic components, allowing us to infer whether these objects share any similarities in their molecular gas structure. We use modelling to pinpoint the kinematic centre of each galaxy, in order to interpret their minor- and major-axis position velocity diagrams (PVDs). From the PVDs, we find that the bulk of the molecular gas in our galaxies is dynamically cold, tracing the rotation curves predicted by our symmetric, rotation-dominated models, but with minor flux asymmetries. Most notably, we find evidence of radial gas motion in a subset of our objects, which demonstrate a characteristic ‘twisting’ in their minor-axis PVDs generally associated with gas flow along the plane of a galaxy. In our highest S/N object, we include bi-symmetric radial flow in our kinematic model, and find (via the Bayesian Information Criterion) that the presence of radial gas motion is strongly favoured. This may provide one mechanism by which molecular gas and star formation are centrally concentrated, enabling the launch of massive ionized gas winds. However, in the remainder of our sample, we do not observe evidence that gas is being driven radially, once again emphasizing the variety of physical processes that may be powering the outflows in these objects, as originally noted in H21.

Non-surgical Rhinoplasty and Use of Hyaluronic Acid Based Dermal Filler-User Experience in Few Subjects.

This study was intended to assess the utility of hyaluronic acid dermal fillers in patients who do not wish surgery in addition to the patients with minor post-surgery asymmetries. This was a prospective study which included post-surgery patients for minor nasal asymmetries, patients unwilling for surgery and those waiting for revision surgery. It is of great use in candidates who do not wish surgery but had the desire for different nasal appearance especially for important life events like marriage etc. This study included 20 patients with follow up period of 18months. The results were compared on Nasal Imperfection Scale and Rhinoplasty Outcome Evaluation along with pre and post injection photographs. Nasal Imperfection Scale difference of 5 and Rhinoplasty Outcome Evaluation Scale differential of 50 is considered to be significant, which was observed in all individual cases. The growing need of medical rhinoplasty by the patient as well as surgeons has led to the introduction of fillers. Hyaluronic acid fillers are safe, easy and effective dermal fillers for patients undergoing all the expected indications of medical rhinoplasty. There is also growing number of candidates who wish for a 'nose job' for desired changes without coming under surgeon's scalpel. Our clinical experience with 20 patients has been described with satisfactory results.

Adjustable Ptosis Correction via Posterior Levator Advancement With Minimal Superior Tarsectomy.

To report the surgical technique and outcomes for adjustable ptosis correction using a posterior levator advancement with minimal superior tarsectomy. A retrospective single-center study was conducted on patients who underwent adjustable ptosis repair via posterior levator advancement with minimal superior tarsectomy by a single surgeon from 2002 to 2018. Patients with greater than 1 mm asymmetry between eyes or contour abnormalities underwent nonsurgical adjustment in the office within 6 days of surgery. A total of 79 patients (146 eyelids) were included in this study. The patients were female (67%), underwent bilateral surgery (87%) with mean age of 63 years (range, 20-92). The mean improvement in marginal reflex distance 1 at postoperative month 1 was 2.56 ± 1.04 mm (p ≤ 0.0001). Postoperative symmetry of 1 mm or less between eyes was achieved in 96.6% of patients. Only 8 eyes (5.4%) underwent in-office adjustment postoperatively. No demographic or clinical differences were noted in eyes that required adjustments. Postoperative complications included dry eyes that resolved by 3 months (13.6%), suture cyst (1.4%), corneal abrasion (1.4%), and persistent eyelid edema (1.4%). Surgical revision was required in 2.8% of eyes. The adjustable posterior levator advancement with minimal superior tarsectomy is an effective surgical technique for ptosis repair with the added benefit of in-office adjustability to correct minor asymmetries.

3D printing guided surgery in the treatment of unicoronal craniosynostosis orbital dysmorphology.

The purpose of our study was to improve the minor asymmetries of fronto-orbital advancement (FOA) by introducing a simple model to guide the FOA in unicoronal synostosis which may help saving time and cost. A retrospective analysis of 16 consecutive patients with unicoronal synostosis corrected by FOA guided by a guide model. Patients with syndromic craniosynostosis or associated craniofacial anomalies were excluded from the analysis. In all cases, 3D mirror image models were used for guiding unilateral fronto-orbital advancement. Demographic, perioperative, and follow-up data were collected for comparison. Cranial and orbital volumes were documented preoperatively and postoperatively and compared with the non-synostotic side. The postsurgical appearance of the face was documented photographically and then evaluated and scored using the Whitaker scoring system. The study included nine males and seven females. The mean age of the patients at the time of the operation was 20.4 months. The mean follow-up duration was 36 months. Mean operative time was 170 min, mean anesthetic time was 230 min, mean blood loss was 50-80 ml, and the average hospital stay was 4.4 days. No relapse that required surgical correction was reported. There were improvements in the orbital indices and volume to be near equal to the normal side. Excellent to good results were obtained in all patients according to the Whitaker classification system. Residual deformity after FOA mandates another tool to optimize the results. Our study introduced a simple, easy, and applicable method to guide the FOA with lesser asymmetries.

Asimetrik dudağın hyaluronik asit dolgu ile tedavisi

A perfectly symmetrical face is not common in human beings, and different degrees of facial asymmetry are usually present in individuals. However, asymmetric lip appearance may need to be treated, because even minor asymmetries in the central location such as lips may cause psychosocial effects negatively, although this is not apparent in some people.

Assessment of facial asymmetry and establishment of threshold of sub-clinical asymmetry in Malwa population

Introduction: The word symmetry is derived from the Greek word ‘symmetries’ which means ‘of like measure’. Facial symmetry can be defined in numerous ways, one being associated with the state of facial equilibrium, in which there is a correspondence in size, shape, and arrangement of facial landmarks on the opposite sides.&#x0D; Materials &amp; Method: The 1427 subjects in the present study were selected from the Out Patient Department of Government College of Dentistry, Indore(M.P), who presented with aesthetically pleasing faces over a period of one year (October 2013-0ctober 2014). Out of the 1427 patients examined 150 (17-30 years) subjects were randomly included. Photographs and orthopantomogram of all the 150 patients were obtained.&#x0D; Result: The photographs and orthopantomogram were analyzed &amp; Absolute value of Asymmetry Index was taken for all the measurements. Comparison of absolute Asymmetry index of different parameters between male and female subjects was performed. Wilcoxon paired test showed right side predominance for the parameter corpus length, middle facial width, cheek length, lower facial width.&#x0D; Conclusion: In the present study an attempt was made to quantify sub-clinical asymmetries in clinically symmetrical faces. Minor asymmetries were observed in nearly all individuals taken up for the study. There is no association of gender with predominance of facial asymmetry. On assessment of side predominance of asymmetry it was concluded that the right side dominance of asymmetry for corpus length, middle facial width, cheek length, lower facial width. A threshold value of 6% for sub-clinical asymmetry was established from this study except for condylar and coronoid.

Correction of the Crooked Nose.

Successful management of the crooked nose can be a formidable task and requires a systematic approach that begins with an understanding of the patients' aesthetic desires, expectations, and functional symptoms. Dividing the nose into thirds and organizing a plan to correct each region individually can simplify the preoperative planning. There are two broad philosophical strategies of surgical management: engineering (reconstructive) and artistic (camouflaging). While the camouflaging technique is helpful for minor asymmetries, protrusions, and depressions, the engineering approach is best for more extreme corrections. The surgeon must be skilled in both approaches as either one or a combination of the two may yield the best results. Once corrected, postoperative care is essential to obtain optimal outcomes.

Sub-4 fs laser pulses at high average power and high repetition rate from an all-solid-state setup.

The generation of high average power, carrier-envelope phase (CEP) stable, near-single-cycle pulses at a repetition rate of 100 kHz is demonstrated using an all solid-state setup. By exploiting self-phase modulation in thin quartz plates and air, the spectrum of intense pulses from a high-power, high repetition rate non-collinear optical parametric chirped pulse amplifier (NOPCPA) is extended to beyond one octave, and pulse compression down to 3.7 fs is achieved. The octave-spanning spectrum furthermore allows performing straightforward f-to-2f interferometry by frequency-doubling the long-wavelength part of the spectrum. Excellent CEP-stability is demonstrated for extended periods of time. A full spatio-spectral characterization of the compressed pulses shows only minor asymmetries between the two perpendicular beam axes. We believe that the completed system represents the first laser system satisfying all requirements for performing high repetition rate attosecond pump-probe experiments with fully correlated detection of all ions and electrons produced in the experiment.

Flux trapping in multi-loop SQUIDs and its impact on SQUID-based absolute magnetometry

The effect of flux trapping on the flux-voltage characteristics of multi-loop SQUID magnetometers was investigated by means of repeated cool-down cycles in a stepwise increased magnetic background field. For a SQUID with N parallel loops, N different flux offsets, each separated by were observed even in zero magnetic field. These flux offsets further split into a so called fine structure, which can be explained by minor asymmetries in the SQUID design. The observed results are discussed with particular regard to their impact on the previously presented absolute SQUID cascade vector magnetometer.

The importance of the posterior joint space for functional mandibular movements: A laboratory cross-sectional study.

BackgroundThe search for the ideal, healthy and reproducible position of the condyles is of utmost importance for dental diagnosis and treatment. Thus, the objective of this laboratory cross-sectional study was to verify the relationship between the posterior joint space and the mandibular lateral movements.Material and MethodsDental casts from 15 women and 15 men with normal mastication, 28 natural teeth and no history of temporomandibular disorders or pain, were fabricated and mounted on a fully adjustable articulator. From the maximum intercuspal position, condylar displacement was evaluated and measured on the working and nonworking sides during mandibular lateral movement, both to the right and left sides.ResultsThe correlation between the measures of interest was assessed with the Pearson correlation coefficient (α=.05). Condylar displacement on the working side and nonworking side condyle was 0.88±0.71 mm and 3.57±1.11 mm (right mandibular lateral movement); and 0.91±0.58 mm and 3.51±0.78mm (left mandibular lateral movement), respectively. No significant correlation in the condylar displacement between the working side condyles on the right and on the left sides was observed (r=.22; P=.248). The condylar poles of the articulator moved posteriorly, simulating the functional movements of the mandible during mastication. In all cases, condylar displacement during mandibular lateral movement both to the right and left occurred posteriorly on the working side condyle.ConclusionsThe condylar poles of the articulator moved posteriorly simulating the functional movements of the mandible during mastication. Moreover, left and right working condyles may require slightly different spaces to function, suggesting minor anatomical asymmetries. Key words:Mastication, dental occlusion, prosthodontics.

IMAGING AN 80 au RADIUS DUST RING AROUND THE F5V STAR HD 157587

ABSTRACT We present H-band near-infrared polarimetric imaging observations of the F5V star HD 157587 obtained with the Gemini Planet Imager (GPI) that reveal the debris disk as a bright ring structure at a separation of ∼80–100 au. The new GPI data complement recent Hubble Space Telescope/STIS observations that show the disk extending out to over 500 au. The GPI image displays a strong asymmetry along the projected minor axis as well as a fainter asymmetry along the projected major axis. We associate the minor and major axis asymmetries with polarized forward scattering and a possible stellocentric offset, respectively. To constrain the disk geometry, we fit two separate disk models to the polarized image, each using a different scattering phase function. Both models favor a disk inclination of ∼70° and a 1.5 ± 0.6 au stellar offset in the plane of the sky along the projected major axis of the disk. We find that the stellar offset in the disk plane, perpendicular to the projected major axis is degenerate with the form of the scattering phase function and remains poorly constrained. The disk is not recovered in total intensity due in part to strong adaptive optics residuals, but we recover three point sources. Considering the system’s proximity to the galactic plane and the point sources’ positions relative to the disk, we consider it likely that they are background objects and unrelated to the disk’s offset from the star.

A rare case of hemimandibular hyperplasia

Facial asymmetry, defined as a difference in the size, shape or relationship of the two sides of the face, has a high correlation with facial harmony, attractiveness and beauty. Minor asymmetries of the human skeleton are common in the general population and usually have no esthetic or functional significance. It is reported that skeletal asymmetry is found even in the most pleasing and apparently symmetrical faces. This is not observed externally because dentoalveolar structures and the facial soft tissues show compensatory changes to minimize the underlying asymmetry; however, moderate and severe asymmetries are easily noticed by the human eye. The etiologic factors that cause facial asymmetries and their underlying mechanisms are not yet completely understood. It is appropriate to classify facial asymmetries into the two basic categories of developmental or acquired asymmetries. Developmental asymmetries include agenesis, hypoplasia, hyperplasia, atrophy, hypertrophy and malpositions of the facial bony structures. Acquired asymmetries occur as a result of traumas, infections, functional shifts and tumors. Hemimandibular hyperplasia is a developmental asymmetry characterized by three-dimensional enlargement of half of the mandible. The hyperplastic side includes the condyle, condylar neck, ramus and corpus, and the anomaly terminates at the symphysis. The unilateral increase in height of the face on the affected side results in a sloping rimaoris or mouth and rotated facial appearance. The maxilla usually follows the mandible and grows downward on the affected side. As a result, the occlusal plane tilts and is at a lower level on the affected side, whereas the teeth generally remain in occlusion.

Three-dimensional Superficial Liposculpture of the Hips, Flank, and Thighs.

Background:In the last 3 decades, liposuction has become a mainstay of the plastic surgeon’s armamentarium, and the technique has evolved considerably. We retrospectively review all of the liposuction procedures that we performed over the past 20 years.Methods:The principles of superficial 3-dimensional liposuction with respect to preoperative, intraoperative, and postoperative management of patients scheduled to undergo liposuction of the hips, flanks, and thighs were described.Results:A total of 4000 patient charts were reviewed. The results indicated that 50 patients experienced a postsurgical seroma that was resolved after syringe aspirations. One patient developed a major mycobacterial infection that was resolved after antibiotic therapy. Twenty patients complained of minor asymmetries that were corrected 6 months later under local anesthesia; 18 patients suffered from minor skin irregularities, which improved after lipofilling. In 6 cases, transient hyperpigmentation (6–12 months) of the skin before the use of suction drainages in the removal of large adiposities in patients with light skin was experienced, and in 2 cases, transient paresthesia (8 and 10 months) was experienced. No skin necrosis, deep vein thrombosis, or death occurred.Conclusions:If performed correctly, 3-dimensional superficial liposuction of the trunk, hips, and thighs can yield very satisfying outcomes because of the excellent contour and the enhanced skin retraction provided by the thin cutaneous adipose flap. Three-dimensional liposuction is a reliable method with proven results. A careful application of the technique combined with accurate surgical planning, a thorough preoperative explanation of real expectations, and postoperative care is crucial.