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Coming Face to Face With Our Own Bias
... The goal of the emergent science and art of facial rejuvenation is restoration of youthfulness and beauty through subtle, natural changes that are within the context of the patient's age. 1,14 Enhancing facial characteristics and symmetry using nonsurgical interventions has been shown to improve first impressions. 1,[15][16][17] However, a face that has an obvious cosmetically altered look is perceived negatively 14 ; therefore, in aesthetic medicine, it is important to achieve gradual, subtle changes that Although the chin and neck play an important role in facial beauty, treatment options for contouring and refining this area have been relatively limited. ...
... 1,14 Enhancing facial characteristics and symmetry using nonsurgical interventions has been shown to improve first impressions. 1,[15][16][17] However, a face that has an obvious cosmetically altered look is perceived negatively 14 ; therefore, in aesthetic medicine, it is important to achieve gradual, subtle changes that Although the chin and neck play an important role in facial beauty, treatment options for contouring and refining this area have been relatively limited. The standard of care for addressing the submental area is surgical intervention, including face/neck lift, direct fat excision, and liposuction. ...
Although millions of aesthetic procedures are performed annually, few patient-reported outcome (PRO) measures have been used in this setting.
To evaluate the impact of onabotulinumtoxinA treatment for crow's feet lines (CFL) on relevant psychological variables and self-perception of age/appearance in subgroup populations.
Facial Lines Outcomes (FLO-11) Questionnaire, Self-Perception of Age (SPA), and Subject Global Assessment of Change in CFL (SGA-CFL) were PRO measures administered in 2 Phase 3, double-blind placebo-controlled trials for the treatment of CFL alone or CFL/glabellar lines (GL). Patient-reported outcome measures were analyzed by subgroups (age, gender, and baseline CFL severity). Subject satisfaction with appearance was also analyzed.
Most subgroups receiving onabotulinumtoxinA demonstrated significant improvements in psychological impact (FLO-11 Items 2, 5, and 8) versus placebo at Day 30 (p ≤ .05). OnabotulinumtoxinA-treated subjects consistently rated themselves as looking younger on SPA versus placebo in all subgroups at Day 30 (p ≤ .05) and showed significant improvements in CFL appearance versus placebo at all time points on SGA-CFL. Overall, subjects were satisfied with their appearance.
OnabotulinumtoxinA-treated subjects experienced significant improvements in perceived appearance, attractiveness, tiredness, age, and satisfaction versus placebo. Subjects treated for CFL and GL experienced even greater effects.
Three experiments tested whether the use of facial make-up elicits positive or negative implicit attitudes. Students in psychology, business, and aesthetics performed a series of Implicit Association Tests (IAT) measuring the link between portrayed women wearing or not wearing make-up and high versus low status professions, pleasant versus unpleasant words, and positive versus negative personality traits. Results showed that make-up was associated with positive traits and high-status professions at the implicit level. They are discussed in relation with previous findings indicating a negative influence of make-up on impression formation with exactly the same photographs and similar subject samples.
The social judgments people make on the basis of the facial appearance of strangers strongly affect their behavior in different contexts. However, almost nothing is known about the physical information underlying these judgments. In this article, we present a new technology (a) to quantify the information in faces that is used for social judgments and (b) to manipulate the image of a human face in a way which is almost imperceptible but changes the personality traits ascribed to the depicted person. This method was developed in a high-dimensional face space by identifying vectors that capture maximum variability in judgments of personality traits. Our method of manipulating the salience of these vectors in faces was successfully transferred to novel photographs from an independent database. We evaluated this method by showing pairs of face photographs which differed only in the salience of one of six personality traits. Subjects were asked to decide which face was more extreme with respect to the trait in question. Results show that the image manipulation produced the intended attribution effect. All response accuracies were significantly above chance level. This approach to understanding and manipulating how a person is socially perceived could be useful in psychological research and could also be applied in advertising or the film industries.
Although outcome measurement in medical care has traditionally included various aspects of clinical and functional status, patient satisfaction is another important metric in the assessment of health care quality. Determining which factors contribute most to patient satisfaction can assist health care providers in improving care. In an era of diminishing resources, satisfaction ratings can further aid third-party payers in determining who provides those services. The authors used the ordinal logistic regression method to develop a predictive model for patient satisfaction in an outpatient plastic surgery clinic. Consecutive patients who attended a university outpatient plastic surgery clinic were asked to complete the Visit Specific Patient Satisfaction Questionnaire (VSQ) after their clinic visit. Type of clinic (e.g., hand clinic, aesthetic clinic, breast clinic) and demographic variables like age, gender, race, and education were added to the questionnaire to control for possible confounding effects. The authors constructed an ordinal logistic regression model using the overall visit response as the dependent variable and the eight other response categories as independent variables. A total of 345 patients completed the VSQ, which takes each patient less than 2 minutes to complete. The patient response rate was more than 95%. Statistically significant predictors included (1) personal manner of physician (odds ratio [OR], 18.0; p = 0.0002), (2) time spent with physician (OR, 4.7; p = 0.0099), (3) length of time to get an appointment (OR, 4.6; p = 0.0055), and (4) explanation of what was done (OR, 3.9; p = 0.0263). There was no statistically significant association between overall satisfaction scores and the following factors: (1) length of wait in the clinic (OR, 2.7; p = 0.0747), (2) getting through to the clinic by phone (OR, 0.71; p = 0.5439), (3) convenience of the clinic's location (OR, 2.3; p = 0.1368), and (4) technical skills of the physician (OR, 1.0; p = 0.9974). The predictive model was adjusted for possible confounding due to the type of clinic and demographic variables. In this study the most important predictors of patient satisfaction were those related to efficient clinic operation (scheduling of appointments and clinic waiting time) and the quality of the patient-physician interaction. Clinic facilities (like clinic location and ease of phone contact) were not significant predictors. Because patients often have difficulty assessing the technical skills of physicians, this variable was not a significant predictor. To improve patient satisfaction in plastic surgery outpatient clinics, efforts and resources should be directed toward expedient and empathic delivery of care.
BACKGROUND: A full-thickness skin graft is often performed by tie-over dressing to compress and immobilize it.
OBJECTIVE: The aim of this study was to compare the results of a full-thickness skin graft with tie-over dressing performed with the classic technique and with simple dressing.
METHODS AND MATERIALS: This was a prospective study in which 25 patients had tulle gras jelly tie-over dressing and 25 patients had a simple tulle gras dressing after full-thickness skin graft for nipple areola reconstruction.
RESULTS: Graft success on the fifth day was evaluated at 100% for patients with a simple dressing and at 99% for those with tie-over dressing.
CONCLUSIONS: In this study, simple dressing appeared to be at least as effective as the tie-over dressing. Simple dressing, however, was faster and left fewer residual marks than the tie-over dressing.
Facial appearance has profound influence on the first impression that is projected to others.
To determine the effects that complete correction of the nasolabial folds (NLFs) with hyaluronic acid (HA) filler has on the first impression one makes.
Twenty-two subjects received injections of HA filler into the NLFs. Photographs of the face in a relaxed pose were taken at baseline, optimal correction visit, and 4 weeks after optimal correction. Three hundred four blinded evaluators completed a survey rating first impression on various measures of success for each photo. In total, 5,776 first impressions were recorded, totaling 46,208 individual assessments of first impression.
Our findings indicate a significant improvement in mean first impression in the categories of dating success, attractiveness, financial success, relationship success, athletic success, and overall first impression at the optimal correction visit. At 4 weeks after the optimal correction visit, significance was observed in all categories measured: social skills, academic performance, dating success, occupational success, attractiveness, financial success, relationship success, athletic success, and overall first impression.
Full correction of the NLFs with HA filler significantly and positively influences the first impression an individual projects.
First impressions are greatly influenced by facial appearance. Clinical data from psychiatric medicine overwhelming indicate that attractive individuals receive better judgment, treatment and behavior [1,2,10]. This study aimed to determine whether cosmetic alteration of facial features projects a better first impression.
Random reviewers were asked independently to grade standardized preoperative and postoperative photographs of patients who underwent facial plastic surgery. The reviewers were blinded to the pre- or postoperative status of the photograph. The questions posed to the reviewers were based on first-impression studies used in the past.
The findings indicate that postoperative cosmetic surgery patients were graded as 31% more attractive, 27% better in social skills, 22% more successful in dating, 19% better in athletic skills, 15% better in relationship skills, and 13% more financially successful.
Facial cosmetic surgery can improve the first impression an individual creates.
Attractiveness is a facial attribute that shapes human affiliative behaviours. In a previous study we reported a linear response to facial attractiveness in orbitofrontal cortex (OFC), a region involved in reward processing. There are strong theoretical grounds for the hypothesis that coding stimulus reward value also involves the amygdala. The aim of the present investigation is to address whether the amygdala is also sensitive to reward value in faces, indexed as facial attractiveness. We hypothesized that contrary to the linear effects reported previously in OFC, the amygdala would show a non-linear effect of attractiveness by responding to both high and low attractive faces relative to middle attractive faces. Such a non-linear response would explain previous failures to report an amygdala response to attractiveness. Human subjects underwent fMRI while they were presented with faces that varied in facial attractiveness where the task was either to rate faces for facial attractiveness or for age. Consistent with our hypothesis, right amygdala showed a predicted non-linear response profile with greater responses to highly attractive and unattractive faces compared to middle-ranked faces, independent of task. Distinct patterns of activity were seen across different regions of OFC, with some sectors showing linear effects of attractiveness, others exhibiting a non-linear response profile and still others demonstrating activation only during age judgments. Significant effects were also seen in medial prefrontal and paracingulate cortices, posterior OFC, insula, and superior temporal sulcus during explicit attractiveness judgments. The non-linear response profile of the amygdala is consistent with a role in sensing the value of social stimuli, a function that may also involve specific sectors of the OFC.
BACKGROUND First impression is influenced by facial appearance and improved by cosmetic surgery. OBJECTIVE We wanted to determine if treatment with botulinum toxin A (BTxnA) would improve first impression. MATERIALS AND METHODS Women received BTxnA in the forehead. Photos were taken prior to, and 1 week after, final BTxnA injection in smiling and relaxed poses. Photos were divided into books with each subject represented only once. Evaluators completed a survey rating first impression on various measures of success for each photo. RESULTS No differences were seen for social skills, financial, or relationship success scales. A significant decrease in first impression scores between treatment photos was seen for academic performance and occupational success. However, analysis of between-subject effects found that "smile/relax" accounted for the decreased score in both scales. Significant increases in first impression scores were seen for dating success, attractiveness, and athletic success scales where smile/relax and BTxnA contributed significantly to the improved scores. CONCLUSIONS BTxnA improved first impression scores for dating success, attractiveness, and athletic success scales. Academic performance and occupational success scores were not affected by BTxnA when the smile/relax variable was included. The smile/relax variable was a more important predictor for academic performance and occupational success scores.