American Society of Plastic Surgeons
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3D Imaging Technique Shows Facial Soft Tissue Strain
Optical Imaging May Help in Understanding How Expressions Affect Facial Aging, Reports Study in PRS GO

How much does facial movement contribute to facial aging? Researchers are using a "real-time dynamic three-dimensional imaging" technique to study the strains placed on the soft tissues by facial expressions, reports a study in Plastic and Reconstructive Surgery—Global Open®, the official open-access medical journal of the American Society of Plastic Surgeons (ASPS).

In a pilot study, ASPS Member Surgeon, Vivian M. Hsu of University of Pennsylvania and colleagues used a technique called "speckle tracking photogrammetry" to evaluate and measure strain on the facial soft tissues produced by facial movements. "The technology of three-dimensional optical imaging can be used to advance our understanding of facial soft tissue dynamics and the effects of animation on facial strain over time," the researchers write.

3D Imaging to Show Facial Soft Tissue Strain

The study used a specialized 3D optical imaging system to measure the strain on soft tissues associated with facial movement. The study included 13 adult volunteers between age 18 and 70. The procedure began by spraying a "speckle" pattern onto the subjects' faces.

After a digital image was made in a "neutral" facial expression, the subjects were photographed making different facial expressions, such as smiling, laughing, and grimacing; surprised and angry expressions; and whistling (pursed lips). Using the speckle pattern, the imaging system software was able to demonstrate and quantify the strain on facial soft tissues caused by these facial movements.

The 3D imaging technique—used by engineers to measure strain on various materials—has recently been applied to measuring the mechanical properties of biological organs and tissues. The system generated a "heat map" color scale, with red indicating the area of greatest strain and blue showing areas of lesser strain.

Facial Strain Is Greater in Older Subjects

For all six expressions, the heat map showed the areas of greatest strain were located in the midface and lower face. For subjects older than 40 years, strain was greater in the perioral region (around the mouth): about 58 percent, compared to 34 percent for those younger than 40.

The age-related increase in strain with lip-pursing was even greater in the nasolabial folds (the lines running from the nose to the corners of the mouth)—about 62 percent in subjects over 40 versus 33 percent in younger subjects. Older subjects also showed greater asymmetry of strain in the nasolabial fold: 18 versus five percent.

Overall stretch in the lower face during lip-pursing was greater in women than men. For smiling and other facial expressions, measurements of strain were similar for older and younger subjects.

The results may lend new insights into the "intricate and multifactorial process" of facial aging. Facial movement is clearly affected by facial aging, but "the relationship between dynamic and static aging remains to be understood," Dr Hsu and coauthors write.

Three-dimensional dynamic imaging techniques may help researchers to better understand "the multidimensional attributes of the aging face." The pilot study confirm what plastic surgeons know from experience: that movement of the perioral tissues is an important contributor to facial aging.

"We hope these data will serve as a first step for improving our ability to understand and develop more effective treatments for the lower face and beyond," Dr Hsu and coauthors write. They believe that soft tissue strain analysis could also have "broad and functional implications" for various types of reconstructive surgery procedures, such as abdominal wall reconstruction, facial reanimation surgery, and facial reconstruction after trauma.

Plastic and Reconstructive Surgery—Global Open® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

About PRS Global Open

Plastic and Reconstructive Surgery—Global Open (PRS Global Open) is an open access, rigorously peer-reviewed, international journal focusing on global plastic and reconstructive surgery. PRS Global Open educates and supports plastic surgeons globally to provide the highest quality patient care and maintain professional and ethical standards through education, research, and advocacy.

About ASPS

The American Society of Plastic Surgeons (ASPS) is the largest organization of board-certified plastic surgeons in the world. Representing more than 11,000 physician members worldwide, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 92 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada.

About Wolters Kluwer

Wolters Kluwer (EURONEXT: WKL) is a global leader in professional information, software solutions and services for the healthcare, tax and accounting, financial and corporate compliance, legal and regulatory and corporate performance and ESG sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services.

Wolters Kluwer reported 2022 annual revenues of €5.5 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries and employs approximately 20,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

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