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Aesthetic Plastic Surgery in Asians: Principles and Techniques is the culmination of a monumental effort by well-known experts in the field, Dr Lee L.Q. Pu and his six coeditors. The magnitude of this undertaking is astounding since it involves 90 contributors from multiple Asian countries. This beautiful two-volume set is very timely since the popularity of aesthetic plastic surgery in Asia is skyrocketing with no limit in sight. The two volumes consist of 74 chapters under 10 major sections and also include four chapters on breast reconstruction. In Asia, breast reconstruction is usually considered cosmetic in nature. The set also includes three DVDs and a complimentary eBook version. The quality of writing and editing is excellent. This by itself is a testament to Dr Pu and his coeditors since many of the authors come from countries where English is not their first language. Many chapters include remarks on pertinent differences between Asian and Caucasian anatomy. High quality artwork and images run throughout the book along with clear tables and algorithms. Each chapter ends with a bulleted list titled “Pearls for Success.” In an age when information is instantly accessible by digital media, and with Asia awakening to the popularity of aesthetic plastic surgery, it might seem daunting to try and capture the essence of Asian aesthetic surgery in a book form. Previous books on this subject have been more limited in scope, with many chapters written by only a handful of authors. This book nicely covers all of the pertinent aesthetic procedures in Asians. There is an interesting chapter on “Scar Management for Asian Cosmetic Surgery Patients,” which includes a summary of available treatments and a discussion of anatomic regions which are at higher risk for heavy scarring. Since skin hyperpigmentation is more problematic in Asians and other darker complected races, it is appropriate that this book includes a chapter on this topic. The chapter nicely reviews the differential diagnoses of various epidermal and dermal-pigmented lesions but would be more complete if it also included a paragraph or two on the use of a Wood's lamp as a diagnostic tool for pigmented skin lesions. Although most Western plastic surgeons don't treat acne on a regular basis, “Treatment for Acne and Acne Scars” provides an excellent discussion of the pathophysiology and treatment of these troublesome entities. Liquid silicone is still available in Asia as a soft tissue filler and its use is discussed along with others fillers for facial rejuvenation. Other chapters reflect similar differences between Asia and the West regarding the popularity of various techniques. For instance, thread-lifting was prevalent for a period of time in the United States but has now fallen in popularity. The chapter on “Facial Rejuvenation with Thread Lift” will have a wider audience in Asia. Another stark difference in practice between Asia and the United States is the use of acellular dermal matrices (ADM). The chapter “Breast Reconstruction with Implant” makes no mention of ADM, even for patients with recurrent severe capsular contractures or patients with prior radiation. Perhaps ADM is not widely used in Asia at the present time, but this is likely to change in the next decade or so. As expected, there is some overlap among various chapters. For instance, a chapter titled “Total Facial Rejuvenation with Microautologous Fat Transplantation” follows “Fat Grafting for Facial Contouring.” In a similar vein, “Botulinum Toxin A Injections for Facial Rejuvenation and Shaping” is followed by “Botulinum Toxin A Injections for Facial Contouring.” Many chapters have excellent discussions of complications and their management, while other chapters are either devoid of such discussions or mention complications only in a cursory manner. As an example, Asian surgeons commonly use alloplastic materials for dorsal nasal augmentation, while Western surgeons shy away from using such materials in the nose because of their known associated complications (implant deviation, palpability, infection, extrusion, capsular contractures, etc.). The chapter “Alloplastic Implants for Rhinoplasty” would be more complete if the above complications were properly addressed. DVDs as a complimentary learning tool are very popular, especially in surgery books which are procedure-oriented. The DVDs in this book set contain a number of very good videos. Unfortunately, only seventeen of the sixty procedure-oriented chapters have associated videos. The complimentary eBook version is a very nice addition since it allows the reader to not only access the book's contents online but also offline via a smartphone or tablet. As far as I am aware, this book represents the most comprehensive treatment of this subject matter to date. I thoroughly enjoyed going through each chapter because the flow was smooth, and the material was presented in a very clear manner. For an undertaking of this magnitude, I congratulate Dr Pu and his coeditors for a job well done. They have succeeded in capturing the essence of aesthetic plastic surgery in Asians today. I highly recommend this work to plastic surgeons of all levels who are interested in aesthetic surgery as it applies to Asians. To purchase: https://www.crcpress.com/Aesthetic-Plastic-Surgery-in-Asians-Principles-and-Techniques-Two-Volume/Pu-Chen-Li-Wu-Park-Takayanagi-Wei/9781482240870. Dr Ishii is an unpaid member of the Kybella (Allergan, Irvine, CA) faculty. The author received no financial support for the research, authorship, and publication of this article.
We introduce a scalable, interpretable computer-vision framework for quantifying aesthetic outcomes of facial plastic surgery using frontal photographs. Our pipeline leverages automated landmark detection, geometric facial symmetry computation, deep-learning-based age estimation, and nasal morphology analysis. To perform this study, we first assemble the largest curated dataset of paired pre- and post-operative facial images to date, encompassing 7,160 photographs from 1,259 patients. This dataset includes a dedicated rhinoplasty-only subset consisting of 732 images from 366 patients, 96.2% of whom showed improvement in at least one of the three nasal measurements with statistically significant group-level change. Among these patients, the greatest statistically significant improvements (p < 0.001) occurred in the alar width to face width ratio (77.0%), nose length to face height ratio (41.5%), and alar width to intercanthal ratio (39.3%). Among the broader frontal-view cohort, comprising 989 rigorously filtered subjects, 71.3% exhibited significant enhancements in global facial symmetry or perceived age (p < 0.01). Importantly, our analysis shows that patient identity remain
Aesthetic plastic surgery has been long practiced for primarily psychological rather than physical benefit to patients. However, evaluation of the psychological impact of aesthetic plastic surgery has often been of limited methodological rigor in both study design and appropriate measurement. This study is intended to evaluate the psychological impact of aesthetic surgery on patients seeking such intervention in regard to concerns about breasts, nose or upper limbs using standardised psychometric instruments. Participants were recruited through the Plastic Surgery Unit (Patients) and general surgery, ENT surgery and Maxillo-facial surgery (Comparisons) at a UK General Hospital. Outcome measures included the Crown-Crisp Experiential Inventory anxiety scale, Beck Depression Inventory and Derriford Appearance Scale-24, a valid and reliable measure of distress and dysfunction in relation to self-consciousness of appearance. Data were collected pre-operatively (T1) and 3 months post-operatively (T2) for both groups. Longitudinal appearance adjustment for the plastic surgery group was also assessed at 12 months (T3). Both groups were less depressed and anxious post-operatively. The improvement in anxiety was significantly greater in the plastic surgery group. Body site specific appearance distress was significantly improved for the plastics group only, and the level of improvement was related to the body site affected.
Postoperative pain management is crucial for aesthetic plastic surgery procedures. Poorly controlled postoperative pain results in negative physiologic effects and can affect length of stay and patient satisfaction. In light of the growing opioid epidemic, plastic surgeons must be keenly familiar with opioid-sparing multimodal analgesia regimens to optimize postoperative pain control. Methods: A review study based on multimodal analgesia was conducted. Results: We present an overview of pain management strategies pertaining to aesthetic plastic surgery and offer a multimodal analgesia model for outpatient aesthetic surgery practices. Conclusion: This review article presents an evidence-based approach to multimodal pain management for aesthetic plastic surgery.
BACKGROUND: Recent evidence suggests tranexamic acid (TXA) may improve outcomes in aesthetic surgery patients. OBJECTIVES: This systematic review aimed to investigate the impact of TXA use in aesthetic plastic surgery on bleeding and aesthetic outcomes. METHODS: A systematic literature search was conducted to identify studies evaluating TXA use in aesthetic plastic surgery. The primary outcome of interest was perioperative bleeding, reported as total blood loss (TBL), ecchymosis, and hematoma formation. Meta-analyses analyzing TBL and postoperative hematoma were performed. RESULTS: Of 287 identified articles, 14 studies evaluating TXA use in rhinoplasty (6), rhytidectomy (3), liposuction (3), reduction mammaplasty (1), and blepharoplasty (1) were included for analysis. Of 820 total patients, 446 (54.4%) received TXA. Meta-analysis demonstrated TXA is associated with 26.3 mL average blood loss reduction (95% CI, -40.0 to -12.7 mL; P < 0.001) and suggested a trend toward decreased odds of postoperative hematoma with TXA use (odds ratio, 0.280; 95% CI, 0.076-1.029; P = 0.055). Heterogeneity among reporting of other outcomes precluded meta-analysis; however, 5 of 7 studies found significantly decreased postoperative ecchymosis levels within 7 days of surgery, 3 studies found statistically significant reductions in postoperative drain output, and 1 study reported significantly improved surgical site quality for patients who received TXA (P = 0.001). CONCLUSIONS: TXA is associated with decreased blood loss and a trend toward decreased hematoma formation in aesthetic plastic surgery. Its use has the potential to increase patient satisfaction with postoperative recovery and decrease costs associated with complications, including hematoma evacuation.
Quality of life (QoL) is an important outcome in plastic surgery. However, authors use different scales to address this subject, making it difficult to compare the outcomes. To address this discrepancy, the aim of this study was to perform a systematic review and a random effect meta-analysis. METHODS: The search was made in two electronic databases (LILACS and PUBMED) using Mesh and non-Mesh terms related to aesthetic plastic surgery and QoL. We performed qualitative and quantitative analyses of the gathered data. We calculated a random effect meta-analysis with Der Simonian and Laird as variance estimator to compare pre- and postoperative QoL standardized mean difference. To check if there is difference between aesthetic surgeries, we compared reduction mammoplasty to other aesthetic surgeries. RESULTS: Of 1,715 identified, 20 studies were included in the qualitative analysis and 16 went through quantitative analysis. The random effect of all aesthetic surgeries shows that QoL improved after surgery. Reduction mammoplasty has improved QoL more than other procedures in social functioning and physical functioning domains. CONCLUSIONS: Aesthetic plastic surgery increases QoL. Reduction mammoplasty seems to have better improvement compared with other aesthetic surgeries.
Despite an increasing surge of exosome use throughout the aesthetic arena, a paucity of published exosome-based literature exists. Exosomes are membrane-bound extracellular vesicles derived from various cell types, exerting effects via intercellular communication and regulation of several signaling pathways. The purpose of this review was to summarize published articles elucidating mechanisms and potential applications, report available products and clinical techniques, and prompt further investigation of this emerging treatment within the plastic surgery community. Methods: A literature review was performed using PubMed with keywords exosomes, secretomes, extracellular vesicles, plastic surgery, skin rejuvenation, scar revision, hair growth, body contouring, and breast augmentation. Publications from 2010 to 2021 were analyzed for relevance and level of evidence. A Google search identified exosome distributors, where manufacturing/procurement details, price, efficacy, and clinical indications for use were obtained by direct contact and summarized in table format. Results: Exosomes are currently derived from bone marrow, placental, adipose, and umbilical cord tissue. Laboratory-based exosome studies demonstrate enhanced outcomes in skin rejuvenation, scar revision, hair restoration, and fat graft survival on the macro and micro levels. Clinical studies are limited to anecdotal results. Prices vary considerably from $60 to nearly $5000 based on company, source tissue, and exosome concentration. No exosome-based products are currently Food and Drug Administration-approved. Conclusions: Administered alone or as an adjunct, current reports show promise in several areas of aesthetic plastic surgery. However, ongoing investigation is warranted to further delineate concentration, application, safety profile, and overall outcome efficacy.
Aesthetic Image Captioning (AIC) aims to generate textual descriptions of image aesthetics, becoming a key research direction in the field of computational aesthetics. In recent years, pretrained Multimodal Large Language Models (MLLMs) have advanced rapidly, leading to a significant increase in image aesthetics research that integrates both visual and textual modalities. However, most existing studies on image aesthetics primarily focus on predicting aesthetic ratings and have shown limited application in AIC. Existing AIC works leveraging MLLMs predominantly rely on fine-tuning methods without specifically adapting MLLMs to focus on target aesthetic content. To address this limitation, we propose the Aesthetic Saliency Enhanced Multimodal Large Language Model (ASE-MLLM), an end-to-end framework that explicitly incorporates aesthetic saliency into MLLMs. Within this framework, we introduce the Image Aesthetic Saliency Module (IASM), which efficiently and effectively extracts aesthetic saliency features from images. Additionally, we design IAS-ViT as the image encoder for MLLMs, this module fuses aesthetic saliency features with original image features via a cross-attention mechani
The aesthetic quality of a scene depends strongly on camera viewpoint. Existing approaches for aesthetic viewpoint suggestion are either single-view adjustments, predicting limited camera adjustments from a single image without understanding scene geometry, or 3D exploration approaches, which rely on dense captures or prebuilt 3D environments coupled with costly reinforcement learning (RL) searches. In this work, we introduce the notion of 3D aesthetic field that enables geometry-grounded aesthetic reasoning in 3D with sparse captures, allowing efficient viewpoint suggestions in contrast to costly RL searches. We opt to learn this 3D aesthetic field using a feedforward 3D Gaussian Splatting network that distills high-level aesthetic knowledge from a pretrained 2D aesthetic model into 3D space, enabling aesthetic prediction for novel viewpoints from only sparse input views. Building on this field, we propose a two-stage search pipeline that combines coarse viewpoint sampling with gradient-based refinement, efficiently identifying aesthetically appealing viewpoints without dense captures or RL exploration. Extensive experiments show that our method consistently suggests viewpoints wi
As 3D Gaussian Splatting (3DGS) gains attention in immersive media and digital content creation, assessing the aesthetics of 3D scenes becomes important in helping creators build more visually compelling 3D content. However, existing evaluation methods for 3D scenes primarily emphasize reconstruction fidelity and perceptual realism, largely overlooking higher-level aesthetic attributes such as composition, harmony, and visual appeal. This limitation comes from two key challenges: (1) the absence of general 3DGS datasets with aesthetic annotations, and (2) the intrinsic nature of 3DGS as a low-level primitive representation, which makes it difficult to capture high-level aesthetic features. To address these challenges, we propose Aes3D, the first systematic framework for assessing the aesthetics of 3D neural rendering scenes. Aes3D includes Aesthetic3D, the first dataset dedicated to 3D scene aesthetic assessment, built on our proposed annotation strategy for 3D scene aesthetics. In addition, we present Aes3DGSNet, a lightweight model that directly predicts scene-level aesthetic scores from 3DGS representations. Notably, our model operates solely on 3D Gaussian primitives, eliminati
The dataset spans diverse artistic styles, including regionally grounded aesthetics from the Middle East, Northern Europe, East Asia, and South Asia, alongside general categories such as sketch and oil painting. All images are generated using the Moonworks Lunara model and intentionally crafted to embody distinct, high-quality aesthetic styles, yielding a first-of-its-kind dataset with substantially higher aesthetic scores, exceeding even aesthetics-focused datasets, and general-purpose datasets by a larger margin. Each image is accompanied by a human-refined prompt and structured annotations that jointly describe salient objects, attributes, relationships, and stylistic cues. Unlike large-scale web-derived datasets that emphasize breadth over precision, the Lunara Aesthetic Dataset prioritizes aesthetic quality, stylistic diversity, and licensing transparency, and is released under the Apache 2.0 license to support research and unrestricted academic and commercial use.
Automated Program Repair (APR) aspires to automatically generate patches for an input buggy program. Traditional APR tools typically focus on specific bug types and fixes through the use of templates, heuristics, and formal specifications. However, these techniques are limited in terms of the bug types and patch variety they can produce. As such, researchers have designed various learning-based APR tools with recent work focused on directly using Large Language Models (LLMs) for APR. While LLM-based APR tools are able to achieve state-of-the-art performance on many repair datasets, the LLMs used for direct repair are not fully aware of the project-specific information such as unique variable or method names. The plastic surgery hypothesis is a well-known insight for APR, which states that the code ingredients to fix the bug usually already exist within the same project. Traditional APR tools have largely leveraged the plastic surgery hypothesis by designing manual or heuristic-based approaches to exploit such existing code ingredients. However, as recent APR research starts focusing on LLM-based approaches, the plastic surgery hypothesis has been largely ignored. In this paper, we
The Plastic Surgery In-Service Training Exam (PSITE) is an important indicator of resident proficiency and serves as a useful benchmark for evaluating OpenAI's GPT. Unlike many of the simulated tests or practice questions shown in the GPT-4 Technical Paper, the multiple-choice questions evaluated here are authentic PSITE questions. These questions offer realistic clinical vignettes that a plastic surgeon commonly encounters in practice and scores highly correlate with passing the written boards required to become a Board Certified Plastic Surgeon. Our evaluation shows dramatic improvement of GPT-4 (without vision) over GPT-3.5 with both the 2022 and 2021 exams respectively increasing the score from 8th to 88th percentile and 3rd to 99th percentile. The final results of the 2023 PSITE are set to be released on April 11, 2023, and this is an exciting moment to continue our research with a fresh exam. Our evaluation pipeline is ready for the moment that the exam is released so long as we have access via OpenAI to the GPT-4 API. With multimodal input, we may achieve superhuman performance on the 2023.
With the recent fast development of generative models, instruction-based image editing has shown great potential in generating high-quality images. However, the quality of editing highly depends on carefully designed instructions, placing the burden of task decomposition and sequencing entirely on the user. To achieve autonomous image editing, we present PhotoAgent, a system that advances image editing through explicit aesthetic planning. Specifically, PhotoAgent formulates autonomous image editing as a long-horizon decision-making problem. It reasons over user aesthetic intent, plans multi-step editing actions via tree search, and iteratively refines results through closed-loop execution with memory and visual feedback, without requiring step-by-step user prompts. To support reliable evaluation in real-world scenarios, we introduce UGC-Edit, an aesthetic evaluation benchmark consisting of 7,000 photos and a learned aesthetic reward model. We also construct a test set containing 1,017 photos to systematically assess autonomous photo editing performance. Extensive experiments demonstrate that PhotoAgent consistently improves both instruction adherence and visual quality compared wit
The allure of aesthetic appeal in images captivates our senses, yet the underlying intricacies of aesthetic preferences remain elusive. In this study, we pioneer a novel perspective by utilizing several different machine learning (ML) models that focus on aesthetic attributes known to influence preferences. Our models process these attributes as inputs to predict the aesthetic scores of images. Moreover, to delve deeper and obtain interpretable explanations regarding the factors driving aesthetic preferences, we utilize the popular Explainable AI (XAI) technique known as SHapley Additive exPlanations (SHAP). Our methodology compares the performance of various ML models, including Random Forest, XGBoost, Support Vector Regression, and Multilayer Perceptron, in accurately predicting aesthetic scores, and consistently observing results in conjunction with SHAP. We conduct experiments on three image aesthetic benchmarks, namely Aesthetics with Attributes Database (AADB), Explainable Visual Aesthetics (EVA), and Personalized image Aesthetics database with Rich Attributes (PARA), providing insights into the roles of attributes and their interactions. Finally, our study presents ML models
Computational aesthetic evaluation has made remarkable contribution to visual art works, but its application to music is still rare. Currently, subjective evaluation is still the most effective form of evaluating artistic works. However, subjective evaluation of artistic works will consume a lot of human and material resources. The popular AI generated content (AIGC) tasks nowadays have flooded all industries, and music is no exception. While compared to music produced by humans, AI generated music still sounds mechanical, monotonous, and lacks aesthetic appeal. Due to the lack of music datasets with rating annotations, we have to choose traditional aesthetic equations to objectively measure the beauty of music. In order to improve the quality of AI music generation and further guide computer music production, synthesis, recommendation and other tasks, we use Birkhoff's aesthetic measure to design a aesthetic model, objectively measuring the aesthetic beauty of music, and form a recommendation list according to the aesthetic feeling of music. Experiments show that our objective aesthetic model and recommendation method are effective.
While it is easy for human observers to judge an image as beautiful or ugly, aesthetic decisions result from a combination of entangled perceptual and cognitive (semantic) factors, making the understanding of aesthetic judgements particularly challenging from a scientific point of view. Furthermore, our research shows a prevailing bias in current databases, which include mostly beautiful images, further complicating the study and prediction of aesthetic responses. We address these limitations by creating a database of images with minimal semantic content and devising, and next exploiting, a method to generate images on the ugly side of aesthetic valuations. The resulting Minimum Semantic Content (MSC) database consists of a large and balanced collection of 10,426 images, each evaluated by 100 observers. We next use established image metrics to demonstrate how augmenting an image set biased towards beautiful images with ugly images can modify, or even invert, an observed relationship between image features and aesthetics valuation. Taken together, our study reveals that works in empirical aesthetics attempting to link image content and aesthetic judgements may magnify, underestimate
Multimodal large language models (MLLMs) are now routinely deployed for visual understanding, generation, and curation. A substantial fraction of these applications require an explicit aesthetic judgment. Most existing solutions reduce this judgment to predicting a scalar score for a single image. We first ask whether such scores faithfully capture comparative preference: in a controlled study with eight expert annotators, score-derived rankings align poorly with the same annotators' direct comparisons, while direct ranking yields substantially higher inter-annotator agreement on best- and worst-image labels. Motivated by this finding, we introduce the Visual Aesthetic Benchmark (VAB), which casts aesthetic evaluation as comparative selection over candidate sets with matched subject matter. VAB contains 400 tasks and 1,195 images across fine art, photography, and illustration, with labels derived from the consensus of 10 independent expert judges per task. Evaluating 20 frontier MLLMs and six dedicated visual-quality reward models, we find that the strongest system identifies both the best and the worst image correctly across three random permutations of the candidate order in only
Aesthetic assessment of images can be categorized into two main forms: numerical assessment and language assessment. Aesthetics caption of photographs is the only task of aesthetic language assessment that has been addressed. In this paper, we propose a new task of aesthetic language assessment: aesthetic visual question and answering (AVQA) of images. If we give a question of images aesthetics, model can predict the answer. We use images from \textit{www.flickr.com}. The objective QA pairs are generated by the proposed aesthetic attributes analysis algorithms. Moreover, we introduce subjective QA pairs that are converted from aesthetic numerical labels and sentiment analysis from large-scale pre-train models. We build the first aesthetic visual question answering dataset, AesVQA, that contains 72,168 high-quality images and 324,756 pairs of aesthetic questions. Two methods for adjusting the data distribution have been proposed and proved to improve the accuracy of existing models. This is the first work that both addresses the task of aesthetic VQA and introduces subjectiveness into VQA tasks. The experimental results reveal that our methods outperform other VQA models on this new