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Background Facial wrinkles, pores, and uneven skin tone are major beauty concerns. There is differential manifestation of aging signs in different ethnic groups. In this regard, studies on Black Africans from the African continent are scarce. Objective To investigate facial wrinkles, pores, and skin tone in Black African women from Mauritius Island and elucidate the differences to Caucasian women from France. Methods Facial images were taken using the imaging system ColorFace® . Wrinkles and pores were measured by their length, depth, surface, volume, and number; for skin tone, we measured L*a*b* and calculated ITA, IWANewtone , and color homogeneity. Results We found good correlations of wrinkle and pore scores with expert ranking done on ColorFace® images for Caucasians (Spearman's rho = 0.78 and 0.72) and Black Africans (Spearman's rho = 0.86 and 0.65). Caucasians showed more advanced facial signs of aging than Black Africans. Exceptions were vertical lines on upper lip and the depth of pores which were greatest for the Black African subjects. Black Africans had higher heterogeneity scores indicative for uneven skin tone. Luminance (L*) was significantly higher in Caucasians but a* and b* values were significantly higher in the Black African subjects. ITA and IWANewtone were significantly higher for Caucasians. Conclusions The high correlation between expert ranking and wrinkle and pore measurements prove ColorFace® a valid imaging system to study skin aging. Our results show that Africans from the African continent show delayed signs of aging compared to Caucasians. Some exceptions suggest that ethnic differences in facial aging are a complex phenomenon.

Age invariant face recognition (AIFR) is highly required in many applications like law enforcement, national databases and security. Recognizing faces across aging is difficult even for humans; hence, it presents a unique challenge for computer vision systems. Face recognition under various intra-person variations such as expression, pose and occlusion has been an intensively researched field. However, age invariant face recognition still faces many challenges due to age related biological transformations in presence of the other appearance variations. In this paper, we present a comprehensive review of literature on cross age face recognition. Starting with the biological effects of aging, this paper presents a survey of techniques, effects of aging on performance analysis and facial aging databases. The published AIFR techniques are reviewed and categorized into generative, discriminative and deep learning methods on the basis of face representation and learning techniques. Analysis of the effect of aging on the performance of age-invariant face recognition system is an important dimension. Hence, such analysis is reviewed and summarized. In addition, important facial aging databases are briefly described in terms of the number of subjects and images per subject along with their age ranges. We finally present discussions on the findings, conclusions and future directions for new researchers.

Neck rejuvenation attempts to correct the unattractive features that result from the process of facial aging. The aesthetic goals of surgery include creating a well-defined jaw contour, optimal cervicomental angle, smooth-appearing skin, and a healthy redistribution of soft tissue volume. Unique patient characteristics create inherent challenges that may limit the degree to which improvement can be made. Psychological expectations and motivations influence patient satisfaction and must be understood through careful evaluation and counseling. This article describes common difficult situations encountered during neck rejuvenation and discusses unresolved problems. Several clinical examples along with specific surgical solutions are included.

Facial aging is an important problem of face recognition in missing children and automatic template update. As aging is a temporal process, it alters the facial appearance of the individuals. The sources of variations in facial appearance are caused by wrinkles (under eyes, forehead, around lips, and jawline), facial growth (cranial size and skull), and skin tone. The other factors such as health, lifestyle, and gender also impose variations in the aging process. Therefore, predicting facial aging with considering all those factors is a very difficult task. We present our 3D gender-specific aging model which automatically produces simulated images at age y by taking only one input image at age x irrespective of the pose and lighting conditions. The gender-specific aging model is constructed by various datasets (FG-NET, PCSO, Celebrities, BROWNS, Private), and its quality is evaluated with respect to various combinations of the datasets. We further fine-tune the aging model by changing the length of shape and texture eigenvectors and examine how these parameters affect the simulation results. Comparisons of the simulation results with state-of-the-art approaches as well as ground truth images demonstrate the effectiveness of the proposed methods. The subjective and objective evaluations are also carried out which emphasize the potential of our proposed gender-specific 3D aging model.

Background: the skin displays the most visible manifestations of aging. Research interest in aging process has grown and people are becoming obsessed with looking young. The face has received most of the attention and generated most of the studies related to beauty and aging because it is the most expressive part of human body. Aim of the Work: to assess the different clinical patterns of facial wrinkles and signs of skin aging among different age categories of Egyptian females. Subjects and Methods: this cross-sectional study was carried out in the Dermatology, Venereology and Andrology department of Ain Shams University Hospitals after Institutional Review Board approval. The study included included 100 adult females ranged from 20-60 years old. Results: the mean age was (38.570±11.634) with a range of 20-60 years. Skin phototype was Fitzpatrick Type III in 8 patients (8%), IV in 55 females (55%) and V in 37 females (37%). Glogau classification for severity of skin aging signs was type I in 39 cases (39%), Type II in 20 (20%), Type III in 26 (26%) and type VI in 15 (15%). All patients reported history of excessive sun exposure for extended hours; 32 cases reported sunscreen use but not regular, while 68 cases didn’t use sunscreen. Conclusion: skin Type IV showed more wrinkles indentation index, roughness, melanin concentration, melanin heterogeneity and HGB heterogeneity. There was a significant correlation between the sunscreen use and average melanin concentration, where cases that used sunscreen showed lower average melanin concentration. The relation between sun screen use and severity of wrinkles (Indentation index) was non-significant.

Facial aging involves a combination of volume loss and descent, loss of skin elasticity, dynamic lines due to facial mimetic muscle action, and development of static rhytids. Although surgery remains an option for treatment, minimally invasive aesthetic procedures continue to gain popularity with the use of neuromodulators and soft tissue fillers being the most sought-after procedures. Although these may be used in isolation to treat specific concerns, they are often combined to address multiple facets of aging. Multiple different neuromodulators and fillers are commercially available. Although relatively effective and safe, a thorough understanding of their indications, compositions, and potential adverse effects is paramount. This article will review the available aesthetic products for minimally invasive periorbital rejuvenation with botulinum toxin and injectable fillers. Although it will not focus on other therapies aimed at facial rejuvenation, such as resurfacing techniques or surgical interventions, it is important to note that an individualized treatment plan may combine multiple therapies to optimize patient outcomes and satisfaction.

Background Injectable dermal fillers are commonly used by physicians in the treatment of the signs of aging. The most commonly used dermal filler is hyaluronic acid. Skinfill plus (SFP) belongs to the family of monophasic monodensified fillers. In this post-marketing clinical study, we have evaluated the efficacy of SFP for the treatment of facial aging. Methods The study enrolled 109 patients in three different centers that were treated with various SFP fillers to treat facial aging. Analyses of the cosmetic effects were performed by using the Wrinkle Severity Rating Scale (WSRS) and the Global Aesthetic Improvement Scale (GAIS). Results Statistical analysis showed a significant effect on facial aging for all the SFP fillers used at all time-points studied. Moreover, a significant correlation was found, by analyzing the grade of facial aging, calculated by using the WSRS or the lifestyle of the patients (smokers or non-smokers) in relation to the cosmetic effects of the treatment. Conclusions The study confirms the good performance and safety of SFP for a range of facial indications in routine clinical practice.

During the aging process, the appearance of the human face changes significantly due to fundamental alterations in the bones, soft tissues, and skin. Both endogenous and environmental factors are involved in age- related transformations of the face ; however, facial skin is particularly influenced by environmental factors, and the risk of overexposure and consequent premature facial aging. This review summarizes the current state of knowledge of the most common facial skin changes in the mature patient, including pathogenesis of both intrinsic and extrinsic skin aging, as well as clinical and histologic features of skin aging. Because the majority of facial skin changes in the elderly develop as the consequence of ultraviolet radiation, these can be prevented by adequate photoprotection.

Age-dependent modification of the facial subcutaneous white adipose tissue (sWAT) connected with reduction of its volume, modification of collagen content and adhesion between dermal and adipose layers can significantly influence mechanical stability of the skin and cause the development of aging symptoms such as wrinkles. Typical aging appearance in facial skin is at least partly connected with special phenotypical features of facial preadipocytes and mature adipocytes. In this paper, we have discussed the possible roles of local inflammation, compartmental structure of facial sWAT and trans-differentiation processes such as beiging of white adipocytes and adipocyte-myofibroblast transition in facial skin aging.

Uwe Wollina,1 Reinhard Wetzker,2 Mohamed Badawy Abdel-Naser,3 Ilja L Kruglikov4 1Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, 2Department of Anesthesiology and Intensive Care Medicine, and Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany; 3Department of Dermatology and Venereology, Ain Shams University Hospital, Cairo, Egypt; 4Wellcomet GmbH, Karlsruhe, Germany Abstract: Age-dependent modification of the facial subcutaneous white adipose tissue (sWAT) connected with reduction of its volume, modification of collagen content and adhesion between dermal and adipose layers can significantly influence mechanical stability of the skin and cause the development of aging symptoms such as wrinkles. Typical aging appearance in facial skin is at least partly connected with special phenotypical features of facial preadipocytes and mature adipocytes. In this paper, we have discussed the possible roles of local inflammation, compartmental structure of facial sWAT and trans-differentiation processes such as beiging of white adipocytes and adipocyte-myofibroblast transition in facial skin aging. Keywords: facial aging, adipose tissue, preadipocytes, adipocytes, inflammation, beiging, adipocyte-myofibroblast transition&nbsp

The orbicularis oculi muscle, an important mimetic muscle, was investigated to ascertain its anatomical relation to facial aging-especially its orbital part (Oo). Previous studies of the distinct muscle bundles frequently found inferior to the Oo have provided various definitions, including that of the malaris muscle. This study aimed to examine these muscle bundles and clarify their function in facial aging. Twelve heads of Japanese cadavers (average age: 82.5 years old) were dissected to observe the muscles, focusing in particular on those in the periorbital region. Six specimens were further dissected from the inner surfaces to examine the patterns of facial nerve branches under the operating microscope. Histological examinations of two head halves were carried out to investigate the relationship between the muscle bundles and the intraorbital structures. Muscle bundles consisting of lateral, medial, and U-shaped suspending bundles were observed in the region inferior to the Oo. Lateral and suspending bundles were found in all specimens, while the medial bundles were noted in only 9 of 22 specimens. Some branches of the facial nerve penetrated through the lateral, medial, and suspending bundles. The relationship between the suspending bundles and the protruding orbital fat was assessed. The muscle bundles found in this study were regarded as the malaris muscle-a transitional muscle between the superficial and deep facial layers. The suspending bundle may play a role in sustaining the intraorbital structures.

Sabrina Fabi,1 Tatjana Pavicic,2 André Braz,3 Jeremy B Green,4,5 Kyle Seo,6 Jani AJ van Loghem7 1Cosmetic Laser Dermatology, San Diego, CA, USA; 2Private Practice for Dermatology and Aesthetics, Munich, Germany; 3Division of the Policlínica Geral do Rio de Janeiro (PGRJ), Rio de Janeiro, Brazil; 4Skin Associates of South Florida, Miami, 5University of Miami Department of Dermatology, Miami, FL, USA; 6Seoul National University, Seoul, South Korea; 7Doctors Inc., Amsterdam, The Netherlands Abstract: The Merz Institute of Advanced Aesthetics Expert Summit was held in Prague, Czech Republic, from 19–20 November 2016. The meeting had a distinct advisory board character and invited aesthetic practitioners from all over the world to hear an international faculty present a range of keynote lectures and conduct live injection sessions with an emphasis on recent developments in combination aesthetic interventions for face and body rejuvenation and beautification. Aging is associated with changes in bones, muscles, ligaments, adipose tissue, and skin and, moreover, involves interactions among these tissue types. To achieve the most natural and harmonious rejuvenation of the face, all changes that result from the aging process should be corrected, which generally involves treatment with more than a single agent or technology. Presentations described innovative treatment algorithms for the face and body and focused on patients’ desires for natural-looking rejuvenation and how this requires a three-dimensional approach combining products that relax the musculature, volumize, and re-drape the skin. Besides treating the aging face, these procedures are increasingly used to enhance facial features as well as to delay facial aging in younger patients. The presentations covered patients from different ethnicities as well as the treatment of non-facial areas, with a particular focus on the use of Ultherapy® for skin lifting and tightening, and new aesthetic procedures such as Cellfina® and diluted Radiesse®. The current report provides a summary of key presentations from the meeting. Keywords: calcium hydroxylapatite, Cellfina, hyaluronic acid, incobotulinumtoxinA, Ultherapy

The aim of this study was to evaluate the efficacy and safety of the fractional ablative carbon dioxide laser for facial rejuvenation.Twenty-nine female who have the complaint of facial aging were recruited for the study. Participants received a maximum of three laser treatment sessions with one-month intervals and were scored using a 5-point scale on seven categories for facial aging before and after the treatment by the physicians. Self-assessments by participants were done at the last month of follow-up period and 3 years after the last session.Mean facial aging score before the treatment was 11,24 ± 4,30 and after the treatment was 10,51 ± 3,86 (p = 0.003). The decrease in the score was mild in 18 (62,1%) participants, whereas it was moderate in only 1 (3,4%) participant. None of the participants had significant or perfect improvement. When the seven categories were analyzed seperately, the only statistically significant alteration in the score was found in the skin tone category (p = 0.0001).Results show that rejuvenation with the fractional ablative carbon dioxide laser decreases mildly the symptoms of facial aging in more than half of the patients.

Research in facial aging has focused on soft-tissue changes rather than bony changes despite evidence of the importance of underlying bony structural changes. Research has also been limited by comparing different patients in separate age groups rather than the same patients over time.To longitudinally document patterns of change in the facial skeleton and determine a consistent methodology for measuring these changes.Case series study of university hospital system records using facial computed tomographic (CT) images timed at least 8 years apart in adults initially aged 40 to 55 years with no history of facial surgery who required repeated facial imaging that included the entire midface and cranium.Face CTs were analyzed for 3-dimensional constructions and 2-dimensional measurements to document changes in glabellar, piriform, and maxillary angles and piriform height and width.Fourteen patients (5 men, 9 women; mean [SD] age, 51.1 [5.8] years) with mean (SD) follow-up of 9.7 (1.4) years were eligible for 2-dimensional analysis, which revealed statistically significant decreases in mean (SD) glabellar angles (from 68.8° [7.6°] to 66.5° [8.6°]) and maxillary angles on both the right (from 82.5° [6.3°] to 81.0° [7.1°]) and left (from 83.0° [5.8°] to 81.0° [7.0°]), as well as increases in mean (SD) piriform width (from 24.5 [1.6] mm to 25.5 [1.3] mm). Nine patients (3 men, 6 women; mean [SD] age, 51.4 [6.3] years) with mean (SD) follow-up imaging at 9.6 (1.5) years were eligible for 3-dimensional analysis, which revealed statistically significant decreases in mean (SD) maxillary angles (from 56.5° [6.6°] to 51.6° [7.6°]) and piriform angles (from 50.8° [3.4°] to 49.1° [3.4°]). Statistically significant differences between the sexes were also noted: Initial mean (SD) glabellar angle for men was 61.7° (5.7°) vs 72.7° (5.4°) for women, with final values of 57.9° (4.9°) vs 71.2° (6.0°). Mean (SD) maxillary angle initial values were 87.8° (6.1°) (right) and 87.1° (4.9°) (left) for men, with 79.6° (4.3°) and 80.6° (5.0°) for women, respectively. Final values were 87.0° (4.4°) and 86.9° (4.1°) for men and 77.7° (6.1°) and 77.7° (6.2°) for women, respectively. Mean (SD) piriform height for men was 35.0 (2.0) mm initially and 35.5 (2.1) mm finally, vs 31.3 (2.8) and 31.6 (3.0) mm for women, respectively.Our pilot study of repeated CT images of patients over several years supports previous studies of bony facial aging and further characterizes these changes. This study is the first, to our knowledge, to document bony changes of the face in the same group of patients at different time points to better characterize facial aging. We also detail an improved methodology to study bony aging to contribute to additional research in the field.NA.

Facial aging is a complex process individualized by interaction with exogenous and endogenous factors. The upper lip is one of the facial components by which facial attractiveness is defined. Upper lip aging is significantly influenced by maxillary bone and teeth. Aging of the cutaneous part can be aggravated by solar radiation and smoking. We provide a review about minimally invasive techniques for correction of aging signs of the upper lip with a tailored approach to patient's characteristics. The treatment is based upon use of fillers, laser, and minor surgery.

For optimal results, facial rejuvenation procedures should address both the tissue laxity and volume deflation associated with facial aging. The lift-and-fill face lift, in which fat grafting provides volumetric rejuvenation to the face while surgical lift effectively repositions and removes ptotic and redundant tissue, has revolutionized the plastic surgeon's approach to the aged face. An understanding of the intricate anatomy of distinct facial fat compartments and a systematic method to assess areas of fat atrophy and volume depletion are keys to provide patients with a natural and youthful result. Fat grafting may be used to improve contour in any area treatable by nonautologous injectable fillers, including the temples, forehead, upper and lower orbit, cheeks, perioral region, nasolabial fold, jawline, and chin—with the benefit of a more natural contour and integration with native tissue.

BACKGROUND The use of stem cells derived growth factors is representing a novel treatment modality in facial rejuvenation. Nowadays, skin needling is considered a very famous treatment of skin aging. However, the addition of such derived products, augments its therapeutic efficacy in the management and delay of skin aging. OBJECTIVE Comparing the effect of amniotic fluid mesenchymal stem cell derived conditioned media (AF-MSC-CM) combined with skin needling versus the needling alone in the management of facial aging. METHODS Both sides of the face of ten volunteers, suffering from facial aging, were treated with five sessions of skin needling, 2 weeks apart. After skin microneedling, AF-MSC-CM was added topically to the right side only. Clinical, histological, and morphometrical assessment of the treated skin was done at 1 month after the last session. RESULTS The percentage of improvement of aged skin increased significantly on the combined treated side (AF-MSC-CM and dermaroller [DR]), when compared with the other side (DR only) (P

Objectives (a) To assess and compare the changes in five facial signs with age between genders of Caucasian subjects and (b) to evaluate their links with perceived ages and tiredness. Material and methods Once zoomed from standardized digital photographs, five facial signs of 518 Caucasian French subjects of both genders and different ages (18-69 years) were graded by 15 experts, using a referential Skin Aging Atlas. A large naive panel of 1000 French subjects (500 men and 500 women) was asked to attribute a perceived age and a degree of tiredness to 200 subjects (among the 518). Results The severity of the facial signs increases with time at a linear-like rate. The changes in marionette lines significantly differ between genders, much more pronounced in women, and nasolabial fold was found more pronounced in men at older ages (>50 years). Before 50's, Forehead wrinkles present a slightly higher severity in men whereas at 50's women present more severe ptosis. Crow's feet wrinkles did not show significant changes. Perceived ages were found significantly correlated with the severities of the facial signs and the perception of tiredness was associated with perceived ages in men, but not in women older than 40 years. The gender-related perceptions from the naive panel in both perceived ages and tiredness showed a low discrepancy. Interestingly, as for changes in facial signs, the upper-half face seems more affected for men and lower-half face for women; after 40 years, the naive panel seems more focusing on the same areas to predict a perceived age. Conclusion As compared to the previous Chinese study, the present work reveals some slight ethnical-related differences, indicating that the facial signs of the lower face play a major role in the assessment of perceived age of both genders from different ethnicity.

The poly-L-lactic acid (PLLA) injection technique stimulates neocollagenesis and provides a natural look. In recent years there has been a growing interest for using this in other body areas such as the neck, chest, back of hands, lower breast region, thoraco-axillary fold, buttocks, arms and medial thighs. Both in facial application as in the body, there is no consensus regarding the best dilution or application technique, and their descriptions mainly based on the authors experience. In this chapter will approach a new technique for body areas and the dilution of the quantity of the product per application. The application of PLLA for rejuvenation of body areas is a minimally invasive procedure, durable and low frequency of complications. The poly-l-lactic acid (PLLA) was approved in Europe in 1999 and approved in the United States in 2004 by the FDA for the treatment of facial lipoatrophy associated with human immunodeficiency virus (HIV). In 2009, FDA approved PLLA for cosmetic indication in immunocompetent patients [1, 2]. Over the past 20 years of experience, PLLA was safe and effective. It is a widely used and safe application to restore volume in facial aging and bofy sagging.

Volume loss in the face is a key component of facial aging. Autologous volume restoration using fat to fill and lift the tissues has been a successful procedure used to minimize the signs of aging or to enhance facial features and maintain signs of youth.

Are shorter telomeres causal risk factors for facial aging on a large population level? To examine if longer, genetically predicted telomeres were causally associated with less facial aging using Mendelian randomization analysis. Two-sample Mendelian randomization methods were applied to the summary statistics of a genome-wide association study (GWAS) for self-reported facial aging from 417, 772 participants of the UK Biobank data. Twenty single-nucleotide polymorphisms (SNPs) that were of genome-wide significance were selected as instrumental variables for leukocyte telomere length. The main analyses were performed primarily using the random-effects inverse-variance weighted method and were complemented with the MR-Egger regression, weighted median, and weighted mode approaches. The intercept of MR-Egger regression was used to assess horizontal pleiotropy. Longer genetically predicted telomeres were associated with a lower likelihood of facial aging (β = − 0.02, 95% confidence interval: − 0.04, − 0.002). Comparable results were obtained using MR-Egger regression, weighted median, and weighted mode approaches. The intercept of MR-Egger regression was close to zero (0.002) that was not suggestive of horizontal pleiotropy. Our findings provided evidence to support a potential causal relationship between longer genetically predicted telomeres and less facial aging.

A wide variety of chemical peels can be used in the eye region to provide periorbital rejuvenation (POR) and treat post inflammatory hyperpigmentation (POH). Less invasive treatment options include superficial to medium peels using trichloroacetic acid, glycolic acid, and other agents. Segmental phenol peels offer a more aggressive option. Skin types and facial structure should be considered in determining the best treatment plan for each case. To optimize results, chemical peel treatments may be combined with a blepharoplasty or other surgical or injectable options. Periorbital chemical peels can be highly rewarding to both patient and physician as the eye region tends to have the earliest and most noticeable signs of facial aging.

Facial aging is a complex process, and the changes in the inner layers of the skin will affect how the light scatters from the skin. To observe whether a light scattering model parameter is suitable to be used for age classification/estimation, this study investigated and analyzed the relationship between the parameter of an analytical-based light scattering model and skins of various ages using photometry method. Multiple models are used to investigate and compare the relationship between the model parameters and the subject’s age. The results show that all of the models’ roughness parameter representation has a significant positive correlation with age (\(p

The face is organized in five different layers (skin, muscles, supportive ligaments, fat pads and bones), which are continuous and interconnected with each other from the scalp to the neck. As a result of aging, changes occur in all its tissues and structures, triggering a cascade of effects in the adjacent areas. Actually, the more it is known about the loss of volume, the better it is to establish the target spots for volume replacement, with consequent more natural- and harmonious-looking outcomes. However, the skin is the outer envelope of the face, which, in the natural process of aging, has a lower capacity to completely accommodate any underlying volume loss or displacement. The result is the formation of creases and folds due to skin sagging. To describe the effects of the injection of calcium hydroxyapatite (CaHA) targeting two objectives at the same time: the restoration of volume loss to compensate the changes in the tridimensional structure and the improvement in skin texture caused by the stimulus to collagen synthesis, thus reducing the sagging of soft tissues envelope. Owing to the mechanism of action of CaHA, its application can be done in two differentiated and little invasive ways so that these objectives can be reached simultaneously. This technique can provide safe, natural and long-lasting rejuvenating effects. DOI: http://dx.doi.org/10.5281/zenodo.3569835