Where Do We Look? Assessing Gaze Patterns in Cosmetic Face-Lift Surgery with Eye Tracking Technology.
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
entrez:
28
6
2019
pubmed:
28
6
2019
medline:
30
10
2019
Statut:
ppublish
Résumé
Aesthetics plays a central role in determining success in plastic surgery. Understanding perceptions of favorable aesthetics is critical to ensure patient satisfaction. Eye-tracking technology offers an objective way of evaluating attention and understanding how viewers direct their focus on patients who undergo cosmetic face-lift procedures. Thirty-six subjects ranging from layperson to attending plastic surgeon viewed 15 sets of photographs before and after patients underwent an elective face-lift procedure. They were instructed to evaluate the aesthetic quality on a Likert scale while eye-tracking equipment tracked their gaze and analyzed their distribution of attention. Postoperative images showed a Likert score improvement of 0.51 ± 0.26, with the greatest difference in attending cosmetic plastic surgeons (1.36 ± 0.22; p < 0.05). The nose was the most common first fixation location (31 percent of first fixations) and the most viewed area (16 ± 3 percent of fixation time) for all subjects. Experienced subjects spent less time in nonrelevant areas (30 ± 11 percent for attending cosmetic plastic surgeons and 37 ± 10 percent for attending noncosmetic plastic surgeons) compared with less experienced subjects (50 ± 15 percent for laypersons). This study demonstrates that viewers with greater experience in cosmetic surgery focus quickly on the cheeks, chin, and neck and have evenly distributed gaze across the entire face. These results suggest that a layperson's gaze is drawn to the center of the face (because of both unfamiliarity with the face-lift procedure and the natural tendency to look at the central face), whereas attending plastic surgeons exhibit holistic gaze patterns and are more aware of the impact of the procedure.
Sections du résumé
BACKGROUND
Aesthetics plays a central role in determining success in plastic surgery. Understanding perceptions of favorable aesthetics is critical to ensure patient satisfaction. Eye-tracking technology offers an objective way of evaluating attention and understanding how viewers direct their focus on patients who undergo cosmetic face-lift procedures.
METHODS
Thirty-six subjects ranging from layperson to attending plastic surgeon viewed 15 sets of photographs before and after patients underwent an elective face-lift procedure. They were instructed to evaluate the aesthetic quality on a Likert scale while eye-tracking equipment tracked their gaze and analyzed their distribution of attention.
RESULTS
Postoperative images showed a Likert score improvement of 0.51 ± 0.26, with the greatest difference in attending cosmetic plastic surgeons (1.36 ± 0.22; p < 0.05). The nose was the most common first fixation location (31 percent of first fixations) and the most viewed area (16 ± 3 percent of fixation time) for all subjects. Experienced subjects spent less time in nonrelevant areas (30 ± 11 percent for attending cosmetic plastic surgeons and 37 ± 10 percent for attending noncosmetic plastic surgeons) compared with less experienced subjects (50 ± 15 percent for laypersons).
CONCLUSIONS
This study demonstrates that viewers with greater experience in cosmetic surgery focus quickly on the cheeks, chin, and neck and have evenly distributed gaze across the entire face. These results suggest that a layperson's gaze is drawn to the center of the face (because of both unfamiliarity with the face-lift procedure and the natural tendency to look at the central face), whereas attending plastic surgeons exhibit holistic gaze patterns and are more aware of the impact of the procedure.
Identifiants
pubmed: 31246802
doi: 10.1097/PRS.0000000000005700
pii: 00006534-201907000-00014
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
63-70Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn
Références
Jones BM, Lo SJ. How long does a face lift last? Objective and subjective measurements over a 5-year period. Plast Reconstr Surg. 2012;130:1317–1327.
American Society of Plastic Surgeons. 2016 plastic surgery statistics report. Available at: https://www.plasticsurgery.org/documents/News/Statistics/2016/plastic-surgery-statistics-full-report-2016.pdf. Accessed April 10, 2018.
Cosmetic surgery national data bank statistics. Aesthet Surg J. 2016;36(Suppl 1):1–29.
Kosowski TR, McCarthy C, Reavey PL, et al. A systematic review of patient-reported outcome measures after facial cosmetic surgery and/or nonsurgical facial rejuvenation. Plast Reconstr Surg. 2009;123:1819–1827.
Naimtu J III. Cosmetic Facial Surgery. 2017.Edinburgh: Elsevier.
Gupta V, Winocour J, Shi H, Shack RB, Grotting JC, Higdon KK. Preoperative risk factors and complication rates in facelift: Analysis of 11,300 patients. Aesthet Surg J. 2016;36:1–13.
Derby BM, Codner MA. Evidence-based medicine: Face lift. Plast Reconstr Surg. 2017;139:151e–167e.
Matarasso A, Elkwood A, Rankin M, Elkowitz M. National plastic surgery survey: Face lift techniques and complications. Plast Reconstr Surg. 2000;106:1185–1195; discussion 1196.
Chang S, Pusic A, Rohrich RJ. A systematic review of comparison of efficacy and complication rates among face-lift techniques. Plast Reconstr Surg. 2011;127:423–433.
Alsarraf R, Larrabee WF Jr, Anderson S, Murakami CS, Johnson CM Jr. Measuring cosmetic facial plastic surgery outcomes: A pilot study. Arch Facial Plast Surg. 2001;3:198–201.
Goin MK, Burgoyne RW, Goin JM. Face-lift operation: The patient’s secret motivations and reactions to “informed consent”. Plast Reconstr Surg. 1976;58:273–279.
Nixon HK. Attention and interest in advertising. Arch Psychol. 1924;72:5–67.
Chandon P, Hutchinson JW, Bradlow ET, Young SH. Does in-store marketing work? Effects of the number and position of shelf facings on brand attention and evaluation at the point of purchase. J Mark. 2009;73:1–17.
Pusic AL, Klassen AF, Scott AM, Cano SJ. Development and psychometric evaluation of the FACE-Q satisfaction with appearance scale: A new patient-reported outcome instrument for facial aesthetics patients. Clin Plast Surg. 2013;40:249–260.
Klassen AF, Cano SJ, East CA, et al. Development and psychometric evaluation of the FACE-Q scales for patients undergoing rhinoplasty. JAMA Facial Plast Surg. 2016;18:27–35.
Klassen AF, Cano SJ, Schwitzer JA, et al. Development and psychometric validation of the FACE-Q skin, lips, and facial rhytids appearance scales and adverse effects checklists for cosmetic procedures. JAMA Dermatol. 2016;152:443–451.
Henderson JM, Choi W. Neural correlates of fixation duration during real-world scene viewing: Evidence from fixation-related (FIRE) fMRI. J Cogn Neurosci. 2015;27:1137–1145.
Isaacowitz DM, Wadlinger HA, Goren D, Wilson HR. Selective preference in visual fixation away from negative images in old age? An eye-tracking study. Psychol Aging 2006;21:40–48.
Senju A, Johnson MH. The eye contact effect: Mechanisms and development. Trends Cogn Sci. 2009;13:127–134.
Frazier TW, Strauss M, Klingemier EW, et al. A meta-analysis of gaze differences to social and nonsocial information between individuals with and without autism. J Am Acad Child Adolesc Psychiatry 2017;56:546–555.
Cai LZ, Paro JAM, Lee GK, Nazerali RS. Where do we look? Assessing gaze patterns in breast reconstructive surgery with eye-tracking technology. Plast Reconstr Surg. 2018;141:331e–340e.
Meyer-Marcotty P, Gerdes AB, Stellzig-Eisenhauer A, Alpers GW. Visual face perception of adults with unilateral cleft lip and palate in comparison to controls: An eye-tracking study. Cleft Palate Craniofac J. 2011;48:210–216.
Olsen A. The Tobii I-VT fixation filter. Available at: https://www.tobiipro.com/siteassets/tobii-pro/learn-and-support/analyze/how-do-we-classify-eye-movements/tobii-pro-i-vt-fixation-filter.pdf. Accessed April 13, 2018.
Olsen A, Matos R. Identifying parameter values for an I-VT fixation filter suitable for handling data sampled with various sampling frequencies. Paper presented at: Symposium on Eye Tracking Research and Applications; March 28–30, 2012; Santa Barbara, Calif.
Chuk T, Chan AB, Hsiao JH. Understanding eye movements in face recognition using hidden Markov models. J Vis. 2014;14:8.
Young AW, Hay DC, McWeeny KH, Flude BM, Ellis AW. Matching familiar and unfamiliar faces on internal and external features. Perception 1985;14:737–746.