The Art & Science of Beauty

DST and Evolution of Double Eyelid Surgery

2017-09-11T19:08:00.000-07:00

Eyes are the window to the soul.

This is a quote that dates back to the years past that describes the fascination and importance placed on our eyes. An interesting study was conducted in 2007 to support this age-old belief. According to its findings, the eyes really do say a lot about us. The patterns on our irises (the part which gives the colour to our eyes) can indicate if we are warm and friendly, or downright neurotic and impulsive. Nonetheless, its main message is clear – our eyes speak volumes in conveying to people what we feel and think.

Apart from that, the eyes have also been subject to many debates as to how certain shapes or sizes are considered to be more beautiful and attractive as compared to others. Some may prefer almond-shaped eyes while others tend to favour deep-set or hooded ones. Subjective though the perceptions may be for ideal eyes, there seems to be a unifying belief that larger eyes are the more attractive ones, especially to men.

This belief may have been the main contributor to the popularity of eye surgery to create double eyelids. Why? It is simply because double eyelids give the appearance of larger eyes. Studies have shown that approximately 50% of people of the Asian origin do not have the upper eyelid crease. As such, the double eyelid surgery is mostly opted by Asians, so much so that it is also known as the Asian blepharoplasty.

Evolution of the double eyelid surgery

Double eyelid procedure is generally divided into two main categories – incisional and non-incisional. As the name indicates, incisional blepharoplasty involves a significant incision to be made on the upper eyelid where skin and fat is removed and the incision sewn up to create a crease. Meanwhile, non-incisional procedures involve the use of sutures in place of cutting to create a fold on the eyelid.

Back in the days

The procedure can be traced as far back as the 1st century AD, where it was initially performed to correct eye deformities. It is said that Aulus Cornelius Celus was the first person to have performed the first surgery to relax the eye muscles.

Aulus Cornelius Celus

However, literature show that it was not only until 1896 that double eyelid procedure was conducted purely for cosmetic purposes. Initiated by surgeon Mikamo in Japan, the earliest recorded cosmetic double eyelid procedure was performed on a Japanese patient to create a crease in one of the patient’s eyelids using a suture technique (a non-incisional procedure). Sutures made of silk were passed through the patient’s upper eyelid and were left in place to create sufficient depth to the crease before they were removed. This same method was adopted by another Japanese surgeon, Uchida in 1926 who employed catgut sutures to create the creases, where they were left in place for four days prior to their removal.

Blepharoplasty throughout the years

The first incisional blepharoplasty then came into play in 1929 when Maruo, yet another Japanese surgeon, reported to have combined both the suturing and incisional methods. A 7mm incision was first made across the patient’s eyelid and was later sutured to create the desired crease. Many surgeons then followed in Maruo’s footsteps in using the combination method, fine-tuning their techniques along the way.

In the years that followed, these two methods have evolved to become different blepharoplasty procedures in their own right, each with its own distinctive techniques.

Now, blepharoplasty is a widely accepted and commonly performed procedure to create double eyelids in the worldwide quest to possess eyes that appear bigger and brighter.

And now, the Double Suture and Twist

If cutting away the skin and tissue from your eyelids sounds a little extreme (not to mention scary!) for you, there is another viable alternative to having double eyelids – a non-incisional Asian double eyelid creation technique, called the Double Suture and Twist (DST) or Minami Technique.

What is DST?

DST is a technique that was published in 2001 by Dr Akihiro Minami, a renowned plastic surgeon in Japan. Designed to be a minimally invasive procedure, DST does not require significant incisions to be made, hence does not leave behind significant scars on the patient’s eyelids.

Also described as the most sophisticated suture technique with proven durability, it takes about 30 minutes to create the creases for both eyes.

Inventor of the DST technique, Dr Akihiro Minami, Japan (Left) and DST practitioner, Dr David Low (Right).

How is DST performed?

The surgeon first makes 3 small punctures on the upper eyelid of each eye. Then, using a specific twisting technique, two sutures are passed through those punctures and twisted around each other four to five times. After minimal suturing, the double sutures are tied together to create a fold on the upper eyelid. The result of this procedure is that when the patient opens his or her eyes, the underbelly of the skin is pulled inwards, resulting in a natural looking crease.Although a quick and often less painful method to obtaining double eyelids, non-incisional procedures in general are said to be less effective when compared to incisional ones, owing to its high suture breakage rate and results that can fade over time.

However, studies have shown DST to be both a safe and relatively durable procedure. Besides that, the results are also reversible in case patients change their minds.
Furthermore, downtime for the patient is also shorter than incisional double eyelid surgeries which usually require a longer period swelling.

The Double Suture and Twist (DST) Technique or Minami Technique.

Is DST for everyone?

Although it can benefit everyone, it is however more suited to certain candidates, in particular, the younger generation who are below 40s.

On the other hand, DST is not suitable for those with problematic eyelids such as those with asymmetrical or sagging eyelids and/or a lot of fatty tissues around the eyelids. Candidates with these issues are usually advised to opt for the conventional blepharoplasty for best results.

Moving forward with non-incisional techniques

As seen above, double eyelid creation methods and techniques are constantly improving over time to provide patients with better and safer experiences in obtaining their desired looks.

For patients who fear surgeries, non-incisional procedures such as DST can help take a load off their minds. Without involving significant incisions, patients are able to enjoy a reduced healing period with long-lasting results that are also reversible, just in case. As such, they need not worry about permanent scars and/or taking a long time off work to recover after the procedure.

DST has the potential to emerge as the more practical method among non-incisional procedures in creating a long-lasting, natural looking crease to make your eyes appear bigger and brighter.

Looking ahead, who knows what more the future may bring to the world of double eyelid surgeries…

Thread Facial Rejuvenation

2014-02-12T02:26:00.002-08:00

The aging process begins to appear around the 30s. This process reverses the “triangle of beauty” whose base is at the top of the face during adolescence. Around the 35s this triangle inevitably reverses with time due to the sagging of the deep tissues. Deep furrows and wrinkles begin appearing, indicating an inner change in the supporting structure of the skin.

In the last decade, there has been increasing popularity of nonsurgical cosmetic procedures performed. This reflects the increasing demand for facial rejuvenation with quick recovery period, low risk, not too costly, and provides natural results. The commonest nonsurgical cosmetic procedures include cosmetic muscle relaxation using botulinum toxin and soft tissue augmentation with dermal fillers such as hyaluronic acid. In addition, there are also several tissue-tightening devices such as infrared ligh and radiofrequency to improve skin laxity by heating the deep dermis. However, none of these modalities address the sagging of deeper tissues of the face.

Thread facial rejuvenation techniques are good adjuvants to tissue-tightening machines and injection procedures for patients who would benefit from lifting of mild to moderate sagginess, but they do not replace surgical facelift procedures for those with more severe sagginess or excessive skin laxity. Volume changes are usually due to aging process and occur both in the underlying bone and the soft tissues. Small changes due to volume loss and bony resorption can be addressed using dermal fillers.

In the midface, the cheek fat pad descends gradually from its normal position over the cheek bone. Gravity facilitates this process by providing a downward vector for tissue that has lost elasticity and underlying structural support. As the fat falls away from the lid–cheek junction, the lower lid appears to lengthen and a hollow below the eye develops, also known as the tear trough deformity. The nose-lip fold deepens as the cheek fat pad adjacent to it drops. Further descent of the cheek fat pad accentuates the jowls and flattens the cheek above. Aging in the lower face and neck begins with accumulation of fat in the jowls and below chin area, skin laxity in the neck, and prominent 'turkey neck' bands. These changes results in a loss in definition of the jawline, a rectangular-shaped face, and an increase in the neck-chin angle.

The rationale for treatment using threads is to reverse the early signs of aging by lifting and suspending tissues that have begun to drop. By repositioning soft tissues in this way, not only are sagging tissues lifted, but volume is also restored in important areas, such as the midface. These techniques are not intended to correct more advanced signs of aging where significant skin laxity is present. Similarly, excessive fatty deposits in the face, below chin area, and neck are not improved with threads alone, particularly when the overlying skin is tight. These problems require more aggressive measures such as surgical facelift. The ideal candidate for a suture lift has mild sagginess of brow, outer eye angle, cheek fat pad, jowls, or neck. Even mild sagginess in these areas can produce a sad or sullen look and lifting by a few millimeters will give a more pleasing contour. Skin laxity should not be excessive and facial volume should be fair. If there is drastic skin laxity or the face is too thin, the threads may cause excessive bunching or irregularities. Patients should have realistic expectations and understand that thread facial rejuvenation techniques do not replace conventional surgical facelift.

The face and human interactions

2013-11-05T08:50:00.000-08:00

Psychologist Albert Mehrabian described 3 components in face-to-face communications namely, verbal, vocal and visual. Also known as the Mehrabian Rule, this rule states that 7% of communication involves words, 38% tone of voice and 55% body language. Usually the 3 components have to be congruent to support each other in communication. When words and body language fail to agree, one tends to believe the body language.

People see, observe and judge others via their facial expressions. Facial expressions are therefore essential for daily life to enable effective communication.

Often times, people express concern that their facial features are communicating unintended signals.

Often times, people express concern that their facial features are

communicating unintended signals such as disapproval (frown lines), tiredness or disinterest (droopy eyelids), aging (forehead wrinkles and crow’s feet), worry (droopy angle of mouth, eyebrow and frown lines).

Hyperactive corrugator muscles can send out unintended signals of worry or disapproval.

Dental and skull deformity can also impair the ability to express oneself, with an observer potentially misinterpreting one’s emotions or personality. For example, people with short chin, protruding incisors, or gummy smiles may appear unintelligent. People with huge jaw tend to appear more aggressive and a smile may appear more like a grimace. Those with flat cheek bones or saggy face often have down-turned angle of the mouth, thus looking angry or sad.

A small eye with single eyelid and wide inter-eye distance is sometimes misinterpreted as disinterest or tired

In other words, the face can malfunction as an organ of communication. As a great deal of human communication takes place without the need for words, facial expression is immensely significant in non-verbal communication. As aesthetic medical treatment is increasingly accessible, more people are seeking such services to improve their quality of life in terms of social interactions, carrier development and personal satisfaction.

Droopy brow and deep nose-lip fold with saggy mouth angle may appear as sad or angry.

DST 缝制无痕双眼皮

2013-01-31T20:13:00.002-08:00

交叉式勾双眼皮（Double sutures and twisting method /DST) 手术法是最复杂的双眼皮手术。

相对而言，传统的缝合法具有较高的损伤率和不清晰的皱折，其将随着时间的消逝而退化。

交叉式勾双眼皮（Double sutures and twisting method /DST)不仅可以解决这些不足，还可以保有缝合法的优势，如皱折几乎无痕、自然，并有潜在的可逆性、恢复迅速快（仅需要几天而非几周）。

在埋线法手术中，折痕的生成是通过永久性地埋入无排斥反应的线（聚丙烯纺织纤维，用于心瓣膜手术），至眼睑的深度软组织。分析显示埋入线通常不会断裂，但埋入线可能切穿上眼睑的软组织。

交叉式勾双眼皮(DST)矫正了这个问题，并让埋入线更结实，还降低了让埋入线切穿软组织的可能性。首先，把埋入线的一端固定在上眼睑最结实的组织——睑板（其由坚固的软骨组成）；埋入线的另一端与临近的埋入线链接，正如两个连接在一条链上。在打结前，眼睑皮肤下方被捏入埋入线。这就形成一个坚固且互锁的折皱，极为有效地防止了其切穿或断裂。

以下为部分完成的交叉式勾双眼皮例子：-

A History of Asian Double Eyelid Surgery

2013-01-30T00:42:00.000-08:00

Is double eyelid surgery an attempt at Westernization of the Asian Eyelid?

Here is an abstract from PMC:

Asian Blepharoplasty

Marilyn Q. Nguyen, M.D., Patrick W. Hsu, M.D., and Tue A. Dinh, M.D.

Semin Plast Surg. 2009 August; 23(3): 185–197.
doi: 10.1055/s-0029-1224798

The “double eyelid” operation, or surgical creation of a supratarsal crease, is the most commonly performed aesthetic procedure in Asia. Whereas this procedure is considered by some to be an attempt at Westernization of the Asian eyelid, the first published description of the procedure was in the late 1800s, long before the existence of a strong Western presence in Asia.

Early publication in the Japanese medical literature favored the suture ligation method. In 1896, Mikamo described the “double eyelid” feature and how it was considered an indicator of beauty by writers and artists of that time period. Single eyelids that did not possess a distinct supratarsal crease were described as “monotonous and impassive.” He estimated the incidence of the single eyelid in Japanese women to be approximately 17 to 18% and thus concluded that the double eyelid was the physiologically normal appearance. Mikamo's technique was a modification of a surgical procedure used to correct entropion that was first described and used in the ophthalmology literature. He referenced Kamoto by saying that the procedure not only corrected entropion but also created a “clear double eyelid and a more attractive look.” In this first publication on Asian blepharoplasty, Mikamo described how three sutures were passed through the full thickness of the eyelid to include the tarsus. Each suture was placed approximately 3 mm apart, 6 to 8 mm superior to the lid margin, and removed after 4 to 6 days. He emphasized maintaining an appropriate distance between the lid margin and the suture line such that the double lid remained commensurate with those of Japanese women who had a naturally occurring crease. This again highlights the fact that the initial operation was not intended to Westernize the eyelid but to create an overall more expressive look.

After these initial case reports by Mikamo, little was published until the 1920s, when increased Western presence introduced new concepts of beauty and changed the Asian attitude toward aesthetic surgery. The suture ligation technique continued to be the only method and was described by several authors including Uchida. In Uchida's article, he described his results with 1523 eyelids in 396 males and 444 females. The crease was designed similarly to Mikamo's description; it was placed 7 to 8 mm from the ciliary margin, and the sutures were removed on postoperative day 4.

Maruo described the first external incision technique in 1929. His technique required an incision across the lid 7 mm from the ciliary margin. Closure of the incision included a trans-lid passage from the conjunctiva to the superior tarsal border of the anterior skin edge to the tarsal plate.

Over time, a greater Western influence was clearly seen and reflected in the procedures that followed. Hata described creating a higher crease at 10 mm in 1933, and in the 1940s to 1950s, multiple authors including Hayashi, Inoue, Sayoc, Mitsui, Fernandez, and Boo-Chai described techniques including excision of muscle and fat to create a deeper-set eye in addition to creating a double eyelid.

Today, the literature contains abundant material on both suture ligation and external incision techniques, as well as a new focus on procedures to eliminate the epicanthal fold. The surgeon should be aware of the broad range of surgical options in modifying the eyelid and tailor procedures according to each individual patient's preferences, which can vary widely even between different Asian populations. According to the 2006 cosmetic demographics published by the American Society of Plastic Surgeons, Asian Americans compose 6% of the cosmetic patient population with blepharoplasty ranking as the third most commonly requested surgical procedure behind rhinoplasty and breast augmentation. Although most patients desire the creation of a supratarsal crease, the expectation of the size, shape, and height of the crease can differ significantly between different subsets of the Asian population. All in all, most surgeons agree with the idea that the double eyelid procedure should create a lid that remains within the norms for the Asian face, rather than Westernize the eyelid altogether.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884917/

The Math Behind Beauty

2012-12-12T00:17:00.000-08:00

A plastic surgeon computes the perfect face.

By Bruno Maddox|Friday, June 01, 2007

“What is Beauty?”

Marylin Monroe (1957) by Milton H. Greene
Image courtesy of Marquardt Beauty Analysis

Very little has surprised me more, in my years as a public intellectual, than how often I get collared on the street by some desperate pedestrian demanding an answer to this most fundamental question. Almost never. It hardly ever happens.

Which is odd, because people still care about Beauty—quite a lot in fact—especially here in Southern California, if I can be the first to make that observation. Last night in my room at the Sunset Marquis I reached out for what I assumed was the room-service menu and passed a few fleeting surreal moments trying to imagine what “Upper Leg with Bikini” might taste like, for a mere $100. It turned out that I had grabbed the Beauty Menu by mistake and that for $240 someone was prepared to come to my room and give my skin a “Firming Renovateur.”

But while people may care about being beautiful as much as they ever did, it seems they have largely stopped trying to figure out what Beauty actually is.

It wasn’t always thus. The ancient Greeks, for their part, were convinced that an explanation of, and definition for, Beauty was as concrete and discoverable as the answer to why the days got shorter in winter or why your toga weighed more after you’d gone swimming in it. Indeed, no less a thinker than Pythagoras, he of hypotenuse fame, logged some impressive early results. In music, Pythagoras showed that the notes of the musical scale were not arbitrary but reflected the tones produced by a lute string—or any string—when its length was subdivided precisely into such simple ratios as 2:1 or 3:2. In architecture and design, similarly, he managed to show that the shapes people found most pleasing were those whose sides were related by the so-called golden ratio.

The golden ratio, briefly, is the proportional relationship between two lines a and b such that (a + b) is to a as a is to b; in other words, the ratio between the whole and one of its parts is the same as the ratio between its two parts. This doesn’t sound like much in algebra form (a/b = (a + b)/a) and still less when expressed as a decimal (1:1.61814). But draw a rectangle—or build a Parthenon—with sides of a and b, and the sheer cosmic rightness of the thing leaps out at you. If you were to be stranded on a desert island with one particular rectangle, that’s the one you’d go with. Palpably, it’s the first rectangle that occurred to God when he realized he needed another four-sided, right-angled shape to complement his juvenile masterpiece, the square.

This was good enough for Plato, the 800-pound gorilla of ancient Greek intellectual life, to include Beauty as one of his famous forms: those transcendent, invisible archetypes of which this reality is nothing but a set of blurry ramshackle imitations. Beauty was not in the eye of the beholder. On the contrary, to borrow Plato’s legendary cave metaphor, the beholder had his back to Beauty, able to see only its flickering shadows on the grimy cave wall of reality.

In short, the Science of Beauty was inaugurated by the two classical thinkers upon whose shoulders the science of pretty much everything else would eventually come to rest. Among historians of science, that’s what is known as a rollicking and auspicious start.

Imagine the surprise, therefore, of one Dr. Stephen Marquardt, a plastic surgeon working in Southern California at the tail end of the 20th century, who checked in on the progress of the Science of Beauty since Pythagoras and found that very little had been made.

As Los Angeles plastic surgeons go, Marquardt (now retired from clinical practice) was the serious, unsleazy sort. His patients weren’t the standard Valley girls and divorcées whose breasts a doctor could breezily augment to the tinkle of a Japanese water feature before checking his teeth in the shine of his scalpel and heading off for cocktails at Skybar. His patients were deformed. They were people who were born without chins or who had taken a speedboat turbine to the face. And they came to him with dreams not of gorgeousness or superstardom but of one day being able to ingest food orally.

Yet herein lay a paradox. The fact that aesthetic perfection was the last thing on his patients’ minds meant that Marquardt had to think about it all the time, far more than if he’d been just another surgeon slinging collagen up in Beverly Hills. People didn’t come to him wanting a cleft in their chin; they came to him wanting a chin, and they generally left it up to Marquardt to decide what the thing was actually going to look like.

Which was harder than it sounds. Often Marquardt would walk out of surgery thinking he’d gotten someone’s chin exactly right, only to find weeks later, when the bandages came off, that the thing just didn’t work on an aesthetic level.

The solution, Marquardt decided, was to ramp up the degree of proportional precision. But he could find nothing useful in the literature. After Pythagoras with his golden ratio and Plato with his forms, the mathematics of Beauty went largely untouched until Leonardo da Vinci. Da Vinci’s Vitruvian Man, that famous sepia sketch of a nude, spread-eagled person touching a square and a circle with his extremities, asserted the eerie proportional coincidences of the ideal human form (arm span = height; height = hand length x 10) but said nothing about the face.

So Marquardt went it alone. He collected photographs of faces the world deemed beautiful and began measuring their dimensions. Whereupon something peculiar and thrilling presented itself: the golden ratio. Beautiful people’s mouths were 1.618 times wider than their noses, it seemed, their noses 1.618 times wider than the tip of their noses. As his data set expanded, Marquardt found indeed that the perfect face was lousy with golden ratios. Even the triangle formed by the nose and the mouth was a perfect acute golden triangle.

Marquardt went public, making a splash with his unveiling of the Golden Mask, his understandably grandiose name for what was, if he was right, nothing less than a blueprint for the perfect face—and more than enough reason, you would think, for this reporter, passing through Los Angeles, to check in with Marquardt to see where his work has gone from there.

So I did, and I have to say I left Marquardt’s comfortable home in Huntington Beach not entirely convinced. Gunning my rented Ford Escape back to Los Angeles, I couldn’t help but think that the good doctor was overreaching—perhaps quite a lot—with this whole Golden Mask thing.

society and culture may call us ugly, but that’s only because society hasn’t yet gone to the trouble of comparing our faces to the golden mask.

The iris, in particular, gave me pause. Marquardt contends that the golden ratio can be detected in the iris, the colored part of the eye. Take 10 golden triangles, arrange them with their sharp points touching, and you have a golden decagon, fitting perfectly within the iris of the eye, vertices neatly touching the rim. But surely, so would a square, if you sized it right. Or an equilateral triangle. Or a bull’s-eye.

Then there was the way the Mask did not quite fit supposedly beautiful faces as well as Marquardt told me it did, while he helpfully talked me through the images on his Web site (beautyanalysis.com). As well as the way it seemed to fit supposedly ugly faces much better than you’d expect. Marquardt conceded this last point and hailed it as proof that the human race has evolved to the point that—hooray!—most of us, in objective terms, are actually rather attractive. Society and culture may call us ugly, but that’s only because society hasn’t yet gone to the trouble of comparing our faces to the Golden Mask, which was derived by studying faces that society deems beautiful . . . which would seem to me to invalidate the whole ball of wax.

It was only later that I changed my mind—a gradual, nay, ineffable process I should probably describe, for the sake of Beauty, as an epiphany at the end of a pier in Santa Monica while watching the sun go down through my Ray-Bans.

So what if Marquardt’s overreaching? I suddenly realized. If he’s right only in his assertion that the most pleasing faces have mouths that relate to the noses above them by the ancient and mysterious golden ratio, that’s not nothing. That’s a lot. And if he’s also right, as he once told The Washington Post, that the width of the front two teeth in a supermodel’s smile is 1.618 times the height of each tooth, then he is actually really onto something.

Maybe Plato was right as well: that nothing in this world is perfect, be it a table, a face, or the life’s work of a California scientist, until you tune out the noise and break through to what is true—and even a whiff of mathematical insight into Beauty gets the job done. For as John Keats once said, frantically overachieving en route to his glamorous early grave, “Beauty is truth, truth beauty—that is all ye know on earth, and all ye need to know.”

Other scholars can debate whether Keats, at 24, dying, working in the anything-goes medium of poetry, actually knew what he was talking about when he wrote those words. But I think perhaps that I, peering through the faux-deep shallows of Southern California to its faux-shallow depths, finally do.

Babies can spot pretty face right from birth

2012-11-29T02:29:00.001-08:00

By Mark Henderson, Science Correspondent
Times Online, Sept 6, 2004

BEAUTY is not in the eye of the beholder: British scientists have discovered that human infants are born with an innate concept of what makes an attractive face.

The findings suggest that ideals of facial beauty are not determined by culture alone, but also rely on universal standards that have been hard-wired, or imprinted, in our genes.

“Attractiveness is not simply in the eye of the beholder, it is in the brains of newborn infants, right from the moment of birth,” said Alan Slater, a developmental psychologist who led the study. “This view contradicts views arguing that the newborn infant enters the world as a tabula rasa — a blank slate on which experience will write.”

Dr Slater will present the results this week at the British Assocation Festival of Science at Exeter University.

Though infants cannot tell scientists that they prefer this face or that, a large volume of research has shown that their attention is much more easily captured by images they find pleasing or interesting.

In the new study, Dr Slater’s team used this effect to test whether newborns with little or no experience of the world shared their elders’ assumptions about facial beauty. The researchers took hundreds of pictures of female members of the public, and asked adult volunteers to rate their attractiveness on a scale of one to five.

Dr Slater then paired particularly beautiful faces, with an average score of close to five, with particularly unattractive ones scoring close to one. Care was taken to match qualities such as hair colour and length that might otherwise interfere with the experiment. Almost 100 newborn babies, with an average age of two days, were then shown these paired images.

About 80 per cent of the time the babies looked exclusively or mainly at the face judged “prettier”. The effect was also seen when the experiment was repeated with male faces and faces from many different ethnic groups.

Dr Slater said: “A lot of it is hard-wired, and you can’t get away from that hard-wiring.”

There are two probable evolutionary explanations for the phenomenon. First, facial symmetry — which is strongly linked to beauty across cultures — may be an “honest” signal of good genes, good health and an absence of parasitic diseases.

We may be primed to recognise this as a way of selecting sexual partners with the best breeding prospects. Second, the preference could be a by-product of an evolved mental capacity to recognise faces from birth. It is thought that babies fit faces to some sort of average facial template.

Beauty Is in the Brain of the Beholder

2012-11-28T19:34:00.004-08:00

Ideals of facial beauty are not determined by culture alone, but also rely on universal standards that have been hard-wired, or imprinted, in our brains. Even babies can spot pretty face right from birth.

Live Science, 6 July 2011 - Whether you're admiring a painting or enjoying a song, all the works of art you favor lead to activity in the same region of the brain, a new study shows. The findings go some way to support the view that beauty is in the perception of the beholder rather than in the object.

Researchers asked 21 volunteers from different cultures and ethnic backgrounds to rate a series of paintings or pieces of music as beautiful, indifferent or ugly. Participants then looked at the pictures or listened to the music while lying in a functional magnetic resonance imaging (fMRI) scanner, which measures brain activity.

That the same area of the brain was activated for both visual and auditory beauty implies that beauty exists as an abstract concept within the brain, researchers from the University College London's Wellcome Laboratory of Neurobiology say.

The finding showed that the medial orbitofrontal cortex, which is part of the brain's pleasure and reward center, was more active in participants when they listened to music or viewed a picture that they had rated as beautiful. However, no particular region of the brain correlated generally with artwork rated as ugly.

Activity in another region, the caudate nucleus, located near the center of the brain, increased in proportion to the relative visual beauty of a painting. The region has been previously reported to correlate with romantic love, suggesting a neural association for the relationship between beauty and love.

The findings were published today (July 6) in the journal PLoS One.

Remi Melina, Live Science Staff Writer

Why Do Men Find Women with Larger Eyes Attractive?

2012-06-15T03:42:00.000-07:00

Zidbits, Science, June 2, 2011 - According to studies done, research has shown that men generally find larger eyes on women more attractive. This has lead to a growing trend (especially in Asia) for many women to use cosmetics and contact lenses with larger limbal rings to give the illusion of larger eyes. Some have even done this permanently through cosmetic surgery.

But why do men find larger eyes attractive?

There seems to be two separate reasons why larger eyes on a female are more attractive. The first is that larger eyes (along with fuller lips, bigger breasts and smaller chins) is a sign of higher levels of estrogen. Women that have higher levels of estrogen will be more successful and have an easier time conceiving than women with lower levels. This means that women with larger eyes will be seen as a better ‘mate’.

The second reason is that large eyes are a neotenous feature.

A neotenous feature is a characteristic of youth shared by babies and children that humans evolved to retain so they could attract quality mates with “protective and nurturing impulses” which would be more likely to help raise their offspring and raise reproductive success. Since human eyes do not grow in size during development as much as the rest of the body, the size of the eye relative to the face decreases as we grow. This means that babies have relatively large eyes compared to older children and adults. As a consequence, people who have large eyes are often perceived to be younger than they really are. Since perceived youth of a mate is also a sign of fertility, men tend to prefer women with neotenous features, like large eyes.

However, this isn’t saying that men want to mate with babies and small children – that would be incredibly maladaptive because they are not fecund. So, then, why do males usually prefer women who, in essence, look like babies?

It’s thanks to something that happens in evolution called Fisherian runaway selection. Fisherian selection suggests that, when one sex prefers mates with certain genetic traits, then, through the process of sexual selection, the other sex will come to possess the trait in increasingly exaggerated forms.

The process is called “runaway” because over time, it would cause the development of greater preference and more pronounced traits, until the costs of producing the trait balance the reproductive benefit of possessing it. The peacock’s tail is an example of this. Its tail requires a great deal of energy to grow and maintain, it reduces the bird’s agility, and increases the animal’s visibility to predators. Yet it has evolved which indicates that peacocks with longer tails have some advantage.

This same process occurs with men’s preference for women with neotenous features.

GUIDELINE ON AESTHETIC MEDICAL PRACTICE II

2012-05-10T02:56:00.000-07:00

Prerequisites of the Practitioner practising Aesthetic Medicine

The registered medical practitioner practising aesthetic medicine:

May be a general (family) practitioner or a specialist in any recognized field;
Must possess experience through recognized practical training courses conducted by bona fide professional bodies specialising in aesthetic medicine;
Shall provide documentary evidence that he has undergone such training and practical/written examination in a bona fide professional body. The Ministry of Health reserves the right to examine documents so produced and either permit or reject the application by a registered medical practitioner to be registered in the Aesthetic Medicine Practitioners Register.
Must exercise strict patient selection criteria, must communicate to the potential client/patient the risks involved, the possible outcome, obtain valid consent for the aesthetic procedure planned, and generally observe all aspects of the Code of Professional Conduct of the Malaysian Medical Council;
Must place client/patient safety as the primary concern and should provide aesthetic medicine services in an approved healthcare facility as required by the Private Healthcare Facilities and Services Act 1998 and Regulations 2006.
Is subject to all relevant parts of the Medical Act 1971, the Regulations 1974, the Code of Professional Conduct and Guidelines of the Malaysian Medical Council.

GUIDELINE ON AESTHETIC MEDICAL PRACTICE - Malaysian Medical Council

2012-05-01T19:55:00.000-07:00

History and Background

Aesthetic medicine was introduced as a scientific movement by JJ Lengrand, a
Parisian Endocrinologist in France in 1973. It originates from the belief that the
well-being of an individual is about being satisfied with one’s health, job and the
environment he or she lives in. The goal is the creation of a harmonious physical
and psychological balance as desired by clients, by administering medical
treatment which is both preventive and corrective.

Although aesthetic medicine has not been recognized as a medical specialty in
Malaysia, the practice of aesthetic medicine is currently inevitably on the rise and
is gaining popular demand nationwide.

Definition

For purposes of this Guideline, Aesthetic Medicine is defined as an area of
multidisciplinary medical practice carried out by registered medical practitioners to provide treatment which is evidence-based, with the objective of addressing the aesthetic desires of clients.

Aesthetic Medicine is not a spin-off of traditional or complementary medicine, and
is recognised to be scientific in its approach and practice. Such practice may be
through non-invasive and minimally invasive modalities.

Double Suture and Twist (DST) - The Durable Non-Cutting Double Eyelid Procedure for Asians

2012-04-29T05:48:00.000-07:00

Double-eyelid procedure is the most popular cosmetic procedure in Asia. Whereas most surgeons in the United States perform cutting-type double eyelid surgery, Japanese women prefer non-incisional or suture methods.

Publications in the early Japanese medical literature favoured the suture method. The first description of this method, by Mikamo was published in 1896. Between 1896 and 1950, 11 articles relating to the suture methods were published in the Japanese medical literature.

The configuration of a double eyelid consists of four important parameters, namely, height, shape, continuity and permanence. As the suture method has been criticized for its high breakage rate and poorly define crease which fade over time, permanency is the major challenge the suture method is facing along its evolution.

In 2001, an improved non-cutting method to create double eyelids in Asian patients is reported. Dr Katsuhiro Kure, and Dr Akihiro Minami described an improved procedure that uses double sutures and twists (DST) to create double eyelids in Asian patients. Dr. Kure says the non-incisional procedure is “simple, durable, and virtually scar free.” The method uses only two sutures on each upper eyelid, with the durability explained by the areas of ties and the central twists that result in more secure and therefore longer-lasting results.

The average operative time ranged from 20 minutes (one side) to 60 minutes (bilateral). Most patients did not require sedation, and the surgeries were performed with only local anesthesia. Recovery time was short (3-7 days), and complications were minor and rare.

The published report for breakage or loss of fold is approximately one percent per year (ten year follow up). An extraordinarily low failure rate for this method has therefore been scientifically established, comparable to an incision method. There is a notion that the DST technique frequently fails or disappears over time. In many anecdotal comments, the most common source of misinformation has been in confusing the DST technique with traditional suture techniques that are unreliable. It is therefore important to verify that the technique used is DST before you decide to undergo such procedure.

The credential of the doctor is of course first and foremost. The registration of a doctor can be verified at the Malaysian Medical Council website.

This method is suitable for younger candidates with eyelids which do not have lots of loose skin or fat, or any obvious eyelid deformities.

Some examples of double eyelids created using DST:

The types of eyelids which are not suitable for this non-cutting technique:

Obvious ptosis (droopy eyelids)

Obvious asymmetrical eyelids

Dermatochalasis (Eyelid with lots of sagging skin)

Thick eyelids with lots of fat

These cases require incisional blepharoplasty (Cutting double eyelid surgery), a procedure which requires a highly meticulous and precise work of a well-trained and talented oculoplastic surgeon as it involves highly accurate measurements, skin removal, cutting into deeper structures and the ability and experience to manage possible complications promptly. Such invasive procedure if carried out by unscrupulous cosmetic practitioner is at risk of suffering a permanent deformity due to excessive fat removal, ptosis (droopy eyelid) due to damage to the muscle and tendon which opens the upper eyelid (levator muscle and aponeurosis), lagophthalmos (lid retraction or unable to close the eyelid fully) due to excessive skin removal and worst of all, blindness due to retrobulbar haematoma (accumulation of blood behind the eyeball) resulting in compression and damage to the optic nerve.

A thorough assessment is therefore crucial before deciding on which kind of double eyelid procedure is suitable for an individual. Appropriate referral to a talented and experienced oculoplastic surgeon has to be made where DST is not suitable to ensure safety and best outcome for the individual.

Double Eyelid Surgery

2012-04-12T00:09:00.000-07:00

Eyes with a lid crease between the eyelashes and the eyebrows are described as having a ‘double eyelid’, whereas those without a crease have a ‘single eyelid’.

We all know that having double eyelids makes our eyes look bigger, wider and culturally perceived to be more alert, friendly, confident and attractive. Having a double eyelid also allows easier application of cosmetics and no need to stick eyelid tapes anymore.

Studies have shown that about 50% of Asians do not have an upper eyelid crease, the other 50% have a least some form of crease. Therefore, it has been very popular among the Asians to opt for procedures that create double eyelids.

There have been various popular methods of creating double eyelids. The decision on which procedure is most suitable depends on the type and condition of one’s eyelids.

There are incisional (cutting) and non-incisional (non-cutting) methods. The incisional method involves plastic surgery through which some of the eyelid skin is excised. The patient will be required to return to the clinic and have the sutures removed. It may leave a prominent scar on the eyelid where the skin is removed. This is an excellent approach for those eyelids with too much loose skin around the eyes or lots of fat.

The non-incisional method is called the suture (stitching) method. In this method, no removal of skin using the knife is involved. Instead, sutures are passed through the eyelids via small punctures to create a fold by pulling the underbelly of the skin inwards when the eyes are opened. This method does not leave a prominent scar, no removal of sutures is required and recovery time is very short as no significant incision is made.

However, the traditional suture method is highly criticized for it’s short lifespan. Until recently, the advent of a new suture method known as the Double Suture and Twist (DST) technique, well-known for its longevity, addresses these disadvantages but maintaining the benefits of a suture method such as the quick recovery, scarlessness, naturalness of the crease and reversibility. This method is suitable for younger candidates with eyelids which do not have lots of loose skin or fat, or any obvious eyelid deformities.

Some examples of double eyelids created using the DST technique:

靓丽必备圣物——玻尿酸！

2012-01-31T09:46:00.000-08:00

玻尿酸，原来就以胶状形态存在于人体皮肤的真皮组织中，负责储存水分、增加皮肤容积，让皮肤看起来饱满、丰盈、有弹性。小婴儿肌肤中的玻尿酸含量最高，所以肌肤柔嫩程度堪比白煮蛋。但玻尿酸会随着年龄增长而消失，使皮肤失去储水的能力，逐渐变得暗沉、老化，并形成细小的皱纹。

皮肤的玻尿酸从 25 岁以后就开始流失， 30 岁时只剩下幼年期65% 、60 岁时只剩下 25% ，皮肤的水分也会跟着玻尿酸而散失，皮肤失去弹性与光泽，逐渐产生皱纹，皮肤老化。然而JUVÉDERM玻尿酸的面世，让希望保持年轻靓丽外表的朋友爱不释手，只因不但立刻见效、效果自然，更重要的是，只要是由合格医生注射，将会非常安全。

【如何使用玻尿酸以让你看起来更加靓丽！】

自然塑型：隆鼻、隆颏、丰额、丰唇、丰下巴、丰耳垂等

JUVÉDERM玻尿酸是改变面部轮廓的一种新型的方法，玻尿酸在塑形方面不仅可以隆鼻，还用来隆颏、丰唇、丰耳垂等，在一定程度上都达到了美容塑形医疗效果。安全性高没有过多副作用，见效快，是演艺圈明星的美丽武器。

填充物如玻尿酸不但天然安全，更能让人随心所欲地塑出标准脸型。轻松美丽不是梦！

高效去皱：抬头纹、眉间横纹、鼻唇沟、鱼尾纹、法令纹、眉间纹、泪沟、眼角纹等面部皱纹

JUVÉDERM玻尿酸抚平皱纹，使您重现青春靓丽的容颜。其最强的功能就是可以除皱，而且是大皱小皱皆可除。其中美容大王觉得最棒、最推荐的，就是用玻尿酸除泪沟！泪沟真的是很难处理，不管用什么方法都无法尽善尽美，直到玻尿酸出现。

面部凹陷填充：丰太阳穴、丰面颊、颧部填充、痘疤、痘坑、皮肤凹陷、疤痕修复等
JUVÉDERM玻尿酸可用于面部轮廓塑形，美化面部曲线。有些人觉得脸太凹，给人上了年纪或是很刻薄的感觉，还是脸颊饱满一点比较好看；有些人则是觉得脸颊丰腴一点看起来命会比较好。想要让凹陷的脸颊丰满起来，目前最好的选择就是玻尿酸。

长效保湿留住肌肤水分：面部、手背、胸前等

JUVÉDERM玻尿酸海绵般强劲的吸水能力，1分子玻尿酸大约可以结合500倍水分子，少量就能达到很好的保湿效果。不但能锁住肌肤的水分，还能将外界环境的水分子抓住，持续不断地保持肌肤湿润，维持皮肤水嫩、紧致状态，预防肌肤松弛、皱纹产生。

提醒：挑选受国际认证的玻尿酸牌子，让你轻松安全地漂亮示人！

What is JUVÉDERM® XC?

2012-01-17T10:04:00.000-08:00

HA fillers have revolutionized the treatment of facial aging. These fillers come under many names including Restylane, Prevelle, Juvederm, Perlane and others. They are all variations of the same stuff, hyaluronic acid. Hyaluronic acid is a naturally occurring substance that is present throughout the body. For example, HA provides support and hydration of the skin and it lubricates joint spaces. No one is allergic to hyaluronic acid so there is no need for a skin test prior to injection.

Facial aging involves many factors; gravity causing sags and bags, thinning of the skin and fat of the face causing deflation, and creases in the caused by sun damage or facial movement. Fillers can address all three of these problems and, to some extent and for some areas, are actually more effective than surgery. Fillers do not tighten or thin the face and well done filler injections look very, very natural (very, very important is a city like Seattle). HA fillers have become my treatment of choice for some types of facial aging and for lip enhancement.

Therefore, JUVÉDERM^® XC is the smooth gel filler that highly recommended to instantly smooth away wrinkles around your mouth and nose. With just one treatment, you’ll get smooth and natural-looking results that last up to a year.

JUVÉDERM^® XC is manufactured using HYLACROSS^™ technology, creating a smooth-consistency gel. It is infused with lidocaine to improve comfort during treatment. With JUVÉDERM^® XC you get the smooth results you expect, with the improved comfort you want.

Everyone will notice, but no one will know.

And now it's time to SEE the results brought by JUVÉDERM^® XC. These photos are for demonstrative purposes only. Source of Info *Individual results may vary.

你也可以拥有无岁月痕迹的瓜子脸！——肉毒杆菌

2012-01-03T12:11:00.000-08:00

【肉毒杆菌素是什么-肉毒杆菌素】

“肉毒素”实际上是“肉毒杆菌素”的俗称。又名“Botox”和“Myobloc”，是肉毒杆菌在繁殖过程中分泌的毒性蛋白质，具有很强的神经毒性。

拥有光滑瓜子脸不是梦想！

肉毒杆菌毒素并非如其名称那么可怕。这种生物制品，可以经过基因工程的方法大规模生产。由于它具有神经阻断作用，在神经内科、眼科、整形、美容外科十分常用。目前的使用剂量仅仅是其最全剂量的百分之一，所以十分安全。

肉毒杆菌是一种神经毒素，可以临时麻痹肌肉的特性，使肌肉因失去功能而萎缩变小，这样就达到了瘦肌肉修饰脸部轮廓的目的。对单纯性咬肌肥大型圆脸效果格外好。

打肉毒杆菌瘦脸实际上是指注射瘦脸针。瘦脸针即A型肉毒素针剂，首要作用于肌肉组织，因常用解决咬肌肥大，被称为瘦脸针。瘦脸针瘦脸实质上就是采用肉毒杆菌毒素注射治疗咬肌肥大。原理上，瘦脸针是阻断神经与肌肉的神经冲动，让过度收缩的肌肉松弛，麻痹过于发达的肌肉，达到瘦脸的功效。瘦脸针的注射效果是慢慢出现的，注射后约两周到一个月左右开始出现效果。目前，瘦脸针是非常流行的一种瘦脸方式，很受女性青睐。

肉毒杆菌素除皱的基本原理肉毒素是一种神经毒素，它可以阻断神经与肌肉间的神经冲动，使过度收缩的小肌肉放松，进而达到除皱的效果。肉毒素被誉为返老还童的灵丹妙药。最早在战争中使用，医学上被用于治疗面部肌肉痉挛，1986年，加拿大科学家发现用它消除皱纹效果奇佳，引发美容界 Botox狂飙。

肉毒杆菌素适合什么皱纹？肉毒素最适合的皱纹是动力性皱纹，也就是做表情时出现的皱纹，比如：笑起来的鱼尾纹，皱眉时的眉间纹，抬头时的额纹等等，经常施打动态纹，可以延缓静态纹的出现。肉毒素主要适用于动态的皱纹以及面部上三分之一以上的皱纹，对于合并有静态皱纹的人士，在肉毒素注射的情况下，可能还需要配合玻尿酸等注射填充术才会达到最佳的效果。

肉毒杆菌素除皱优势肉毒素注射除皱具有损伤小、无创伤、见效快、操作方便、价格便宜、不影响工作等特点。和传统的化学剥皮、拉皮、胶原注射、脂肪充填或小切口除皱等方式相比，它只需将一定剂量的肉毒素注射进前额或眉间即可，整个过程仅几分钟，且无痛苦。

DST 的好处 / Advantages of DST

2011-12-06T08:35:00.000-08:00

轻松安全拥有迷人双眼皮，让您双眼更加深邃动人

由Dr.David Low 医学美容诊所所提供的 DST技术好处：

无痕
更耐久（根据医学报告显示，第一批于20年前接受DST技术双眼睑制成的案例，双眼皮至今仍然明显可见）
由日本著名的整容医师 Dr Akihiro Minami 所研发
恢复期极短（80%案例可于第二天上班而不会惹人注目）
无须拆线
更加自然
可逆性强（万一不满意效果，亦可作出调整而不会留下疤痕）
免费复诊/调整至完全满意为止
由经过专业培训的合格医生执行

Advantages of DST:

1. Scarless
2. Lasting results
3. Invented by Japanese plastic surgeon, Dr Akihiro Minami
4. Short recovery time: ability to return to work within a short duration
5. No removal of stitches needed
6. Natural looking
7. Potentially reversible, should you change your mind

DST 缝制无痕双眼皮

2011-12-02T00:36:00.000-08:00

以下为部分Dr. David Low完成的交叉式勾双眼皮例子：-

The Durable Non-cutting Double Eyelid Procedure for Asians

2011-11-30T00:24:00.000-08:00

New York, NY - An improved non-incisional technique to create double eyelids in Asian patients is reported in the year 2000 issue of Aesthetic Surgery Journal (ASJ), the peer-reviewed publication of the American Society for Aesthetic Plastic Surgery (ASAPS).

Double-eyelid surgery is the most popular cosmetic surgical procedure in Japan. Whereas most surgeons in the United States perform cutting-type double eyelid surgery, Japanese women prefer non-incisional techniques. According to the authors of a study appearing in ASJ, current non-incisional techniques for creating double eyelids are either technically complex or do not produce lasting results.

Doctors in Japan and the USA describe an improved procedure that uses double sutures and twists (called DST technique) to create double eyelids in Asian patients. They say the non-incisional procedure is “simple, durable, and virtually scar free.” As described in the article, the method uses only two sutures on each upper eyelid, with the durability explained by the areas of ties and the central twists that result in more secure and therefore longer-lasting results.

The authors performed 1108 cases using the DST method during the past ten years, with no loss of double eyelid line after follow-up periods ranging from one month to seven years (with a mean follow-up time of 32 months). The average operative time ranged from 20 minutes (one side) to 60 minutes (bilateral). Most patients did not require sedation, and the surgeries were performed with only local anesthesia. Complications were minor and rare.

Double eyelids created using the DST method:-

眼睑手术 (blepharoplasty)

2011-11-28T08:28:00.000-08:00

外貌影响着我们如何感觉我们自己和这个世界。人们对容貌的审视，首先从眼睛开始。一个人的眼睛，特别是微妙的变化常常是表达各种感情和体现人的内在美和外在美的窗口，故有眼睛为“心灵之窗”的美称。著名作家老舍先生曾写到过：“眼睛能替她的口说出最难以表达的心意与情感”。

美学家称人的双眼是“美之窗”。一双清澈明亮、抚媚动人的眼睛，不但能增添容貌之美，也使人更具魅力和风采，而且能遮去或掩饰面部其它器官的不足和缺陷。

如果你的眼睛看起来下垂、有眼袋，眼睑成形术将帮助你去除浮肿的眼睑，恢复你的青春容貌。另外，对亚州人而言，双眼皮手术是一项目非常盛行的眼睑手术。

在亚州，尽管约有一半的人有双眼皮，而另一半却没有。针对没有双眼皮的个人，睑成形术即在亚州称为双眼皮手术，能帮助他们拥有自然的眼睑皱折——即双眼皮。

传统的双眼皮手术分为割与缝两种方式。割式双眼皮意味着在上眼睑利用手术刀切开一道痕，效果永久但会闭上眼时难免会看见其疤痕，有失美观。

缝式双眼皮适合上睑眶隔脂肪少、皮肤薄而紧的年轻人，处理方式是将皮肤的真皮和睑板或上睑提肌腱缝合在一起依靠其手术创伤所形成的瘢痕粘连，形成重睑。好处是简单，易操作，术后恢复快，缺点是双眼皮易随着时间而消失。

而日前最新的技术：交叉式勾双眼皮（Double sutures and twisting method /DST) 手术法则是最复杂的双眼皮手术。除了效果持久、还可以保有缝合法的优势，如皱折几乎无痕、自然，并有潜在的可逆性、恢复迅速快，是传统割式与缝式远远无法相比的双眼皮最佳制成术。