BACKGROUND: Photoaging, a result of chronic sun exposure, leads to skin damage and pigmentation changes. Traditional treatments may have limitations in high-altitude areas like Yunnan Province. Intradermal Col Ι injections stimulate collagen production, potentially improving skin quality. This study aims to assess the efficacy and safety of this treatment for photoaging.
OBJECTIVE: To evaluate the efficacy and safety of intradermal type Ι collagen (Col Ι) injection for treating photoaging.
METHODS: This prospective, self-controlled study investigated the impact of intradermal injections of Col Ι on skin photodamage in 20 patients from the Yunnan Province. Total six treatment sessions were conducted every 4 wk ± 3 d. Before and after each treatment, facial skin characteristics were quantified using a VISIA skin detector. Skin thickness data were assessed using the ultrasound probes of the Dermalab skin detector. The Face-Q scale was used for subjective evaluation of the treatment effect by the patients.
RESULTS: The skin thickness of the right cheek consistently increased after each treatment session compared with baseline. The skin thickness of the left cheek significantly increased after the third through sixth treatment sessions compared with baseline. The skin thickness of the right zygomatic region increased after the second to sixth treatment sessions, whereas that of the left zygomatic region showed a significant increase after the fourth through sixth treatment sessions. The skin thickness of both temporal regions significantly increased after the fifth and sixth treatment sessions compared with baseline (P < 0.05). These findings were also supported by skin ultrasound images. The feature count for the red areas and wrinkle feature count decreased following the treatment (P < 0.05). VISIA assessments also revealed a decrease in the red areas after treatment. The Face-Q-Satisfaction with Facial Appearance Overall and Face-Q-Satisfaction with Skin scores significantly increased after each treatment session. The overall appearance of the patients improved after treatment.
CONCLUSIONS: Intradermal Col Ι injection improves photoaging, with higher patient satisfaction and fewer adverse reactions, and could be an effective treatment method for populations residing in high-altitude areas.

This study aimed to conduct a linguistic validation of all FACE-Q eye module scales in German, and to evaluate the reliability and validity of the scales in patients with blepharoplasty. According to international recommendations, all FACE-Q scales and checklists were translated from English to German. Psychometric testing of blepharoplasty surgery-related scales of translated versions were administered to patients with blepharochalasis or dermatochalasis and a history of blepharoplasty surgery (n = 64; 11 scales) or no history of blepharoplasty surgery (n = 65; seven scales), and to a group of control subjects (n = 64; seven scales). Most of the subscales showed acceptable internal consistency, with Cronbach\'s alphas ranging from 0.75 to 0.97. Intraclass correlation coefficients were high (0.70-0.92), indicating good reliability, with total values of 0.63 (95% CI 0.46-0.76) and 0.68 (95% CI 0.53-0.80) for the upper eyelid and social function scores, respectively. There was good discriminability between pre- and post-blepharoplasty patients and normal subjects (p < 0.05). The German-language version of the FACE-Q eye module is a successfully validated and helpful tool for assessing outcomes after blepharoplasty surgery, especially with respect to \'satisfaction with overall facial appearance\', \'psychological well-being, social function\', \'decision satisfaction, outcome satisfaction\', and \'early-life impact recovery\'.

OBJECTIVE: The objective of this study was to assess satisfaction and psychosocial status before and after facial bone contouring surgery using the Face-Q.
METHODS: The Face-Q, a multimodular patient-reported outcome (PRO) instrument, comprises independently functioning scales and checklists designed to assess outcomes in facial aesthetic patients. A prospective cohort study was conducted from November 2020 to May 2022. Participants undergoing facial bone contouring surgery (reduction mandibuloplasty and/or malarplasty) were asked to complete the Face-Q preoperatively and 12 months postoperatively. Comparative analyses were conducted using normative Face-Q data from 534 matched normal individuals. Face-Q scores were evaluated for each domain on a scale of 0 to 100, with higher scores indicating greater satisfaction with appearance or a superior quality of life.
RESULTS: A total of 284 patients (274 female and 10 male) completed the Face-Q preoperatively and 12 months postoperatively. Of these, 146 underwent reduction mandibuloplasty, 18 underwent malarplasty, and 120 underwent both procedures. Post-surgery, patients experienced significant improvements in overall appearance, features altered by surgery, and quality of life, excluding the patient-perceived age. Preoperatively, patients demonstrated significantly lower scores compared to normative data, with scores significantly increasing postoperatively to levels representative of the general population. Satisfaction with outcome was significantly correlated with postoperative Face-Q measurements but not preoperatively.
CONCLUSIONS: Facial bone contouring surgery significantly improves the satisfaction and quality of life in patients with square faces, reaching a level at least equivalent to the normative population. The use of Face-Q should be highlighted in the clinic practice.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266.

Previous studies on the efficacy of trans-sutural distraction osteogenesis (TSDO) to treat midface hypoplasia caused by cleft lip and palate (CLP) have mainly focused on objective measurements while ignoring the subjective feelings of patients. This study aimed to analyse the changes in and correlation between computed tomography (CT) measurements and FACE-Q scores in patients who underwent TSDO by performing a comprehensive evaluation from both objective and subjective perspectives. This retrospective study included 25 patients with an average age of 10.7 years who had midface hypoplasia caused by CLP and underwent TSDO between August 2018 and December 2022. The average follow-up time was 18.8 ± 7.7 months. Facial morphology and CT measurements, including A-CR, N-A⊥HR, the SNA angle and the L-ZA, indicated significant improvements in midface concavity (all p < 0.0001). All FACE-Q scores (except for facial function) exhibited a significant increase. The ΔA-CR, ΔN-A⊥HR, and ΔSNA angle were strongly correlated with specific aspects of the FACE-Q-Appearance items, including the ΔFACE-Q-Appearance of the cheeks (all p < 0.0001), the ΔFACE-Q-Appearance of the face (all p < 0.0001), the ΔFACE-Q-Appearance of the jaws (all p < 0.01), the ΔSatisfaction with decision (all p < 0.0001) and the ΔSatisfaction with outcome (all p < 0.001). However, the ΔA-CR, ΔN-A⊥HR, and ΔSNA were weakly correlated with other FACE-Q-Health-related quality of life and function items. These findings suggest that both CT findings and FACE-Q scores have their own emphases and advantages. It is necessary to establish an integrated curative effect evaluation model that combines FACE-Q scores with CT measurements to evaluate both the physical health and psychological status of patients.

Single eyelids are common among Asians. It is not uncommon to see people with single eyelids raise their eyebrows to wide open their eyes. This results in frequent compensatory contraction of the frontalis muscle and thus leads to deep forehead wrinkles. Double-eyelid blepharoplasty creates a larger visual field. In theory, patients who receive the surgery will stop overusing the frontalis muscle. Therefore, the forehead wrinkles can be improved.
35 patients who underwent double-eyelid blepharoplasty were enrolled. FACE-Q forehead wrinkle assessment scale was adopted to evaluate the forehead wrinkles preoperatively and postoperatively. In addition, anthropometric measurements were taken to indirectly evaluate frontalis muscle contraction in maximum eye-opening position.
According to the FACE-Q scale, forehead wrinkles were improved after double-eyelid blepharoplasty, and the improvement was long-lasting in the 3-month follow-up. This was because the frontalis muscle contraction reduced after the surgery, as shown by the anthropometric measurements.
This study used subjective and objective methods to prove that double-eyelid surgery improves forehead wrinkles.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Double eye-lid surgery is one of the most popular performed aesthetic procedures in young Asians. Reliable measurement of patient reported outcomes is crucial for facial aesthetics. The FACE-Q is a new patient-reported outcome tool (PRO) composed of numerous independently functioning scales and checklists designed to measure outcomes. Here we described FACE-Q scales for double eye-lid surgery with minor incision in young Asians.
200 patients (400 eyes) aged from 21 to 30 years-old were recruited from 2012 to 2014. They underwent minor incision procedure for double-eyelid blepharoplasty, epicanthic fold correction, excessive orbit fat removal and blepharoptosis correction simultaneously. An incision of 1 cm long in the middle of upper eyelid and modified Park\'s Z-plasty for epicanthus correction were designed. Three stitches were carried out in levator aponeurosis-inferior dermis procedure. By the middle incision in the upper eyelid, blepharoptosis correction and excessive orbit fat removal can be executed. Those patients were asked to complete anonymously the FACE-Q by e-mail. FACE-Q scores were assessed for each domain (range, 0 to 100), with higher scores indicating greater satisfaction with appearance or superior quality of life.
After a mean of 2 years\' follow-up, postoperative complications included partial or complete loss of the double-eyelid fold in 8 and 0 cases, respectively, no hypertrophic scar formation, and asymmetric fold in four cases. One patient received re-operation on blepharoptosis correction. Except hematoma occurring in one female case, no obvious edema was observed. Patients demonstrated high levels of satisfaction with eye appearance overall (mean ± SD, 81.7 ± 18.3). Quality of Life Patients exhibited high levels of quality of life, including in social confidence (95.4 ± 12.6), psychological well-being (97.8 ± 10.3), and early life impact of the procedure (90.2 ± 13.4). Patients reported high satisfaction with the decision to undergo and the outcome of the procedure.
Minimally invasive procedure is a reliable tool for correcting disfigurement in double-eyelid blepharoplasty. However, this method is not suitable for those cases whose upper eyelids are featured by relaxation. Excessive amount of skin must be removed. Patients who responded in this study were extremely satisfied with their decision to undergo double-eyelid surgery and the outcomes and quality of life following the procedure.