Facial expression of emotion is a foundational aspect of social interaction and nonverbal communication. In this study, we use a computer-animated 3D facial tool to investigate how dynamic properties of a smile are perceived. We created smile animations where we systematically manipulated the smile’s angle, extent, dental show, and dynamic symmetry. Then we asked a diverse sample of 802 participants to rate the smiles in terms of their effectiveness, genuineness, pleasantness, and perceived emotional intent. We define a “successful smile” as one that is rated effective, genuine, and pleasant in the colloquial sense of these words. We found that a successful smile can be expressed via a variety of different spatiotemporal trajectories, involving an intricate balance of mouth angle, smile extent, and dental show combined with dynamic symmetry. These findings have broad applications in a variety of areas, such as facial reanimation surgery, rehabilitation, computer graphics, and psychology.

Clinical rating tools such as the electronic, clinician-graded facial function (eFACE) scale provide detailed information about aspects of facial functioning relevant to the assessment and treatment of facial paralysis. Past research has established that eFACE scores significantly relate to expert ratings of facial disfigurement. However, no studies have examined the extent to which eFACE scores relate to casual observers’ perceptions of disfigurement in facial paralysis. Casual observers (n = 539) were recruited at the 2016 Minnesota State Fair, and were shown short videos of facial expressions made by patients (n = 61) with unilateral facial paralysis. Observer ratings of disfigurement were recorded and related to eFACE scores (total and subscores) using mixed-effect regression models. Patients’ eFACE scores were significantly related to observers’ disfigurement ratings, such that improved function (as indicated by a higher eFACE score) corresponded to a decreased perception of disfigurement. The resting face of patients, their total movement capability, and their involuntary movement through synkinesis all played a significant role in predicting the casual observers’ ratings. The results establish a clear connection between clinician eFACE ratings of facial function and casual observer judgments of disfigurement. In addition, the findings provide insight into which clinical aspects of facial dysfunction are most salient for casual observers’ perceptions of disfigurement. Such insights can help both patients and clinicians better understand the expected social implications of different clinical aspects of facial dysfunction.

Purpose of review: Although tranexamic acid is commonly used in surgical fields such as obstetrics, orthopedics, and trauma, its utilization in facial plastic surgery is a recently emerging concept, and studies examining its potential impact have been few. This review highlights how tranexamic acid may be employed during facial plastic procedures and the promising impact it may have. Recent findings: Tranexamic acid is primarily being studied in rhinoplasties and rhytidectomies, with intravenous administration and local infiltration being the most common routs of application, respectively. During rhinoplasties, tranexamic acid has the potential to improve the visualization of the surgical field by decreasing blood loss and to improve postoperative edema and ecchymosis. For rhytidectomies, on the contrary, it may shorten time to attain hemostasis, lessen the rate of hematoma formation, and lead to lower surgical drain output. Its efficacy is preserved at low doses, and significant medication side effects have not been reported after facial plastic procedures. Summary: Altogether, tranexamic acid may present a valuable adjuvant to facial plastic surgery, as it could increase both surgeon and patient satisfaction while exhibiting a benign safety profile.

Facial Plastic Surgery & Aesthetic Medicine

Background: Past studies demonstrate that certain facial features systematically affect first impressions of psychological traits. However, no previous studies have examined how individual differences in facial health affect first impressions of psychological traits. Methods: In this study, we asked a large sample of fairgoers to give their first impressions of psychological traits in response to viewing videos of unilateral facial paralysis patients with varying degrees of facial functioning. Then, we used linear mixed-effects regression models to understand how individual differences in facial health predict first impressions. Results: Our results replicate previous findings regarding first impressions of faces, such as the attractiveness halo effect, as well as age (maturity) and gender (masculinity) effects. More importantly, our results reveal that facial health, as measured by a clinician-graded scale, is a significant predictor of first impressions. Specifically, we found that individuals with better dynamic facial health (as assessed by clinicians) were perceived to be more competent and more affiliative, but not more dominant, than individuals with lower levels of dynamic facial functioning. Conclusions: Our results have important implications for personalized medicine via the development and refinement of individually tailored therapies to improve facial reanimation surgery outcomes.