Measuring the effects of facial regional changes following excessive aesthetic treatments—A survey and eye-tracking-based investigation

Background: 

The increasing popularity of minimally invasive soft tissue filler injections has been accompanied by a significant rise in filler reversal procedures, highlighting the concerns regarding adverse effects, including the facial overfilled syndrome (FOS). This trend suggests a growing need to understand individual facial regions contributing to FOS and their influence on patient perception.

Objective: 

To investigate the influence of exaggerated volumization of facial regions on the perceptions of attractiveness and gender traits using eye-tracking and survey methods to better understand FOS. 

Methods: 

A total of 50 volunteers (30 women and 20 men) rated frontal images of different modified facial regions (i.e., eyes, cheeks, and lips) and the combination thereof on 5-point Likert scales for attractiveness, unattractiveness, masculinity, and femininity. Their gaze patterns and eye movements were analyzed using eye-tracking technology. 

Results: 

Elevating the lateral canthal angle sharply reduces the attractiveness in male and female faces. Accentuating the zygomatic arch generally decreases attractiveness and masculinity, particularly in men, while slightly increasing femininity. Lip volumization in women marginally increases attractiveness without significantly altering femininity. In combined modifications, the decrease in attractiveness is predominantly driven by the eye modification aspect, leading to the most substantial decline in the perceived attractiveness and gender-specific traits. 

Conclusion: 

Certain facial modifications such as lip enhancement may increase attractiveness, while cheek enhancements may increase femininity. However, most alterations, particularly those involving the eyes or combinations of treatments, generally decrease attractiveness and impact the perceptions of femininity and masculinity. This underscores the need for balanced aesthetic treatments to prevent overcorrection.