From the Division of Plastic and Reconstructive Surgery, Stanford University, and Stanford School of Medicine.
Plast Reconstr Surg. 2019 Jul;144(1):63-70. doi: 10.1097/PRS.0000000000005700.
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.
美学在整形手术的成功中起着核心作用。了解对美学的看法对于确保患者满意度至关重要。眼动追踪技术为评估注意力提供了一种客观的方法，并了解观看者如何将注意力集中在接受美容面部提升手术的患者身上。
36 名受试者（从外行人到主治整形外科医生）在患者接受选择性面部提升手术前后观看了 15 组照片。他们被指示根据李克特量表评估美学质量，同时眼动跟踪设备跟踪他们的注视并分析他们注意力的分布。
术后图像的李克特评分提高了 0.51 ± 0.26，主治美容整形外科医生的差异最大（1.36 ± 0.22；p < 0.05）。鼻子是最常见的第一个固定位置（31%的第一次固定）和最受关注的区域（16 ± 3%的固定时间），适用于所有受试者。有经验的受试者在非相关区域花费的时间更少（主治美容整形外科医生为 30 ± 11%，主治非美容整形外科医生为 37 ± 10%），而经验较少的受试者（外行人的 50 ± 15%）。
本研究表明，在美容手术方面经验更丰富的观察者会迅速将注意力集中在脸颊、下巴和颈部，并且会均匀地注视整个面部。这些结果表明，外行人的目光会被吸引到面部中央（因为对面部提升手术不熟悉，以及自然倾向于注视面部中央），而主治整形外科医生则表现出整体的注视模式，并且更能意识到手术的影响。
