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  1. Lim T, Frank K, Hadjab B
    J Cosmet Dermatol, 2022 Jan;21(1):207-219.
    PMID: 34255904 DOI: 10.1111/jocd.14342
    Injectable rejuvenation treatments used in Caucasians might not always suit Asians as the visible signs of aging manifest differently, underscoring a need for Asian-specific strategies that correct underlying structural deficiencies and cumulative age-related changes. The presented Target-Specific Sandwich Technique (TSST) aims to simultaneously restore, rejuvenate, and enhance faces through the distribution of minute amounts of different fillers with different rheologies, using a minimal number of entry points in strategic facial areas and different soft tissue layers in Asians. A total of 14 patients underwent the presented TSST and were subsequently assessed for satisfaction with the treatment and the outcome of the treatment. With 3 cc of fillers, patients experienced a rejuvenated appearance with brow support, brow ridge softening, less severe nasolabial folds, and corrected tear trough hollows. Fillers in the lateral canthal and mandibular angles lifted mouth corners, improved submandibular jowls, and defined the lower face. Although the prejowl sulcus received minimal filler, it appeared subtler, relaxed, and had fewer lines visible while smiling. Overall, patients appeared less tense, rejuvenated, and had improved light reflection and firmer skin. These were due to tissues being supported upward and laterally by fillers in areas of bone resorption-induced volume loss.
  2. Frank K, Krell FT, Slade EM, Raine EH, Chiew LY, Schmitt T, et al.
    Ecol Lett, 2018 08;21(8):1229-1236.
    PMID: 29938888 DOI: 10.1111/ele.13095
    At the global scale, species diversity is known to strongly increase towards the equator for most taxa. According to theory, a higher resource specificity of consumers facilitates the coexistence of a larger number of species and has been suggested as an explanation for the latitudinal diversity gradient. However, only few studies support the predicted increase in specialisation or even showed opposite results. Surprisingly, analyses for detritivores are still missing. Therefore, we performed an analysis on the degree of trophic specialisation of dung beetles. We summarised 45 studies, covering the resource preferences of a total of 994503 individuals, to calculate the dung specificity in each study region. Our results highlighted a significant (4.3-fold) increase in the diversity of beetles attracted to vertebrate dung towards the equator. However, their resource specificity was low, unrelated to diversity and revealed a highly generalistic use of dung resources that remained similar along the latitudinal gradient.
  3. Lim T, Kerscher M, Ogilvie A, Pavicic T, Lorenc PZ, Frank K, et al.
    Plast Reconstr Surg Glob Open, 2023 Sep;11(9):e5287.
    PMID: 37744770 DOI: 10.1097/GOX.0000000000005287
    BACKGROUND: The objective of this investigation was to create and validate five-point photonumeric scales which assess static and dynamic forehead lines.

    METHODS: Two different novel five-point photonumeric scales for the assessment of static and dynamic forehead lines were developed. Moreover, a photoguide was created, including subjects from both sexes, all age groups, and different Fitzpatrick skin types. A total of 11 raters from all over the world were involved in the digital validation, whereas four raters performed a live validation.

    RESULTS: The Croma Static Forehead Lines-Assessment Scale showed almost perfect inter and intra-rater agreement in both the digital and the live setting with inter-rater intraclass correlation coefficients of 0.86 [95% confidence interval (CI): 0.82-0.89] in the first digital rating and 0.82 [95% CI: 0.78-0.86] in the second digital rating. The Croma Dynamic Forehead Lines-Assessment Scale showed almost perfect inter and intra-rater agreement in the digital setting with inter-rater intraclass correlation coefficients of 0.83 [95% CI: 0.79-0.86] in the first digital rating and 0.80 [95% CI: 0.75-0.84] in the second rating and almost substantial agreement in the live setting.

    CONCLUSIONS: The Croma Static Forehead Lines-Assessment Scale and the Croma Dynamic Forehead Lines-Assessment Scale have excellent inter and intra-rater agreements to be justifiably used in the clinical and study setting, both digitally and live across ethnic groups.

  4. Kerscher M, Green J, Day D, Ogilvie A, Pavicic T, Lim T, et al.
    Aesthet Surg J, 2023 Feb 25.
    PMID: 36840504 DOI: 10.1093/asj/sjad041
    BACKGROUND: A scarcity of scales which assess platysmal bands, wrinkles in the décolleté, and horizontal necklines in the digital and live setting exist.

    OBJECTIVES: The objective of this investigation was to create and validate 5-point photo numeric scales which assess horizontal necklines, platysmal bands and wrinkles in the décolleté.

    METHODS: A medical team created 3 different novel 5-point photonumeric scale for the assessment of horizontal necklines, platysmal bands and décolleté wrinkling. Eleven international raters were involved in the digital validation, while 4 raters performed a live validation.

    RESULTS: The Croma Horizontal Neck Line - Assessment Scale showed substantial inter-rater agreement and almost perfect intra-rater agreement in the digital and live validations. The Croma Platysmal Bands-Assessment Scale showed substantial intra-rater agreement in both, digital and live validations. For the décolleté, a static and a dynamic scale was created and validated. The Croma Static Décolleté Wrinkling-Assessment Scale showed substantial and almost perfect inter-rater agreement in the digital validation and live-validation, respectively, while the intra-rater agreement was in both almost perfect. The Croma Dynamic Décolleté Wrinkling-Assessment Scale showed almost perfect agreement in both validation settings for both, inter-and intra-rater agreement.

    CONCLUSIONS: The Croma Horizontal Neck Line - Assessment Scale, the Croma Static and Dynamic Décolleté Wrinkling-Assessment Scales have sufficient inter and intrarater agreements to be justifiably used in the clinical and study setting.

  5. Hayano W, Kerscher M, Day D, Ogilvie A, Pavicic T, Lim T, et al.
    Aesthet Surg J, 2023 Apr 13.
    PMID: 37052953 DOI: 10.1093/asj/sjad103
    BACKGROUND: The use of validated scales is still considered the gold standard in evaluating the severity of an aesthetic facial condition.

    OBJECTIVES: The objective of this investigation was to create and validate 5-point photo numeric scales which assess perioral lines and marionette lines.

    METHODS: A medical team created two different novel 5-point photonumeric scale for the assessment of perioral lines and marionette lines. Eleven international raters were involved in the digital validation, while 4 raters performed a live validation.

    RESULTS: For the Croma Static Perioral Lines-Assessment Scale digital inter-rater ICCs were 0.88 [95% CI: 0.85-0.91] in the first rating and 0.87 [0.83-0.90] in the second rating. The digital intra-rater ICCs were 0.90 [95% CI: 0.87-0.92]. In the live rating, the inter-rater ICCs were 0.89 [95% CI: 0.85-0.93] in the first rating and 0.91 [95% CI: 0.87-0.93] in the second rating with an intra-rater ICC of 0.91 [95% CI: 0.88-0.95]. For the Croma Marionette Lines-Assessment scale the digital rating inter-rater ICCs were 0.85 [95% CI: 0.81-0.89] in the first rating and 0.87 [95% CI: 0.84-0.90] in the second rating with an intra-rater ICC of 0.89 [95% CI: 0.88-0.91]. In the live rating, the inter-rater ICCs were 0.73 [95% CI: 0.54-0.83] in the first rating and 0.79 [95% CI: 0.65-0.87] in the second rating with an intra-rater ICC of 0.88 [95% CI: 0.83-0.94].

    CONCLUSIONS: It is to be concluded that the Croma Static Perioral Lines-Assessment Scale and the Croma Marionette Lines-Assessment Scale have exceptional inter- and intra-rater agreements to be justifiably used in the clinical and study setting for all ethnic groups.

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