Chen's Double Eyelid Fold Illusion: An Eye Size Assimilation Illusion Induced by a Supratarsal Fold in the Brow-Eye Unit, A Preliminary Report.

BACKGROUND: Double eyelidplasty can enhance the eye size and facial attractiveness of Asian individuals with single eyelids. The authors hypothesize that a supratarsal fold can induce an eye size assimilation illusion to enhance eye dimensions and aesthetics, and seek to define the optimum vertical proportion between a supratarsal fold and the eye fissure associated with maximal induction of the size assimilation illusion. METHODS: A photometric study of the replicated photographs of ten female Taiwanese patients after double eyelidplasty was designed. Each photograph was edited by shifting the supratarsal folds vertically at a regular fold/eye ratio increment of 0.1. The perceived attractiveness of edited photographs of each patient was rated by 100 adult observers using a score of 1-5. The palpebral parameters were measured and analyzed. RESULTS: The mean rating score increased gradually when a supratarsal fold was added and peaked when the fold/eye ratio was 0.3 and the mean Chen's double eyelid fold ratio was 0.631 ± 0.023. After the peak, the mean score decreased gradually and was lower than the photograph without a fold when the fold/eye ratio exceeded 0.5 and the mean Chen's ratio exceeded 0.729 ± 0.027. CONCLUSION: Within the optimal ranges of the fold/eye ratio and Chen's double eyelid fold ratio, eyes are perceived as larger and more attractive due to a hybrid presentation of two interdependent eye size assimilation illusions induced by a supratarsal fold in the brow-eye unit. "Chen's double eyelid fold illusion" is proposed to describe this complex visual phenomenon. LEVEL OF EVIDENCE IV: 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 Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A Wireless and Batteryless Intelligent Carbon Monoxide Sensor.

Carbon monoxide (CO) poisoning from natural gas water heaters is a common household accident in Taiwan. We propose a wireless and batteryless intelligent CO sensor for improving the safety of operating natural gas water heaters. A micro-hydropower generator supplies power to a CO sensor without battery (COSWOB) (2.5 W at a flow rate of 4.2 L/min), and the power consumption of the COSWOB is only ~13 mW. The COSWOB monitors the CO concentration in ambient conditions around natural gas water heaters and transmits it to an intelligent gateway. When the CO level reaches a dangerous level, the COSWOB alarm sounds loudly. Meanwhile, the intelligent gateway also sends a trigger to activate Wi-Fi alarms and sends notifications to the mobile device through the Internet. Our strategy can warn people indoors and outdoors, thereby reducing CO poisoning accidents. We also believe that our technique not only can be used for home security but also can be used in industrial applications (for example, to monitor leak occurrence in a pipeline).

Chen's Double Eyelid Fold Ratio.

BACKGROUND: Double eyelidplasty can construct palpebral folds and enhance beauty perception for Asians with single eyelids. A new palpebral parameter for the quantitative interpretation of surgical outcomes is proposed on the basis of a photometric study of the altered proportions of Asian eyes after double eyelid operation. METHODS: A total of 100 Asian adults with single upper eyelids who were satisfied with the enlarged eyes by operation were included in the study. A retrospective measurement of palpebral parameters in the frontal profile both preoperatively and 6 months postoperatively was performed. The proportions of various parameters in the eyebrow-eye aesthetic unit were calculated and analyzed. RESULTS: Double eyelidplasty can augment the vertical dimension of palpebral fissure by 27.9% increase on average. The vertical ratio of palpebral fissure to the eyebrow-eye unit is augmented by 34.4% increase. The vertical ratio of the subunit below double eyelid fold peak to the unit is augmented by 82.6% increase. CONCLUSIONS: Double eyelidplasty can substantially enlarge the vertical dimensions of the eyes of Asians with single eyelids. The eyes are perceived to be larger because of the visually assimilated illusion of the superimposed eyelid fold and the relative proportions of the eyebrow-eye unit. The authors propose using a vertical ratio of the subunit below double eyelid fold peak in the eyebrow-eye unit to measure the visually perceived proportion of the eye in the unit. This ratio can be applied clinically for a quantitative evaluation of the surgical outcome after double eyelidplasty.

Correction of Sunken Upper-Eyelid Deformity in Young Asians by Minimally-Invasive Double-Eyelid Procedure and Simultaneous Orbital Fat Pad Repositioning: A One-Year Follow-up Study of 250 Cases.

BACKGROUND: Double-eyelid procedure to construct a supratarsal fold is the most common aesthetic surgery in young Asian adults. More complex surgical procedures, such as fat grafting or filler injection, are often indicated during traditional, long-incision, double-eyelid procedures to achieve better aesthetic results for patients with hollowness of the upper eyelids. OBJECTIVES: The authors sought to determine the efficacy of minimally-invasive double-eyelid procedures with concurrent repositioning of the orbital fat pads to correct sunken upper eyelids in young Asian adults. METHODS: The study included 250 patients treated between June 2008 and July 2103. Preoperatively, all patients complained of upper-eyelid hollowness and had positive findings on a lower-eyelid compression test. All patients underwent a minimally-invasive double-eyelid procedure plus repositioning of orbital fat. RESULTS: After the minimum follow-up period of 1 year, the overall patient satisfaction rate was 76%. The relapse rate was 10% within the first year, and the complication rate was 8%. CONCLUSIONS: This minimally-invasive combination procedure may be an option for young Asian adults who have single upper eyelids and sunken eyes. The surgery resulted in a natural double eyelid and more youthful orbital appearance in the majority of patients in this study. Proper patient selection and evaluation, including lower eyelid compression testing, are essential to achieve long-term correction.