title: Eigen-disfigurement model for simulating plausible facial disfigurement after reconstructive surgery.
abstract: BACKGROUND
  Patients with facial cancers can experience disfigurement as they may undergo considerable appearance changes from their illness and its treatment. Individuals with difficulties adjusting to facial cancer are concerned about how others perceive and evaluate their appearance. Therefore, it is important to understand how humans perceive disfigured faces. We describe a new strategy that allows simulation of surgically plausible facial disfigurement on a novel face for elucidating the human perception on facial disfigurement.
  
  
  METHODS
  Longitudinal 3D facial images of patients (N = 17) with facial disfigurement due to cancer treatment were replicated using a facial mannequin model, by applying Thin-Plate Spline (TPS) warping and linear interpolation on the facial mannequin model in polar coordinates. Principal Component Analysis (PCA) was used to capture longitudinal structural and textural variations found within each patient with facial disfigurement arising from the treatment. We treated such variations as disfigurement. Each disfigurement was smoothly stitched on a healthy face by seeking a Poisson solution to guided interpolation using the gradient of the learned disfigurement as the guidance field vector. The modeling technique was quantitatively evaluated. In addition, panel ratings of experienced medical professionals on the plausibility of simulation were used to evaluate the proposed disfigurement model.
  
  
  RESULTS
  The algorithm reproduced the given face effectively using a facial mannequin model with less than 4.4 mm maximum error for the validation fiducial points that were not used for the processing. Panel ratings of experienced medical professionals on the plausibility of simulation showed that the disfigurement model (especially for peripheral disfigurement) yielded predictions comparable to the real disfigurements.
  
  
  CONCLUSIONS
  The modeling technique of this study is able to capture facial disfigurements and its simulation represents plausible outcomes of reconstructive surgery for facial cancers. Thus, our technique can be used to study human perception on facial disfigurement.
authors.affiliation: Department of Electrical and Computer Engineering, The University of Texas at Austin, 2501 Speedway, Stop C0803, Austin, TX, 78712, USA. juhunlee@utexas.edu.|Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. juhunlee@utexas.edu.
authors.forename: Juhun
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. mcfinger@mdanderson.org.|Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. mcfinger@mdanderson.org.
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Fingeret
authors.affiliation: Department of Electrical and Computer Engineering, The University of Texas at Austin, 2501 Speedway, Stop C0803, Austin, TX, 78712, USA. bovik@ece.utexas.edu.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Bovik
authors.affiliation: Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. greece@mdanderson.org.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Reece
authors.affiliation: Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. rjskoracki@mdanderson.org.
authors.forename: Roman J
authors.initials: RJ
authors.lastname: Skoracki
authors.affiliation: Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. mhanasono@mdanderson.org.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Hanasono
authors.affiliation: Department of Biomedical Engineering, The University of Texas at Austin, 107 W Dean Keeton St, Stop C0800, Austin, TX, 78712, USA. mia.markey@utexas.edu.|Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. mia.markey@utexas.edu.
authors.forename: Mia K
authors.initials: MK
authors.lastname: Markey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003198:Computer Simulation; D005145:Face / Q000473:pathology; D005151:Facial Injuries / Q000209:etiology* / Q000473:pathology*; D005153:Facial Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011300:Preoperative Care / Q000379:methods; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D055815:Young Adult