Commentary on: How We Look at Mature Faces—An Eye-Tracking Investigation Into the Perception of Age Free

See the Original Article here.

It is with great pleasure that I review this article about assessing the perception of beauty and aging through tracking eye movements.¹ Perhaps the very first description of eye-tracking was given by David Noton in 1970. Although not called eye-tracking at that time, Noton hypothesized that humans habitually move their eyes in a reliable and reproducible manner corresponding to distinct patterns.² Furthermore, any shift in attention is characterized by an eye movement, also referred to as a scanpath.

The use of eye-tracking systems to objectively assess facial features has become increasingly popular in the last decade. In 2009, Ishii et al demonstrated that observers fixate on areas of faces with obvious deformities when compared to normal control subjects.³ Eye movements are ways in which the human brain interprets novel visual information. In the world of plastic surgery, eye movements can be tracked to objectively determine blemishes and disfigurements before surgery, the effectiveness of the surgery itself,⁴ and the effects of aging over time.

Instinctively, our eyes move towards predictable patterns. For faces of normal appearance, the brain quickly scans the whole face, then focuses on central portions that are unique and essential for identifying individuals (ie, eyes, nose, mouth).⁵ The authors of this study corroborated this tendency by demonstrating that the facial outline (forehead, lateral midface, and jawline) had the shortest fixation times, whereas central (periorbital, nasal, and perioral) portions of the face had the longest fixation times.

With abnormal faces, however, the eyes initially focus on the abnormal portion of the face, then resume scanning the rest of the face.¹ This extra processing step takes a few extra split seconds. Because of the discrepancy from our established “norm” (authors term this our “internal blueprint”), our eyes spend more time trying to analyze and understand what exactly makes the abnormality different from a normal face. In addition to abnormalities, blemishes, asymmetries, or general unattractiveness, the authors hypothesize that aged or mature faces require longer fixation times because these are also different from a youthful normal face.⁶ Moreover, the authors sought to determine which portion of the face specifically contributes most to the perception of the aged face by comparing fixation times in old (>40-year-old) and young (<40-year-old) subjects.

The authors should be commended for their efforts to elucidate how we assess mature faces, and to what extent we fixate on specific facial features. By stratifying the observers and the subjects by age and gender, the authors effectively eliminated potential observer bias. However, the study included only Caucasian subjects, limiting its generalizability. Although it would require a much greater number of observers and subjects, including various ethnicities would expand the external validity of the study.

In this study, the authors found that irrespective of age and gender, fixation times were longer in the older patient cohort. This supports the authors’ primary hypothesis that older faces need more cognitive processing time for full facial analysis. Presuming that longer fixation time implies deformity and/or unattractiveness, the authors posit that this finding is in line with previous studies that older individuals are less beautiful.⁴

The averageness theory of facial attractiveness confirms this conclusion.⁷ This theory states that faces are perceived as attractive when faces are averaged/automatically processed by the human brain. When portions of the face are covered by a mask, the internal processing is disrupted and fixation takes longer.⁸ To accelerate processing, the mind naturally assumes average attractiveness in the areas that are covered, although this sometimes leads to discrepancies between what is imagined and what is actually present.⁹

The more attractive a person is, the faster and easier our brains process the face because they have seen and instinctively averaged a similar face previously. This, in turn, is again the “internal blueprint” the authors refer to in the manuscript. Thus, any deviation from this established average or heuristic will lead to longer fixation times—whether it be secondary to abnormalities, natural aging, or cultural differences.

For facial-region analyses, the authors found that irrespective of age and gender of both observer and subject, the central portion of the face had longer fixation times. The perioral area attracted the viewers’ attention most in both older and younger cohorts. The perioral region had longer fixation times compared with the periorbital and nose regions. The authors contend that the effects of perioral aging negatively influence the overall facial harmony and perceived attractiveness.

Indeed, the perioral region evokes a sign of youthfulness and sensuality—more so than any other facial feature. The authors suggest it is possible that there is a heightened attention to the perioral region in postpandemic times because of the scaling back of mask mandates. Perhaps over time through the pandemic, the perioral area has become associated with a “forbidden” or “private area” of masked faces that has now finally been liberated. Although the eyes are the windows of the soul, the perioral region of the face can more effectively connote and convey sexuality.

In summary, the authors should be applauded for objectively illustrating that older individuals in general, and the perioral region in older individuals, attract most attention from viewers. The results of this study affirm that the perioral portion of the face should not be overlooked in older patients seeking facial rejuvenation. Chemical peels, lasers, neurotoxin injections (for a lip flip), volumizing procedures such as soft tissue fillers and fat grafting, and surgical lip lifts are all viable options in appropriate candidates in isolation or as adjuncts to other facial rejuvenation procedures. Addressing the perioral portion of the face in facial rejuvenation can be an effective method to restore youthful facial harmony and attractiveness.

Disclosures

The author declared no potential conflicts of interest with respect to the research, authorship, and publication of this article.

Funding

The author received no financial support for the research, authorship, and publication of this article.

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