{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T10:07:12Z","timestamp":1788084432183,"version":"build-2784847793"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T00:00:00Z","timestamp":1728000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Botulinum toxin type A (BoNT-A) injections are widely administered for facial rejuvenation, but their effects on facial expressions remain unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>In this study, we aimed to objectively measure the impact of BoNT-A injections on facial expressions with deep learning techniques.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>One hundred eighty patients age 25 to 60 years who underwent BoNT-A application to the upper face were included. Patients were photographed with neutral, happy, surprised, and angry expressions before and 14 days after the procedure. A convolutional neural network (CNN)-based facial emotion recognition (FER) system analyzed 1440 photographs with a hybrid data set of clinical images and the Karolinska Directed Emotional Faces (KDEF) data set.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The CNN model accurately predicted 90.15% of the test images. Significant decreases in the recognition of angry and surprised expressions were observed postinjection (P &amp;lt; .05), with no significant changes in happy or neutral expressions (P &amp;gt; .05). Angry expressions were often misclassified as neutral or happy (P &amp;lt; .05), and surprised expressions were more likely to be perceived as neutral (P &amp;lt; .05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Deep learning can effectively assess the impact of BoNT-A injections on facial expressions, providing more standardized data than traditional surveys. BoNT-A may reduce the expression of anger and surprise, potentially leading to a more positive facial appearance and emotional state. Further studies are needed to understand the broader implications of these changes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of Evidence: 4 (Therapeutic)<\/jats:title>\n                  <jats:p\/>\n               <\/jats:sec>","DOI":"10.1093\/asj\/sjae204","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T12:42:33Z","timestamp":1728045753000},"page":"NP1-NP7","source":"Crossref","is-referenced-by-count":14,"title":["Evaluating the Impact of BoNT-A Injections on Facial Expressions: A Deep Learning Analysis"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4189-6750","authenticated-orcid":false,"given":"Gulay","family":"Aktar Ugurlu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5415-701X","authenticated-orcid":false,"given":"Burak Numan","family":"Ugurlu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4255-5656","authenticated-orcid":false,"given":"Meryem","family":"Yalcinkaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,10,4]]},"reference":[{"key":"2024121200262822100_sjae204-B1","doi-asserted-by":"publisher","first-page":"e0177239","DOI":"10.1371\/journal.pone.0177239","article-title":"Mapping the emotional face. 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