Hierarchical attention transformer provides assistant suggestions for orbital rejuvenation surgery

BackgroundEarly detection of periocular aging is a common concern in cosmetic surgery. Traditional diagnostic and treatment methods often require hospital visits and consultations with plastic surgeons, which are costly and time-consuming. This study aims to develop and evaluate an AI-based decision...

Full description

Saved in:
Bibliographic Details
Main Authors: Xiang Lian, Xin Hu, Guannan Li, Siqi Wu, Yihao Liu, Ke Qin, Kai Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1532195/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849706054091276288
author Xiang Lian
Xiang Lian
Xiang Lian
Xin Hu
Guannan Li
Siqi Wu
Yihao Liu
Ke Qin
Kai Liu
Kai Liu
Kai Liu
author_facet Xiang Lian
Xiang Lian
Xiang Lian
Xin Hu
Guannan Li
Siqi Wu
Yihao Liu
Ke Qin
Kai Liu
Kai Liu
Kai Liu
author_sort Xiang Lian
collection DOAJ
description BackgroundEarly detection of periocular aging is a common concern in cosmetic surgery. Traditional diagnostic and treatment methods often require hospital visits and consultations with plastic surgeons, which are costly and time-consuming. This study aims to develop and evaluate an AI-based decision-making system for periocular cosmetic surgery, utilizing a Hierarchical Attention Transformer (HATrans) model designed for multi-label classification in periocular conditions, allowing for home-based early aging identification.MethodsThis cross-sectional study was conducted at the Department of Plastic and Reconstructive Surgery at Shanghai Jiao Tong University School of Medicine’s Ninth People’s Hospital from September 1, 2010, to April 30, 2024. The study enhanced the Vision Transformer (ViT) by adding two specialized branches: the Region Recognition Branch for foreground area identification, and the Patch Recognition Branch for refined feature representation via contrastive learning. These enhancements allowed for better handling of complex periocular images.ResultsThe HATrans model significantly outperformed baseline architectures such as ResNet and Swin Transformer, achieving superior accuracy, sensitivity, and specificity in identifying periocular aging. Ablation studies demonstrated the critical role of the hierarchical attention mechanism in distinguishing subtle foreground-background differences, improving the model’s performance in smartphone-based image analysis.ConclusionThe HATrans model represents a significant advancement in multi-label classification for facial aesthetics, offering a practical solution for early periocular aging detection at home. The model’s robust performance supports its potential for assisting clinical decision-making in cosmetic surgery, facilitating accessible and timely treatment recommendations.
format Article
id doaj-art-bf26f35488b643d9a7f6c75cf891b04e
institution DOAJ
issn 2296-858X
language English
publishDate 2025-03-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj-art-bf26f35488b643d9a7f6c75cf891b04e2025-08-20T03:16:18ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-03-011210.3389/fmed.2025.15321951532195Hierarchical attention transformer provides assistant suggestions for orbital rejuvenation surgeryXiang Lian0Xiang Lian1Xiang Lian2Xin Hu3Guannan Li4Siqi Wu5Yihao Liu6Ke Qin7Kai Liu8Kai Liu9Kai Liu10Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Key Laboratory of Tissue Engineering, Shanghai Ninth People’s Hospital, National Tissue Engineering Center of China, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Institute for Plastic and Reconstructive Surgery, Shanghai, ChinaUniversity of Electronic Science and Technology of China, Chengdu, Sichuan, ChinaUniversity of Electronic Science and Technology of China, Chengdu, Sichuan, ChinaDepartment of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaEcole Polytechnique, Institut Polytechnique de Paris, Palaiseau, FranceUniversity of Electronic Science and Technology of China, Chengdu, Sichuan, ChinaDepartment of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Key Laboratory of Tissue Engineering, Shanghai Ninth People’s Hospital, National Tissue Engineering Center of China, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Institute for Plastic and Reconstructive Surgery, Shanghai, ChinaBackgroundEarly detection of periocular aging is a common concern in cosmetic surgery. Traditional diagnostic and treatment methods often require hospital visits and consultations with plastic surgeons, which are costly and time-consuming. This study aims to develop and evaluate an AI-based decision-making system for periocular cosmetic surgery, utilizing a Hierarchical Attention Transformer (HATrans) model designed for multi-label classification in periocular conditions, allowing for home-based early aging identification.MethodsThis cross-sectional study was conducted at the Department of Plastic and Reconstructive Surgery at Shanghai Jiao Tong University School of Medicine’s Ninth People’s Hospital from September 1, 2010, to April 30, 2024. The study enhanced the Vision Transformer (ViT) by adding two specialized branches: the Region Recognition Branch for foreground area identification, and the Patch Recognition Branch for refined feature representation via contrastive learning. These enhancements allowed for better handling of complex periocular images.ResultsThe HATrans model significantly outperformed baseline architectures such as ResNet and Swin Transformer, achieving superior accuracy, sensitivity, and specificity in identifying periocular aging. Ablation studies demonstrated the critical role of the hierarchical attention mechanism in distinguishing subtle foreground-background differences, improving the model’s performance in smartphone-based image analysis.ConclusionThe HATrans model represents a significant advancement in multi-label classification for facial aesthetics, offering a practical solution for early periocular aging detection at home. The model’s robust performance supports its potential for assisting clinical decision-making in cosmetic surgery, facilitating accessible and timely treatment recommendations.https://www.frontiersin.org/articles/10.3389/fmed.2025.1532195/fullperiocular agingHierarchical Attention Transformer (HATrans)AI-based decision-makingmulti-label classificationlower blepharoplastydouble eyelid surgery
spellingShingle Xiang Lian
Xiang Lian
Xiang Lian
Xin Hu
Guannan Li
Siqi Wu
Yihao Liu
Ke Qin
Kai Liu
Kai Liu
Kai Liu
Hierarchical attention transformer provides assistant suggestions for orbital rejuvenation surgery
Frontiers in Medicine
periocular aging
Hierarchical Attention Transformer (HATrans)
AI-based decision-making
multi-label classification
lower blepharoplasty
double eyelid surgery
title Hierarchical attention transformer provides assistant suggestions for orbital rejuvenation surgery
title_full Hierarchical attention transformer provides assistant suggestions for orbital rejuvenation surgery
title_fullStr Hierarchical attention transformer provides assistant suggestions for orbital rejuvenation surgery
title_full_unstemmed Hierarchical attention transformer provides assistant suggestions for orbital rejuvenation surgery
title_short Hierarchical attention transformer provides assistant suggestions for orbital rejuvenation surgery
title_sort hierarchical attention transformer provides assistant suggestions for orbital rejuvenation surgery
topic periocular aging
Hierarchical Attention Transformer (HATrans)
AI-based decision-making
multi-label classification
lower blepharoplasty
double eyelid surgery
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1532195/full
work_keys_str_mv AT xianglian hierarchicalattentiontransformerprovidesassistantsuggestionsfororbitalrejuvenationsurgery
AT xianglian hierarchicalattentiontransformerprovidesassistantsuggestionsfororbitalrejuvenationsurgery
AT xianglian hierarchicalattentiontransformerprovidesassistantsuggestionsfororbitalrejuvenationsurgery
AT xinhu hierarchicalattentiontransformerprovidesassistantsuggestionsfororbitalrejuvenationsurgery
AT guannanli hierarchicalattentiontransformerprovidesassistantsuggestionsfororbitalrejuvenationsurgery
AT siqiwu hierarchicalattentiontransformerprovidesassistantsuggestionsfororbitalrejuvenationsurgery
AT yihaoliu hierarchicalattentiontransformerprovidesassistantsuggestionsfororbitalrejuvenationsurgery
AT keqin hierarchicalattentiontransformerprovidesassistantsuggestionsfororbitalrejuvenationsurgery
AT kailiu hierarchicalattentiontransformerprovidesassistantsuggestionsfororbitalrejuvenationsurgery
AT kailiu hierarchicalattentiontransformerprovidesassistantsuggestionsfororbitalrejuvenationsurgery
AT kailiu hierarchicalattentiontransformerprovidesassistantsuggestionsfororbitalrejuvenationsurgery