Background: Patients with facial cancers can experience disfigurement as they may undergo considerable appearance\nchanges from their illness and its treatment. Individuals with difficulties adjusting to facial cancer are concerned about\nhow others perceive and evaluate their appearance. Therefore, it is important to understand how humans perceive\ndisfigured faces. We describe a new strategy that allows simulation of surgically plausible facial disfigurement on a novel\nface for elucidating the human perception on facial disfigurement.\nMethod: Longitudinal 3D facial images of patients (N = 17) with facial disfigurement due to cancer treatment were\nreplicated using a facial mannequin model, by applying Thin-Plate Spline (TPS) warping and linear interpolation on the\nfacial mannequin model in polar coordinates. Principal Component Analysis (PCA) was used to capture longitudinal\nstructural and textural variations found within each patient with facial disfigurement arising from the treatment. We\ntreated such variations as disfigurement. Each disfigurement was smoothly stitched on a healthy face by seeking a\nPoisson solution to guided interpolation using the gradient of the learned disfigurement as the guidance field vector.\nThe modeling technique was quantitatively evaluated. In addition, panel ratings of experienced medical professionals\non the plausibility of simulation were used to evaluate the proposed disfigurement model.\nResults: The algorithm reproduced the given face effectively using a facial mannequin model with less than 4.4mm\nmaximum error for the validation fiducial points that were not used for the processing. Panel ratings of experienced\nmedical professionals on the plausibility of simulation showed that the disfigurement model (especially for peripheral\ndisfigurement) yielded predictions comparable to the real disfigurements.\nConclusions: The modeling technique of this study is able to capture facial disfigurements and its simulation represents\nplausible outcomes of reconstructive surgery for facial cancers. Thus, our technique can be used to study human\nperception on facial disfigurement.
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