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Assessing abdominoplasty aesthetics in women with eye-tracking technology—do patients see things differently?



Eye-tracking technology objectively measures the visual focus of subjects when assessing aesthetics. Identifying attention-drawing features can assist in improving patient satisfaction and perceived outcomes. Using eye-tracking technology, we characterized visual gaze patterns among plastic surgery patients versus laypeople when assessing pre- and post-abdominoplasty images.


Sixteen pairs of pre- and post-abdominoplasty images in AP and lateral views were shown to twenty women with and twenty women without a cosmetic procedure history. An eye-tracking device recorded visual gaze data as participants assessed the aesthetic value of the images.


The patient group spent 22.6% less time evaluating images (p < 0.05) but spent proportionally more time fixated on features of interest: the umbilicus (25.6% of their average viewing time vs 11.6%, p < 0.001), scar line (13.2% vs 5.1%, p < 0.001), and abdominal curvature (7.6% vs 3.6%, p < 0.001). Both groups most commonly first fixated on the umbilicus and abdominal curvature for AP and lateral views, respectively. The patient group’s average increase in aesthetic rating between pre- and post-procedural images was 30.4% higher than the lay group (p < 0.05). No correlation was noted between aesthetic ratings and time spent viewing the areas of interest.


Females who previously underwent cosmetic procedures are more favorable, faster, and focused reviewers of abdominoplasty images, fixating more on relevant anatomy and features than their peers. New patients may benefit from an eye-tracking-based assessment to align procedural planning and consultation with the anatomic areas they visually fixate upon.

Level of evidence: Not ratable.

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Data availability

Specific data are available upon request.




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We thank the Tobii Group for the generous provision of their eye-tracking hardware and software for this study. We also thank Illuminate Plastic Surgery for providing the images used in this study.

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Corresponding author

Correspondence to Dylan J. Peterson.

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Conflict of interest

Dylan J. Peterson, Aikaterina Gkorila, Amee D. Azad, Ashraf A. Patel, David J. Boudreault, and Rahim Nazerali declare that they have no conflict of interest.

Ethics approval

 All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Stanford IRB Protocol # 29557.

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All study subjects were adequately consented and signed a form acknowledging their consent to participate in this study.

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Not applicable.

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Tobii Pro Software is proprietary. Please contact Tobii Technology for requests for their software. Custom analysis code is available upon request.

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Peterson, D.J., Gkorila, A., Azad, A.D. et al. Assessing abdominoplasty aesthetics in women with eye-tracking technology—do patients see things differently?. Eur J Plast Surg 44, 451–458 (2021).

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  • Plastics
  • Cosmetics
  • Aesthetics
  • Abdominoplasty
  • Eye tracking
  • Eye-tracking
  • Visual gaze
  • Fixation