OBJECTIVES: The objective of this investigation was to create and validate 5-point photo numeric scales which assess horizontal necklines, platysmal bands and wrinkles in the décolleté.
METHODS: A medical team created 3 different novel 5-point photonumeric scale for the assessment of horizontal necklines, platysmal bands and décolleté wrinkling. Eleven international raters were involved in the digital validation, while 4 raters performed a live validation.
RESULTS: The Croma Horizontal Neck Line - Assessment Scale showed substantial inter-rater agreement and almost perfect intra-rater agreement in the digital and live validations. The Croma Platysmal Bands-Assessment Scale showed substantial intra-rater agreement in both, digital and live validations. For the décolleté, a static and a dynamic scale was created and validated. The Croma Static Décolleté Wrinkling-Assessment Scale showed substantial and almost perfect inter-rater agreement in the digital validation and live-validation, respectively, while the intra-rater agreement was in both almost perfect. The Croma Dynamic Décolleté Wrinkling-Assessment Scale showed almost perfect agreement in both validation settings for both, inter-and intra-rater agreement.
CONCLUSIONS: The Croma Horizontal Neck Line - Assessment Scale, the Croma Static and Dynamic Décolleté Wrinkling-Assessment Scales have sufficient inter and intrarater agreements to be justifiably used in the clinical and study setting.
OBJECTIVES: The objective of this investigation was to create and validate 5-point photo numeric scales which assess perioral lines and marionette lines.
METHODS: A medical team created two different novel 5-point photonumeric scale for the assessment of perioral lines and marionette lines. Eleven international raters were involved in the digital validation, while 4 raters performed a live validation.
RESULTS: For the Croma Static Perioral Lines-Assessment Scale digital inter-rater ICCs were 0.88 [95% CI: 0.85-0.91] in the first rating and 0.87 [0.83-0.90] in the second rating. The digital intra-rater ICCs were 0.90 [95% CI: 0.87-0.92]. In the live rating, the inter-rater ICCs were 0.89 [95% CI: 0.85-0.93] in the first rating and 0.91 [95% CI: 0.87-0.93] in the second rating with an intra-rater ICC of 0.91 [95% CI: 0.88-0.95]. For the Croma Marionette Lines-Assessment scale the digital rating inter-rater ICCs were 0.85 [95% CI: 0.81-0.89] in the first rating and 0.87 [95% CI: 0.84-0.90] in the second rating with an intra-rater ICC of 0.89 [95% CI: 0.88-0.91]. In the live rating, the inter-rater ICCs were 0.73 [95% CI: 0.54-0.83] in the first rating and 0.79 [95% CI: 0.65-0.87] in the second rating with an intra-rater ICC of 0.88 [95% CI: 0.83-0.94].
CONCLUSIONS: It is to be concluded that the Croma Static Perioral Lines-Assessment Scale and the Croma Marionette Lines-Assessment Scale have exceptional inter- and intra-rater agreements to be justifiably used in the clinical and study setting for all ethnic groups.
OBJECTIVES: This study set out to capture the perception of the ideal nasolabial angle among Canadian, Saudi, Kuwaiti, and Lebanese populations.
METHODS: An online questionnaire-based cross-sectional study was conducted to investigate the ideal nasolabial angle among Canadian, Saudi, Kuwaiti, and Lebanese populations (N = 197). Participants were patients attending outpatient clinics, plastic surgery residents and medical students. The questionnaire consisted of demographics and perception of respondents on the ideal NLA for each gender: Male (85, 90, 95, 100, 110) and Females (95, 100, 110, 115).
RESULTS: The majority of respondents were female (81.2%) aged between 20 and 39 (84.3%). The mean and standard deviation of ideal NLA choices in both male and female models were 97.1 +/- 6.39 and 109.5 +/- 5.32 respectively. The ideal male NLA choices were found to correlate significantly with age (p 0.044) and work status (p 0.019). In choosing the ideal female NLA, age was a significant factor (p 0.012).
CONCLUSIONS: Identifying the ideal NLA is essential for establishing aesthetic goals for patients and surgeons alike. It is important to understand the effects of demographics on the choice of the ideal NLA, which ultimately influences the planning and outcome of rhinoplasty procedure.
OBJECTIVES: We report correction of lying ears and aesthetic modification of helix and ear lobule with HA injections.
METHODS: We performed HA injections at auriculocephalic sulcus (AS) to increase cranioauricular angle (CA) and correct lying ears. The injections at helix and lobule were case-specific. The CA was measured and photographs were taken at baseline and 1-, 3-, 6-, and 10-month follow-ups. Efficacy was assessed using a 5-point global aesthetic improvement scale (GAIS). Adverse events (AEs) were recorded.
RESULTS: Forty-six patients (92 ears) received HA injections and completed follow-ups. Instant correction outcomes were observed. Sixteen (34.8%) patients received one touch-up injection, whose clinical efficacy persisted for 1 to 1.5 years. The GAIS for over 90% of cases with touch-up treatment was "very much improved" or "much improved" at all follow-ups. The GAIS for over 70% of cases without touch-up treatment was "very much improved" or "much improved" at 1, 3, and 6-month follow-ups. CA increased significantly compared with the baseline. Patients also reported "more V-shaped face shape" and "lifted jawline" effects. No serious AEs occurred.
CONCLUSIONS: As an alternative technique to surgeries, HA filler injections at AS effectively corrected lying ears. This technique produced immediate, long-lasting, and aesthetically pleasing results. The side effects and downtime were minimal.