A Validated Lip Fullness Grading Scale

Carruthers, Alastair; Carruthers, Jean; Hardas, Bhushan; Kaur, Mandeep; Goertelmeyer, Roman; Jones, Derek; Rzany, Berthold; Cohen, Joel L.; Kerscher, Martina; Flynn, Timothy C.; Maas, Corey S.; Sattler, Gerhard; Gebauer, Alexander; Pooth, Rainer; MCCLURE, KATHLEEN; Simone-Korbel, Ulli; Buchner, Larry

doi:10.1111/j.1524-4725.2008.34365.x

Cited by 63 publications

(72 citation statements)

References 4 publications

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“…Meanwhile, the uniform distribution has an unambiguous definition with equal percentages of subjects across grades, making it straightforward to compare results across scales and across studies. For some scale reliability studies, this consideration can be addressed by preselecting subject images to ensure uniform distributions across scale grades5, 7, 8, 12, 16; this structure ensures that each grade in the scale is well represented, and the full range of the scale is utilized, explored, and evaluated, as desired in instrument design and testing 37. However, this structure may not be feasible for studies addressing multiple scales with different distributions.…”

Section: Impact Of Distribution Sample Size and Disagreements On Iccmentioning

confidence: 99%

“…Scales that are a combination of phrases and photographs are known as photonumeric scales. In aesthetic studies, some examples of scales are measures for the degree of wrinkling,3, 4, 5, 6, 7, 8 lip fullness,9, 10, 11, 12 sagging,13 photodamage,14 and dyspigmentation,15 and they have been developed and evaluated using reliability indexes. In many aesthetic scale reliability studies, ICC is used to determine consistency, where a higher ICC signifies better consistency 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 16…”

Section: Introductionmentioning

confidence: 99%

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Performance of intraclass correlation coefficient (ICC) as a reliability index under various distributions in scale reliability studies

Mehta

Bastero-Caballero

Sun

et al. 2018

Statistics in Medicine

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121

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Many published scale validation studies determine inter‐rater reliability using the intra‐class correlation coefficient (ICC). However, the use of this statistic must consider its advantages, limitations, and applicability. This paper evaluates how interaction of subject distribution, sample size, and levels of rater disagreement affects ICC and provides an approach for obtaining relevant ICC estimates under suboptimal conditions. Simulation results suggest that for a fixed number of subjects, ICC from the convex distribution is smaller than ICC for the uniform distribution, which in turn is smaller than ICC for the concave distribution. The variance component estimates also show that the dissimilarity of ICC among distributions is attributed to the study design (ie, distribution of subjects) component of subject variability and not the scale quality component of rater error variability. The dependency of ICC on the distribution of subjects makes it difficult to compare results across reliability studies. Hence, it is proposed that reliability studies should be designed using a uniform distribution of subjects because of the standardization it provides for representing objective disagreement. In the absence of uniform distribution, a sampling method is proposed to reduce the non‐uniformity. In addition, as expected, high levels of disagreement result in low ICC, and when the type of distribution is fixed, any increase in the number of subjects beyond a moderately large specification such as n = 80 does not have a major impact on ICC.

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Section: Impact Of Distribution Sample Size and Disagreements On Iccmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Performance of intraclass correlation coefficient (ICC) as a reliability index under various distributions in scale reliability studies

Mehta

Bastero-Caballero

Sun

et al. 2018

Statistics in Medicine

Self Cite

121

View full text Add to dashboard Cite

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“…A validated 5-point photonumeric lip scale, the lip fullness scale (LFS) has been developed by Carutthers et al16 Separate grading for upper and lower lips is recommended. The scale ratings are: very thin (0), thin (1), moderately thick (2), thick (3), and full (4) 16…”

Section: Grading Scales For Perioral Lines and Lip Fullnessmentioning

confidence: 99%

“…This is of utmost importance in normal life. There are more grading systems for the perioral area available but a detailed discussion is not the focus of this review 15,16…”

Section: Grading Scales For Perioral Lines and Lip Fullnessmentioning

confidence: 99%

Perioral rejuvenation: restoration of attractiveness in aging females by minimally invasive procedures

Wollina

2013

CIA

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Lips and the perioral area are of outstanding importance in youthful appearance, attractiveness, and beauty. In contrast to younger and middle aged females, there is only scant published data on minimally invasive procedures to restore and revitalize lips and perioral soft tissue in elderly females. In this review we report the signs of aging in this particular region and the underlying anatomy. We review studies on lip restoration in younger females and present our techniques for elderly women. With an individually tailored approach, elderly females benefit from minimally invasive techniques.

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“…They also developed a grading system for lip fullness to objectify the augmentation goal and to provide aesthetic guidelines and described their favorite techniques24 (Table 1). They state that there are five grades of lip fullness, which range from very thin (0) to full (4) on a 5-point photonumeric rating scale designed to objectively quantify the three-dimensional fullness of the lip 23,24. This scale does not take the relation between upper and lower lip into account.…”

Section: Introductionmentioning

confidence: 99%

Do you know where your fillers go? An ultrastructural investigation of the lips

Vent

Lefarth

Massing

et al. 2014

CCID

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AimTo investigate the exact location and position of hyaluronic acid fillers in the perioral region by ultrasound and optical coherence tomography.IntroductionTo date, there are few in vivo investigations in humans on the exact positioning of injectable hyaluronic acid fillers, and severe complications such as hematoma and thromboembolism are rarely addressed.Materials and methodsThere were nine female patients investigated in this pilot study. All of them were periorally injected with hyaluronic acid. The exact product, amount, and locations, as well as the injection techniques, were recorded and compared. Before, immediately after, and 18 days after injection, photo documentation as well as high-resolution ultrasonography and optical coherence tomography of the lip surface were performed.ResultsMinor bruising occurred, which resolved within 7 to 9 days. On day 18, no more hemorrhage could be detected. Injected material distributed well in the tissue, and no embolism or thrombosis occurred. However, the injected material came close (up to 1 mm) to important structures such as blood vessels. Lip wrinkles improved, and the lip surface was smoother and more even.ConclusionHyaluronic acid injections can improve aesthetics and reduce fine wrinkles of the lips. In the patients investigated in this study, compression of structures such as vessels and nerve fibers did not occur, nor did any severe complications result from injection. However, one must be aware of serious complications (eg, hematoma, thromboembolism) and the important anatomic structures (eg, orbicularis oris muscle, vessels, and nerves), and injecting physicians should always have hyaluronidase as a rescue medication at hand.SummaryHyaluronic acid is a suitable tool for lip augmentation and reduction of fine lines; however, one must be aware of anatomic structures when injecting filler material into the lips and perioral area, and be familiar with the injection techniques.

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A Validated Lip Fullness Grading Scale

Abstract: The 5-point photonumeric scale generated spans the fullness of the upper and lower lip for which patients commonly seek correction. This scale is well stratified, with low intra- and interrater variability.

Cited by 63 publications

References 4 publications

Performance of intraclass correlation coefficient (ICC) as a reliability index under various distributions in scale reliability studies

Performance of intraclass correlation coefficient (ICC) as a reliability index under various distributions in scale reliability studies

Perioral rejuvenation: restoration of attractiveness in aging females by minimally invasive procedures

Do you know where your fillers go? An ultrastructural investigation of the lips

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