A classification of facial wrinkles

An increasing number of injectable filler materials for facial wrinkles and folds points to the need for objective measurements of their effectiveness . Patient satisfaction is the goal, but proof of the value of a particular product requires objective measurement. A wrinkle assessment scale was deve loped as a simple tool for use by plastic surgeons, dermatologists, and aes thetic surgeons who want to assess the changes resulting from injecting fil ler materials in their patients. By correlating the grade of the wrinkle in the reference photographs with the wrinkle in a patient's face, a classifi cation of 0 to 5 is assigned. Reliability of the scale was assessed by "liv e" judgment of 76 wrinkles by nine observers. The same rating was given to 92.7 percent of all wrinkles. In a second trial, photographs from 130 wrink les were presented to eight observers who rated 89.4 percent of all wrinkle s equally. A significant correlation of 87 percent was found between subjec tive ratings and objective wrinkle depth measured by profilometry on 40 sil icone impressions. Manufacturers, monitors of clinical trials, health autho rities, and most important, patients will benefit from objective data on cu rrent and new injectable materials.