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A validated grading scale for marionette lines.

Alastair Carruthers1, Jean Carruthers, Bhushan Hardas

  • 1Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada. alastair@carruthers.net

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|November 22, 2008
PubMed
Summary
This summary is machine-generated.

A new 5-point scale accurately grades marionette lines (melomental folds) severity. This reliable photonumeric scale aids objective quantification in clinical research and practice for facial aging concerns.

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Area of Science:

  • Aesthetics
  • Dermatology
  • Medical Imaging

Background:

  • Melomental folds, commonly known as marionette lines, are a visible sign of facial aging.
  • These wrinkles form from repeated facial movements and the natural aging process, extending from the corners of the mouth downwards.

Purpose of the Study:

  • To develop a standardized Marionette Lines Grading Scale for objective severity assessment.
  • To establish the reliability of this photonumeric scale for clinical research and practice.

Main Methods:

  • A 5-point photonumeric rating scale was created to quantify marionette line severity.
  • Nine experts evaluated 35 subjects' photographs twice, comparing them to morphed images.
  • Inter- and intrarater variability was assessed using intraclass correlation coefficients.

Main Results:

  • High agreement was observed among the expert raters.
  • Bivariate scatter plots indicated consistent, linear judgments by the experts.

Conclusions:

  • The developed 5-point scale effectively covers the range of marionette line severity typically addressed in aesthetic treatments.
  • The scale demonstrates good stratification for consistent and reliable patient assessments.