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Related Experiment Video

Updated: Feb 28, 2026

Author Spotlight: Utilizing Traditional Chinese Acupuncture of the Ear to Improve Sleep Disorders

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Published on: August 18, 2023

A Validated Assessment Scale for the Auriculocephalic Angle in Asians.

Wei-Jin Hong¹, Shi-Wei Wang², Hong-Yi Zhao³

¹Department of Plastic and Reconstructive Surgery, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou City, Guangdong Province, People's Republic of China.

Aesthetic Plastic Surgery

|February 26, 2026

Summary

The Imeik Lying Ears Severity Scale (ILESS) provides a reliable method for assessing the auriculocephalic angle, crucial for facial aesthetics. This validated scale enhances clinical evaluation and treatment planning in aesthetic medicine.

Keywords:

Aesthetic evaluation Asian population Auriculocephalic angle Facial aesthetics Scale validation

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Area of Science:

Plastic Surgery
Aesthetic Medicine
Facial Anatomy

Background:

The auriculocephalic angle significantly influences facial aesthetics, particularly in East Asian populations.
Smaller angles can distort facial proportions, creating undesirable visual effects.
Objective assessment tools for the auriculocephalic angle are currently limited.

Purpose of the Study:

To develop and validate the Imeik Lying Ears Severity Scale (ILESS).
To establish a standardized photonumeric scale for evaluating the auriculocephalic angle.

Main Methods:

A database of 96 participants' photos was created using standardized 2D protocols.
The ILESS scale (grades 0-4) was validated by 12 digital and 6 live expert evaluators.
Inter- and intra-rater reliability were assessed using ICC and weighted Cohen's kappa.

Main Results:

Digital validation demonstrated excellent inter-rater reliability (ICC: 0.90; kappa: 0.89-0.90).
Live validation showed strong agreement (ICC: 0.82-0.85; kappa: 0.82-0.85).
Intra-rater reliability consistently exceeded ICC and kappa values of 0.89, indicating high reproducibility.

Conclusions:

The ILESS scale is a robust and versatile tool for standardized auriculocephalic angle assessment.
Validation in digital and live settings confirms its clinical and research applicability.
The ILESS scale advances aesthetic evaluation, treatment planning, and evidence-based aesthetic medicine.