Development and Validation of the Cheek Smoothness Scale: A Photonumeric Assessment Tool for Cheek Skin Texture.

Area of Science:

• Dermatology
• Aesthetic Science
• Medical Imaging

Background:

• Facial aging significantly impacts cheek skin texture and smoothness.
• Minimally invasive aesthetic procedures targeting cheek skin quality are in high demand.
• Validated, site-specific photonumeric assessment tools for cheek skin are limited.

Purpose of the Study:

• To develop and validate a novel photonumeric assessment tool, the Cheek Smoothness Scale (CSS).
• To evaluate cheek skin smoothness and surface texture using the CSS.

Main Methods:

• Developed a five-grade photonumeric scale (CSS) using standardized clinical photographs.
• Assessed inter- and intra-rater reliability using Fleiss' and Cohen's kappa statistics.
• Examined construct validity via objective skin surface roughness measurements (PRIMOS CR).

Main Results:

• The CSS demonstrated excellent inter- and intra-rater reliability (good-to-very good kappa values).
• Single-angle (45°) assessments showed complete agreement with multi-angle views, validating the 45° view.
• CSS grades correlated with objective roughness measurements (PRIMOS Ra values).

Conclusions:

• The CSS is a reliable, reproducible, and clinically meaningful tool for assessing cheek skin smoothness and texture.
• It integrates visual assessment with objective validation.
• The CSS serves as a valuable outcome measure for clinical research and aesthetic practice.