Publications by authors named "Doris Day"

17 Publications

  • Page 1 of 1

The role of a shelf-ready, human-derived, soft tissue injectable adipose matrix for facial volume correction.

J Cosmet Dermatol 2020 Oct 4;19(10):2476-2483. Epub 2020 Sep 4.

Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA.

Background: Synthetic soft tissue fillers frequently used to restore facial volume do not provide a regenerative framework, limiting their sustained efficacy. Autologous fat transfer for facial rejuvenation supports tissue regeneration but has unpredictable outcomes depending on the quality of harvesting, processing, and implantation.

Aims: Exploration of the pros and cons of available tissue fillers and the role of an injectable Allograft Adipose Matrix (AAM) for facial rejuvenation.

Methods: The results of a literature review conducted by two clinicians with extensive experience in this field were discussed by a panel of dermatologists and surgeons who regularly treat patients with signs and symptoms of facial aging. A manuscript was prepared and reviewed by the panel taking into account the evidence and their clinical experience treating patients for facial rejuvenation.

Results: Facial rejuvenation needs to address the volume deficiency and repositioning of ptotic soft tissues. Frequently used synthetic fillers are suitable candidates for improving the facial appearance of fine lines and for molding. A better understanding of facial volume loss has allowed the use of adipose fat cells for facial rejuvenation. The injectable AAM is readily available and provides a regenerative framework for sustainable results. Prospective clinical and randomized studies support the effective and safe use of AAM for facial rejuvenation.

Conclusion: AAM may offer an alternative to synthetic fillers and autologous fat implantation in the face without the cumbersome process of fat harvesting and processing. More robust studies are to confirm the positive results obtained in smaller studies using the soft tissue bio stimulatory injectable.
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http://dx.doi.org/10.1111/jocd.13680DOI Listing
October 2020

Tretinoin 0.05% Lotion for the Once-Daily Treatment of Moderate-to-Severe Acne Vulgaris: Impact of Gender and Race on Efficacy and Safety

J Drugs Dermatol 2019 Nov;18(11):1128-1138

Background: There has been an increasing interest in gender and racial differences both in the pathogenesis and treatment of acne vulgaris (acne), and postinflammatory hyperpigmentation (PIH) is a major concern in patients of color. Female acne patients report more anxiety and depression with acne improvement positively influencing Quality of Life (QoL) than their male counterparts, and there are differences in acne presentation. The first lotion formulation of tretinoin was developed using novel polymeric emulsion technology to provide an important alternative option to treat these acne patients, especially those who may be sensitive to the irritant effects of other tretinoin formulations. Objective: To determine the impact of gender and race on the efficacy and safety of tretinoin 0.05% lotion in treating moderate or severe acne. Methods: Post hoc analysis of 2 multicenter, randomized, double-blind, vehicle-controlled Phase 3 studies in moderate-to-severe acne. Subjects (aged 9 to 58 years, N=1640) were randomized (1:1) to receive tretinoin 0.05% lotion or vehicle, once-daily for 12 weeks. Efficacy assessments included changes in baseline inflammatory and noninflammatory lesions and treatment success (at least 2-grade reduction in Evaluator’s Global Severity Score [EGSS] and clear/almost clear). Quality of Life was assessed using the validated Acne QoL scale. Safety, adverse events (AEs), cutaneous tolerability, and hypo-/hyper-pigmentation (using a 4-point scale where 0=none and 3=severe) were evaluated at each study visit. Results: At week 12, mean percent reduction in inflammatory lesion counts were 56.9% and 53.4% respectively in female and male patients compared with 47.1% and 39.4% with vehicle (P≤0.001), with females statistically significant to males at week 8 [P=0.026]). Mean percent reduction in noninflammatory lesion counts in females and males were 51.7% and 46.1% respectively, compared with 34.9% and 29.7% with vehicle (P<0.001), with females statistically significant to males at week 12 (P=0.035). Treatment success was achieved by 23.6% and 16.1% of female and male patients treated with tretinoin 0.05% lotion by week 12 (P≤0.001 vs vehicle) with females statistically significant compared with males (P=0.013). Significant differences in inflammatory lesion count reductions were reported in Caucasian patients from week 8, and Black African/American male patients at week 12. Only male patients reported significant differences in both races in terms of noninflammatory lesions, and only Caucasian patients reported significant differences in treatment success. Female patients treated with tretinoin 0.05% lotion had statistically significant improvements in each Acne QoL domain (except role-social) compared with vehicle. Improvements in QoL in male subjects were only statistically different for acne symptoms. Tretinoin 0.05% lotion was well-tolerated in both genders. There were more treatment-related AEs in the female subpopulation, with a significantly greater incidence of skin dryness (P=0.006), that was more common in the younger Caucasian females. Conclusions: Tretinoin 0.05% lotion has been shown to be effective and well tolerated in moderate-to-severe acne. Treatment was significantly more effective in females than males. Tretinoin 0.05% lotion was well tolerated by both genders, although there was a higher incidence of treatment-related AEs, especially skin dryness, in females. There were racial and gender differences in QoL and beneficial effects on PIH in those patients most at risk. J Drugs Dermatol. 2019;18(11):1128-1138.
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November 2019

Impact of Smoking and Alcohol Use on Facial Aging in Women: Results of a Large Multinational, Multiracial, Cross-sectional Survey.

J Clin Aesthet Dermatol 2019 Aug 1;12(8):28-39. Epub 2019 Aug 1.

Dr. Goodman is with Monash University in Clayton, Australia and Skin & Cancer Foundation Inc., in Carlton, Australia.

Data on associations between facial aging and smoking or alcohol consumption are generally derived from small studies, and therefore, vary. The aim of this large multinational study was to determine more accurately which clinical signs of skin- and volume-related facial aging are associated with tobacco and alcohol use in women. This was a subanalysis of a global, cross-sectional, Internet-based survey of self-reported facial aging. Women aged 18 to 75 years old (n=3,267) from the United States, Australia, Canada, and the United Kingdom who described themselves as white, Asian, black, or Hispanic were included. Using a mirror, participants determined their own aging severity on photonumeric rating scales for 11 facial characteristics. Linear regressions were used to assess associations between each feature's severity and smoking status (never vs. current and former smoker); smoking pack years (0 versus 1-10, 11-20, and >20 years); alcohol use (none vs. moderate and heavy); and alcoholic beverage type, after controlling for body mass index, country, age, and race. Smoking was associated with an increased severity of forehead, crow's feet, and glabellar lines; under-eye puffiness; tear-trough hollowing; nasolabial folds; oral commissures; perioral lines; and reduced lip fullness (0.025) but not midface volume loss or visible blood vessels. Heavy alcohol use (≥8 drinks/week) was associated with increased upper facial lines, under-eye puffiness, oral commissures, midface volume loss, and blood vessels (0.042). Smoking and alcohol consumption significantly but differentially impact skin and volume-related facial aging.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6715121PMC
August 2019

Consensus Recommendations on Adjunctive Topical Management of Atopic Dermatitis.

J Drugs Dermatol 2018 Oct;17(10):1070-1076

Atopic dermatitis (AD) is well-recognized as a very common chronic and relapsing pruritic skin disorder affecting both children and adults worldwide. The adverse effects on the quality of life of affected individuals and their families is well-established. The pathophysiology of AD is complex, leading to interindividual variations in clinical presentation and severity. The chronicity of AD, characterized by periods of exacerbation and remission, supports a strong need to develop measures that can effectively and safely prolong remissions between flares of the disease. This article provides an overview of AD including prevalence, severity, and disease course/progression, succinct summaries of pathophysiology and medical management, and discussion of epidermal barrier dysfunction and skin microbiome shifting associated with AD. Additional emphasis is placed on adjunctive topical skin barrier approaches that may prolong disease-free remissions. Results from a panel of dermatologists queried about adjunctive approaches to AD, using a modified-Delphi approach, are also discussed. J Drugs Dermatol. 2018;17(10):1070-1076.

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October 2018

Assessing the Potential Role for Topical Melatonin in an Antiaging Skin Regimen.

J Drugs Dermatol 2018 Sep;17(9):966-969

Background: Melatonin is an endogenous hormone commonly associated with regulation of sleep. However, over the last two decades, research has elucidated a range of effects associated with the compound, including anti-inflammatory, both direct and indirect antioxidant activity, tissue regenerative benefits, and preservation of mitochondrial function. Melatonin's anti-inflammatory and antioxidant support, coupled with its mitochondrial support, make it an intriguing target for use to support skin health. Human skin and hair follicles express functional melatonin receptors. They also engage in substantial melatonin synthesis. By supporting cutaneous homeostasis, melatonin and its metabolites are thought to attenuate carcinogenesis and possibly other pathological processes, including hyperproliferative/inflammatory conditions. The primary extrinsic driver of aging has been considered to be exposure to ultraviolet (UV) light, which is well-established to contribute to sunburn, immunosuppression, skin aging, and carcinogenesis. Topically applied melatonin has been shown to reduce markers of reactive oxygen species formation and to reverse signs of skin aging. As the global population continues to age, photo-damage remains a significant cutaneous concern. While use of sunscreens and UV avoidance strategies are essential to mitigate skin cancer risks, the potential to protect the skin and improve the appearance of photo-damage through the use of topical antioxidant support is appealing. The evidence suggests that melatonin deserves consideration for topical use as an anti-aging and skin protective agent. It is shown to be both safe and effective when topically applied. J Drugs Dermatol. 2018;17(8):966-969.
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September 2018

Three-Dimensional Analysis of Minimally Invasive Vacuum-Assisted Subcision Treatment of Cellulite.

J Drugs Dermatol 2018 Sep;17(9):960-965

Introduction: This was a prospective non-randomized observational study of female subjects seeking treatment for cellulite who were consecutively enrolled into a registry. The objective was to evaluate the efficacy and safety of a tissue stabilized-guided subcision device for the treatment of cellulite using three-dimensional (3D) imaging analysis.

Methods: Subjects received a single treatment to the buttocks and/or posterolateral thighs with the study device. Follow-up telephone evaluations were conducted at 3 and 14 days to evaluate safety and 30 and 90 days to evaluate efficacy. Subjects returned to clinic at three months to obtain follow-up two dimensional and 3D imaging.

Results: Sixteen women of average age 44.1 years with a total of 291 lesions of cellulite were treated. Thirteen subjects presented for all follow up visits. Physicians graded results an average of 2.23/5 or "much improved" to "improved" with 9 subjects as much or very much improved (69.2%). Blinded assessors graded overall improvement an average of 2.8 (26-75% improvement) with 8 subjects having greater than 50% improvement overall (61.6%). Improvement in dimple depth was graded an average of 2.9, with 9 subjects having greater than 50% improvement (69.2%). Analysis of 3D imaging yielded 67.4% average improvement in negative volume and 58.4% improvement in minimum height of dimples. Most expected treatment effects resolved within three months after treatment.

Conclusion: Utilizing three-dimensional imaging analysis, investigators quantitatively and objectively demonstrated efficacy of a tissue stabilized-guided subcision device in the treatment of cellulite of the buttocks and thighs. J Drugs Dermatol. 2018;17(9):960-965.
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September 2018

To Form a More Perfect Dermatologic Union.

Dermatol Surg 2018 Sep;44(9):1243-1245

The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY.

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http://dx.doi.org/10.1097/DSS.0000000000001573DOI Listing
September 2018

Consensus Recommendations for Combined Aesthetic Interventions Using Botulinum Toxin, Fillers, and Microfocused Ultrasound in the Neck, Décolletage, Hands, and Other Areas of the Body.

Dermatol Surg 2016 Oct;42(10):1199-1208

*Cosmetic Laser Dermatology, San Diego, California;†Center for Dermatology and Dermatologic Surgery, Washington, DC;‡University of British Columbia, Vancouver, Canada;§Day Dermatology and Aesthetics, New York, New York;‖European Medical Aesthetics Ltd., London, United Kingdom;¶University of Hamburg, Hamburg, Germany;#Victoria Park Medispa, Montreal, Canada;**Private Practice for Dermatology and Aesthetics, Munich, Germany;††Leaders Clinic, Seoul, Korea;‡‡RZANY & HUND, Berlin, Germany;§§Rosenparkklinik, Darmstadt, Germany;‖‖Seoul National University, Seoul, Korea;¶¶University of Washington, Seattle, Washington;##Rosenparkklinik, Darmstadt, Germany.

Background: The popularity of aesthetic procedures in the face has led to greater disparity between treated areas and those that still show evidence of true age. Although many areas of the body often require multiple treatment procedures for optimal rejuvenation, combination therapy for specific areas is not yet well defined.

Objective: To develop recommendations for the optimal combination and ideal sequence of botulinum toxin (BoNT), hyaluronic acid, calcium hydroxylapatite (CaHA), and microfocused ultrasound with visualization in nonfacial areas across all skin phototypes.

Methods: Fifteen specialists convened under the guidance of a certified moderator. Consensus was defined as approval from 75% to 94% of all participants, whereas agreement of ≥95% denoted a strong consensus.

Results: Recommendations have been provided for the neck, décolletage, and hands and include the timing and sequence of specific procedures when used concurrently or over several treatment sessions. Position statements are offered in lieu of consensus for the upper arms, abdomen, buttocks, and knees.

Conclusion: Nonfacial rejuvenation often requires multiple procedures for optimal results in individuals with significant age-related changes. Further clinical studies are recommended to raise awareness of non-facial indications and provide clinicians with the best evidence for best treatment practices.
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http://dx.doi.org/10.1097/DSS.0000000000000869DOI Listing
October 2016

Consensus Recommendations for Combined Aesthetic Interventions in the Face Using Botulinum Toxin, Fillers, and Energy-Based Devices.

Dermatol Surg 2016 May;42(5):586-97

*University of British Columbia, Vancouver, Canada; †Center for Dermatology and Dermatologic Surgery, Washington, D.C.; ‡Day Dermatology and Aesthetics, New York City, New York; §Cosmetic Laser Dermatology, San Diego, California; ‖European Medical Aesthetics Ltd., London, United Kingdom; ¶University of Hamburg, Hamburg, Germany; #Victoria Park Medispa, Montreal, Canada; **Private Practice for Dermatology and Aesthetics, Munich, Germany; ††Leaders Clinic, Seoul, Korea; ‡‡RZANY & HUND, Berlin, Germany; §§Rosenparkklinik, Darmstadt, Germany; ‖‖Seoul National University, Seoul, Korea; ¶¶University of Washington, Seattle, Washington.

Background: The aging process is a complex interplay of intrinsic and extrinsic factors across multiple layers of the face. Accordingly, combining aesthetic interventions targeting different manifestations of aging often leads to better results than single modalities alone. However, no guidelines for a pan-facial approach using multiple interventions have been published to date.

Objective: To develop consensus recommendations for the optimal combination and ideal sequence of botulinum toxin (BoNT), hyaluronic acid, calcium hydroxylapatite, and microfocused ultrasound with visualization (MFU-V) in persons of all Fitzpatrick skin types.

Methods And Materials: Fifteen specialists convened under the guidance of a certified moderator. Consensus was defined as approval from 75% to 94% of all participants, whereas agreement of ≥95% denoted a strong consensus.

Results: Optimal aesthetic treatment of the face begins with a thorough patient assessment and an individualized treatment plan. Spacing consecutive treatments 1 to 2 weeks apart allows for resolution of side effects and/or to assess results. For same-day treatments, BoNT and fillers may be performed together in either sequence, whereas MFU-V is recommended before injectable agents.

Conclusion: Expert consensus supports a combination approach using multiple modalities in specific sequence for the safe and effective treatment of the aging face.
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http://dx.doi.org/10.1097/DSS.0000000000000754DOI Listing
May 2016

A potential role for the dermatologist in the physical transformation of transgender people: A survey of attitudes and practices within the transgender community.

J Am Acad Dermatol 2016 Feb 5;74(2):303-8. Epub 2015 Dec 5.

Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, New York; Day Dermatology and Aesthetics, New York, New York.

Background: There are an estimated 700,000 or more transgender people in the United States, however their dermatologic needs are not fully established in the medical literature. Unique needs relate to hormone therapy, prior surgeries, and other aspects of physical transitioning.

Objectives: By examining attitudes and practices of transgender individuals, we aimed to identify areas for which dermatologists could contribute to their physical transformation.

Methods: This cross-sectional study used an anonymous online survey, distributed via lesbian, gay, bisexual, and transgender organizations; social media; and at targeted locations and events.

Results: A total of 327 people completed the survey (63% men, 29% women, 9% other). Most transgender women indicated that their face was most imperative to have changed, whereas men noted their chest, in turn influencing procedures. Of women's facial procedures, hair removal predominated, followed by surgery then injectables, mostly performed by plastic surgeons. Hormone-induced facial effects varied, usually taking over 2 years for maximal effect. When choosing procedures, money was the major barrier and good aesthetic outcome the primary concern. Participants did not think that facial procedures necessitate the currently accepted prerequisites for chest and genital surgery.

Limitations: This study has limited size and convenience sampling.

Conclusion: Dermatologists could contribute to the physical transformation of transgender patients through noninvasive procedures.
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http://dx.doi.org/10.1016/j.jaad.2015.10.013DOI Listing
February 2016

Safety and effectiveness of focused cold therapy for the treatment of hyperdynamic forehead wrinkles.

Dermatol Surg 2015 Feb;41(2):232-41

*Myoscience, Inc, Redwood City, California; †The Palmer Code Institute, Beverly Hills, California; ‡Bay Area Laser Institute, San Francisco, California; §Munyon Dermatology, San Francisco, California; ‖Day Dermatology & Aesthetics, New York, New York.

Background: Approximately 25% of patients exploring treatments for wrinkle reduction, have reservations about toxins. Therefore, a nonsurgical, minimally invasive, and toxin-free approach to eliminate facial hyperdynamic lines is desirable.

Objective: To assess the clinical safety and effectiveness of focused cold therapy (FCT) for the reduction of hyperdynamic forehead wrinkles.

Methods: Forty-one subjects received FCT to temporal branches of the facial nerve. Hyperdynamic forehead wrinkles were assessed by the investigator and subject before treatment, immediately after procedure, and at 7, 30, 60, 90, and 120 days after treatment. A validated 5-point wrinkle scale and a 9-point global improvement scale were used to measure line severity.

Results: Five subjects received a lower treatment dose and were therefore excluded from analysis. In the remaining 36 subjects, 91% had at least a 1-point improvement in forehead line severity at 30 days after treatment and 70% had at least a 2-point improvement. There were no serious adverse events.

Conclusion: Subjects treated for forehead wrinkles showed significant clinical improvement with high subject satisfaction and no serious adverse events. Focused cold therapy seems to be an effective, safe nontoxic alternative to popular wrinkle-reducing treatments.
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http://dx.doi.org/10.1097/DSS.0000000000000155DOI Listing
February 2015

Inflammatory acne management with a novel prescription dietary supplement.

J Drugs Dermatol 2012 Dec;11(12):1428-33

Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY, USA.

Background: Inflammatory acne, particularly in post-adolescent women, is increasing in incidence. The most effective therapeutic modality for treatment of this type of acne has been the administration of oral tetracyclines. Long-term acne treatment with such drugs, however, is frequently accompanied by undesirable adverse reactions, including gastrointestinal disturbances, antianabolic effects, headaches, tinnitus, and photosensitivity.

Objective: To assess the usefulness of a novel dietary supplement in the overall management of patients with inflammatory acne vulgaris.

Methods: 235 patients with inflammatory acne vulgaris were enrolled by dermatologists in a multicenter, open-label, 8-week, prospective study evaluating the effects of adding NicAzel, 1 to 4 tablets daily, to their current acne treatment regimen.

Results: A statistically significant (P<.0001) number of patients demonstrated improvement over their previous acne treatment regimens after both 4 and 8 weeks of NicAzel (nicotinamide, azelaic acid, zinc, pyridoxine, copper, folic acid; Elorac Inc, Vernon Hills, IL) use. At week 8, 88% of the patients experienced a visible reduction in inflammatory lesions, and 81% of the patients rated their appearance as much or moderately better compared with baseline. Three-quarters (76%) of the patients thought NicAzel was at least as effective as previous treatment with oral antibiotics.

Conclusion: Patients with inflammatory acne showed significant improvement in acne severity and overall appearance when NicAzel was added to their existing treatment regimen.
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December 2012

Adjunctive skin care of the brow and periorbital region.

Clin Plast Surg 2013 Jan 12;40(1):225-36. Epub 2012 Oct 12.

Private Practice, University of Texas Health Science Center, San Antonio, TX 78212, USA.

This article discusses adjunctive skin care of the brow and periorbital region. Anatomic properties of eyelid skin require skin care products specifically suited to this area. Common patient concerns, including wrinkles, infraorbital dark circles, puffiness, and thinning eyebrows and eyelashes, are addressed in the context of contributing anatomic and physiologic factors and the classes of and/or specific ingredients targeting these problems.
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http://dx.doi.org/10.1016/j.cps.2012.09.003DOI Listing
January 2013

Esthetic rejuvenation of the temple.

Clin Plast Surg 2013 Jan;40(1):77-89

The Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, NY 10016, USA.

Loss of volume in the temples is an early sign of aging that is often overlooked by both the physician and the patient. Augmentation of the temple using soft tissue fillers improves the contours of the upper face with the secondary effect of lengthening and lifting the lateral brow. After replacement of volume, treatment of the overlying skin with skin-tightening devices or laser resurfacing help to complete a comprehensive rejuvenation of the temple and upper one-third of the face.
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http://dx.doi.org/10.1016/j.cps.2012.09.001DOI Listing
January 2013

Counseling patients on facial volume replacement and adherence with posttreatment instructions.

Authors:
Doris Day

Patient Prefer Adherence 2010 Sep 7;4:273-81. Epub 2010 Sep 7.

Day Dermatology and Aesthetics New York, USA.

Use of injectable volume replacement products has increased dramatically in the US in recent years. An optimal outcome with volume replacement depends on a thorough knowledge of the products on the part of the dermatologic/aesthetic physician specialist, identification of patients with a likelihood of benefiting from volume replacement procedures, selection of an appropriate product for the individual patient, and effective patient counseling to ensure adherence to posttreatment care instructions. Adherence to physician instructions in the field of dermatology appears limited, and there is very little published information on adherence to physician instructions following facial volume replacement procedures. The purpose of this review is to provide strategies for understanding and overcoming the barriers to adherence with the widely used dermal fillers. Strategies include using patient-centered techniques, such as a motivational interview encouraging the patient to follow postprocedure care instructions, eg, massage. In this case, demonstrating massage techniques while the patient is still in the office, with patient participation and detailed feedback, also contributes to good adherence with posttreatment care instructions. Telephone counseling, reminder postcards, and text messages may help improve clinic attendance for follow-up. Motivated patients who demonstrate good adherence to physician instructions generally respond well to volume replacement treatments, and usually experience fewer adverse events than patients who do not follow instructions. Although promoting adherence to pretreatment and posttreatment protocols remains a challenge, patient counseling throughout the treatment process can lead to successful results.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943219PMC
http://dx.doi.org/10.2147/ppa.s11024DOI Listing
September 2010

The wrinkle severity rating scale: a validation study.

Am J Clin Dermatol 2004 ;5(1):49-52

Department of Dermatology, New York University Medical Center, New York, New York 10021, USA.

Background: Patient satisfaction is the most important outcome in facial aesthetic surgery. However, the need for evidence-based evaluation of aesthetic procedures dictates the use of more objective and quantitative measures of treatment outcome.

Objective: The present study was undertaken to validate a new clinical outcome instrument, the Wrinkle Severity Rating Scale.

Methods: Five clinical investigators were presented with 30 photographic images of the lower face and asked to rate nasolabial fold severity on each side using the 5-grade Wrinkle Severity Rating Scale (WSRS). Standardized definitions of the five grades were provided to the investigators in visual (photographic) and descriptive formats. To take into account possible facial asymmetry, nasolabial folds on the left and right sides of the face were rated separately. Assessments were conducted independently and were repeated after >or=2 weeks.

Results: Intra-observer (test-retest) agreement was 68.7% (left side) and 72.7% (right side); weighted kappa coefficients for the left and right sides were 0.77 and 0.81, respectively. Mean inter-observer agreement (internal consistency) was 67.7% (left side) and 72.3% (right side); weighted kappa coefficients for the left and right sides were 0.75 (95% CI 0.70-0.79) and 0.78 (95% CI 0.72-0.83), respectively.

Conclusion: The WSRS is a valid and reliable instrument for quantitative assessment of facial skin folds, with good inter- and intra-observer consistency. By allowing objective and reproducible grading of data, the WSRS should prove a useful clinical tool for assessing the effectiveness of soft-tissue augmentation and other facial contouring procedures.
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http://dx.doi.org/10.2165/00128071-200405010-00007DOI Listing
June 2004