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Cosmetic
A Classification of Facial Wrinkles
Gottfried Lemperle, M.D., Ph.D., Ralph E. Holmes, M.D., Steven R. Cohen, M.D., and
Stefan M. Lemperle, M.D.
San Diego, Calif.
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 developed as a simple tool for use by plastic
surgeons, dermatologists, and aesthetic surgeons who
want to assess the changes resulting from injecting filler
materials in their patients. By correlating the grade of the
wrinkle in the reference photographs with the wrinkle in
a patient’s face, a classification of 0 to 5 is assigned. Re-
liability of the scale was assessed by “live” 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 wrinkles were presented to eight observers who
rated 89.4 percent of all wrinkles equally. A significant
correlation of 87 percent was found between subjective
ratings and objective wrinkle depth measured by profilom-
etry on 40 silicone impressions. Manufacturers, monitors
of clinical trials, health authorities, and most important,
patients will benefit from objective data on current and
new injectable materials. (Plast. Reconstr. Surg. 108: 1735,
2001.)
The treatment of facial wrinkles, furrows,
and folds has become a major issue in many
offices of plastic surgeons, dermatologists, and
aesthetic surgeons. The judgment of its suc-
cess, however, still depends on the subjective
feelings of the physician and on the positive or
negative perceptions of the patient. Little has
been published on objective measurements of
wrinkles, furrows, and folds, and physicians are
overly dependent on the manufacturers’ infor-
mation and reliability.
New filler substances are developed every
year. Based purely on patient and physician
satisfaction, some manufacturers claim a last-
ing effect of their injectables
1
without objective
assessment before and after injection. Other
companies are convincing physicians and pa-
tients with preinjection and postinjection pho-
tographs without information on the time in-
terval between pictures.
1
Furthermore, there is
a difference in long-term quality and persis-
tence of a filler substance in animal experi-
ments and in humans: whether it is implanted
as a bulge under the skin of a rat’s forehead
2
or
injected intradermally into a dynamic facial
wrinkle. The onus is on all serious physicians to
objectively evaluate these products before they
become extensively implemented.
T
ERMINOLOGY
A discussion of wrinkles, furrows, and folds is
difficult because there is no commonly ac-
cepted classification or body of terminology
that is based on anatomic, dimensional, or eti-
ologic criteria. Words such as wrinkles, lines,
furrows, and folds are used with heavy reliance
on the intuitive grasp of such terms (Fig. 1).
Superficial wrinkles are associated with tex-
tural changes of the skin surface caused by
intrinsic aging and photoaging of topographi-
cally defined areas. The fine lines of wrinkling
may be discrete at first and then, over time,
become grouped and multidirectional as
noted by Stegman.
3
Apart from cutis rhomboi-
dalis caused by elastosis, they occur as wrin-
kling in the face or as regional static wrinkles
over the whole body. Wrinkle lines are usually
limited to superficial dermal creasing; thus,
they are amenable to treatments such as chem-
ical peeling, dermabrasion, and laser
resurfacing.
4–7
Mimetic wrinkles, commonly referred to as
lines (partial thickness) or furrows (full thick-
ness), are the visible effects of deep dermal
creasing caused by repeated facial movement
and expression combined with dermal elasto-
sis. They are therefore perpendicular to the
From the Division of Plastic Surgery, University of California, and FACESplus, Inc. Received for publication September 15, 2000; revised January
5, 2001.
1735
direction of the underlying facial muscles.
They occur with aging as forehead and glabel-
lar lines, nasolabial folds, radial lip lines, mar-
ionette lines, and lines in the corners of the
mouth.
Glabellar lines result from frequent frown-
ing, and periorbital lines and nasolabial folds
result from smiling. Radial lip and marionette
lines, however, are caused by concomitant
movement of mimetic muscles during chew-
ing. Therapeutically, mimetic wrinkles or fur-
rows do not respond well to resurfacing proce-
dures, but react preferentially to muscle
resection (musculus frontalis, musculus corru-
gator palpebrae), botulinum toxin, or inject-
able skin filler materials.
1,2,8–13
Folds are the result of overlapping skin
caused by genetic laxity, intrinsic aging, loss of
tone, bony atrophy, gravity, and consequent
sagging. They occur as upper and lower lid
folds in blepharoptosis, as nasolabial folds in
midface sagging, and as horizontal neck folds
in lax skin. The correction of folds requires
tightening procedures such as blepharoplasty,
face lift, or direct skin excision.
14
Augmenta-
tion of the bony skeleton by implants, bone
grafts, or skeletal osteotomies may also be nec-
essary to treat folds in properly selected cases.
Combinations of mimetic wrinkles and folds
are commonly present. For example, a sagging
nasolabial fold may be temporarily eliminated
by manual elevation, exposing a crease or fur-
row in its center.
C
LASSIFICATIONS
Fitzpatrick
7
proposed a classification of peri-
oral and periorbital wrinkling for use in estab-
lishing the effect of laser resurfacing of the
skin (Table I). Fitzpatrick’s classification was
F
IG
. 1. Textural changes of the facial skin: (above) wrin-
kling, (center) mimetic wrinkles, and (below) folds.
TABLE I
Fitzpatrick’s Classification of Facial Wrinkling (Perioral
and Periorbital)
Class Score Wrinkling Degree of Elastosis
I1–3 Fine wrinkles Mild (fine textural changes
with subtly accentuated skin
lines)
II 4–6 Fine to moderate
depth wrinkles,
moderate number
of lines
Moderate (distinct papular
elastosis, individual papules
with yellow translucency,
dyschromia)
III 7–9 Fine to deep
wrinkles,
numerous lines,
with or without
redundant skin
Severe (multipapular and
confluent elastosis,
thickened yellow and pallid
cutis rhomboidalis)
1736
PLASTIC AND RECONSTRUCTIVE SURGERY
,November 2001
directed toward generalized wrinkling and
elastosis rather than specific wrinkle depth.
Wrinkle depth analysis, which is not accounted
for by the Fitzpatrick scale, is a more important
measurement when considering wrinkle aug-
mentation with injectable fillers. Glogau
8
has
proposed a classification consisting of type I
(no wrinkles), type II (wrinkles in motion),
type III (wrinkles at rest), and type IV (only
wrinkles). These classifications are confined to
generalized wrinkles and do not address spe-
cific mimetic wrinkles or folds.
The only classification to include facial wrin-
kles, furrows, and folds was published by Ham-
ilton.
15
A choice of appropriate therapy results
simply from categorizing the patient’s prob-
lems with this comprehensive and easily under-
standable chart (Table II). However, this clas-
sification, oriented toward treatment selection,
provides no scale to objectively measure the
outcome of treatment.
M
EASUREMENTS
The first attempts to use quantitative meth-
ods have been described only recently
4–6
and
developed for the assessment of facial skin re-
juvenation after laser treatment of wrinkles.
Negative silicone rubber replicas of facial wrin-
kles were measured directly by use of a simple
light microscope, a technique confirmed by
electron microscopy.
6
Replicas have also been
converted into hard, positive epoxy resin im-
pressions.
16
A mechanical or optical profilome-
ter
17,18
was then used along with an image-
analyzing computer to measure wrinkle
depth.
19,20
These measurements were confined
to superficial wrinkles only, not facial furrows
or folds.
O
BJECTIVES
To develop a scale for the assessment of skin
fillers used in the treatment of facial mimetic
wrinkles or furrows, our goal was to determine
whether a photographically based classification
of mimetic wrinkles could be used reliably and
consistently by clinicians and to determine
whether this classification correlated with mea-
surement of wrinkle depth as determined by
profilometry on negative silicone replicas of
facial wrinkles.
A review of the literature
3,7,8,15
and current
practice revealed that there is not an appropri-
ate classification system for deep facial wrinkles
F
IG
. 2. Anatomic reference points for assessment and
measurement of wrinkle depth. If the deepest point of the
wrinkle is outside of this point, it can be marked or described
separately. HF, horizontal forehead lines; GF, glabellar frown
lines; PO, periorbital lines; PA, preauricular lines; CL, cheek
lines; NL, nasolabial folds; UL, upper radial lip lines; LL, lower
radial lip lines; CM, corner of the mouth lines; ML, mario-
nette lines; LM, labiomental crease; NF, horizontal neck folds.
TABLE II
Hamilton’s Classification of Contour Changes of Facial Skin
Facial
Aging
Clinical
Morphology Tissue Location Clinical Location Etiology Optimal Treatment
A Folds Muscular Nasolabial folds,
neck, eyelids
Loss of tone, gravity Rhytidectomy, blepharoplasty
B Furrows Musculocutaneous Forehead, smile lines Repeated facial expressions Filler substances, injectables, implants
C Wrinkles Cutaneous Cheeks, crow’s feet,
perioral
Intrinsic aging, photoaging Resurfacing, laser, chemical peel
D Combination Combined approach
Vol. 108, No. 6 /
CLASSIFICATION OF FACIAL WRINKLES
1737
and folds. Objective measurements, however,
are necessary to rate the effect of treatments
with injectable materials. In daily practice, a
simple look at a reliable reference scale would
enable clinicians to classify the deep mimetic
wrinkles and folds on a patient’s face.
M
ATERIALS AND
M
ETHODS
Wrinkle Assessment Scale
From hundreds of pictures taken from ran-
domized patients in the first author’s practice
(G. Lemperle), one reference photograph was
selected for each class (0 to 5) of facial wrinkles
from 11 different regions (Fig. 2). As a result,
reference picture sheets were created (Figs. 3
through 13) for use in validating the reliability
of photographic classification.
21
For this study,
four of the regions were selected: right-side
and left-side glabellar lines, right-side and left-
side radial upper lip lines, right-side and left-
side nasolabial folds, and right-side and left-
side marionette lines.
The photographs of the Wrinkle Assessment
Scale were used “live”in direct comparison
with the corresponding wrinkle or fold in the
F
IG
. 3. Wrinkle Assessment Scale of horizontal forehead lines.
1738
PLASTIC AND RECONSTRUCTIVE SURGERY
,November 2001
patient’s face or “indirectly”by comparing a
patient’s photograph with the pictures of the
scale. The assessment was always made at
the same location by use of anatomic land-
marks (Fig. 2). Horizontal forehead lines were
measured at their intersection with the vertical
pupillary line. Glabellar frown lines were mea-
sured at the level of the upper border of the
eyebrows. Periorbital lines were measured 1.5
cm lateral to the lateral canthus. Preauricular
lines were measured at the level of the lower
groove of the tragus. Nasolabial folds were
measured midway between the alar rim and
corner of the mouth (upper nasolabial) and at
the level of the corner of the mouth (lower
nasolabial). Cheek lines were also measured at
the level of the corner of the mouth. The
corner of the mouth lines were measured 5
mm below the commissure. Radial lip lines
were measured 2 mm above or below the ver-
milion border. Marionette lines were mea-
sured midway between the corner of the
mouth and the border of the lower jaw. The
labiomental crease and the neck folds were
measured in the midline.
In the case of multiple wrinkles as in an
upper lip, only the deepest wrinkle was as-
sessed and marked on the photograph or a
F
IG
. 4. Wrinkle Assessment Scale of glabellar frown lines.
Vol. 108, No. 6 /
CLASSIFICATION OF FACIAL WRINKLES
1739
chart for later reference. In cases of asymme-
try, the wrinkles of the right and left upper lip
were assessed separately. The depth of the
wrinkle at its reference point (Fig. 2) was con-
sidered and compared, not its length or over-
lapping skin fold. Some elderly patients have a
pronounced skin fold or redundancy of skin
rather than a wrinkle or crease in the dermis.
In such cases, only the wrinkle was classified. If
it was not evident whether to rate a wrinkle as
a class 3 or class 4, for example, it was rated as
a class 3.5. All ratings were noted on a special
classification sheet (Fig. 14).
Silicone Impressions
A Kerr gun with silicone double cartridges
and mixing tips (Kerr Extrude Wash No.
28418, Kerr Corp., Romulus, Mich.) was used
for making the impression molds. The double
cartridges containing blue silicone fluid and a
hardener were fixed to the gun, the mixing tip
was applied, and the silicone was mixed with
the hardener filled up to the tip. The patient’s
face was fixed in a horizontal position and all
makeup was removed from the wrinkles.
The low viscosity of the elastomer coupled
F
IG
. 5. Wrinkle Assessment Scale of periorbital lines.
1740
PLASTIC AND RECONSTRUCTIVE SURGERY
,November 2001
with its hydrophobic properties promotes its
penetration into all irregularities of the skin.
The crease was filled with blue silicone in its
full length with one stroke from the gun to
prevent air bubbles. A landmark of the face
such as inner eye brow, alar base of the nose, or
corner of the mouth was included in the im-
pression mold.
An ordinary tissue cassette for histologic
preparations or a perforated Aquaplast splint,
22
a2⫻1 inch section cut from a
1
⁄
16
-inch-thick
sheet (A 962-50, Smith and Nephew, German-
town, Wis.), was pressed gently into the still soft
silicone impression until half of its holes were
filled with blue silicone. The silicone polymer
hardens within 1 minute. Therefore, a new
mixing tip was used for each patient.
After 1 minute of polymerization, the im-
pression was removed together with the adher-
ent splint without touching the ridge of the
furrow. A transparent tape was pressed to the
back of the splint and the patient’s initials,
date, side, and wrinkle abbreviation (see Table
III) were recorded with a permanent marker. A
F
IG
. 6. Wrinkle Assessment Scale of preauricular lines.
Vol. 108, No. 6 /
CLASSIFICATION OF FACIAL WRINKLES
1741
black line was drawn to indicate the highest
point for profilometry, and this point was
also marked on the patient’s photographic
chart.
Wrinkle Metrology
Measurements of wrinkle impressions were
made using a stylus profiler (Surfanalyzer 5000
Surface Analysis System, Federal Products Co.,
Providence, R.I.). This instrument uses a dia-
mond ball-tipped stylus mounted to a linear
variable differential transducer with a counter-
balanced downward force of 200 mg. The sty-
lus/transducer assembly is mounted to a pre-
cision reference bar that is straight to within
25 nm over a traverse of 25 mm. The vertical
resolution of the transducer is 25 nm. Thus,
the sample surface being traversed by the
stylus is compared with the reference bar
surface. The peaks and valleys of the sample
surface are displayed as distance versus
height (Fig. 15).
On the drawing of the wrinkle’s profile on a
graph paper, the deepest points of the skin
F
IG
. 7. Wrinkle Assessment Scale of cheek folds.
1742
PLASTIC AND RECONSTRUCTIVE SURGERY
,November 2001
surface on both sides of the wrinkle were lo-
cated and connected, and the depth of the
wrinkle was measured perpendicular to this
line (Fig. 14).
R
ESULTS
Live Ratings
The first test of the Wrinkle Assessment Scale
was made by nine observers (three plastic sur-
geons, three aesthetic surgeons, and three der-
matologists) who were asked to judge the
depth of 76 mimetic wrinkles on the faces of 32
colleagues during a plastic surgery meeting in
Cyprus in 1999. Using the reference photo-
graphs depicting the Wrinkle Assessment Scale
(Figs. 4 and 8 through 10), 689 individual rat-
ings of wrinkle depth were made on the faces
of these 32 colleagues (Table IV).
Interobserver variation occurred in 50 of 689
wrinkles; 92.7 percent of the wrinkles got the
same ratings (Table IV). The variations in the
ratings of three plastic surgeons, three aes-
thetic surgeons, and three dermatologists
showed no significant differences: 6.5 percent,
F
IG
. 8. Wrinkle Assessment Scale of nasolabial folds.
Vol. 108, No. 6 /
CLASSIFICATION OF FACIAL WRINKLES
1743
6.9 percent, and 8.8 percent of the wrinkles
were rated differently from the majority of the
observers. A difference of two classes was rated
in only three of the 50 ratings in which observ-
ers differed.
Photographic Ratings
The next test of the wrinkle scale was per-
formed on 130 different mimetic wrinkles by
eight independent observers (four plastic sur-
geons, four lay persons). The wrinkles were
marked with an arrow at their deepest point.
With the aid of the photographic Wrinkle As-
sessment Scale (Figs. 4 and 8 through 10), the
eight observers were asked to score the depth
of each of the 130 wrinkles. There was an 89.4
percent agreement among the eight observers
in their classification of wrinkle depth using
the Wrinkle Assessment Scale (Table V).
Profilometry
To determine whether the Wrinkle Assess-
ment Scale correlates with the measurement of
wrinkle depth as determined by profilometry,
40 negative silicone impression replicas were
measured (Figs. 16 and 17) and compared with
F
IG
. 9. Wrinkle Assessment Scale of upper lip lines.
1744
PLASTIC AND RECONSTRUCTIVE SURGERY
,November 2001
the photographic ratings by the eight indepen-
dent observers (four plastic surgeons, four lay
persons) of the same wrinkles. There was an
87.0 percent agreement between the impres-
sion mold measurements and the observer rat-
ings with the use of the Wrinkle Assessment
Scale (Table VI).
By listing the average impression depth for
each wrinkle score, a proposed range of wrin-
kle depth was defined for each wrinkle score
(Table VII).
Statistical Analysis
The intraclass correlation,
24
which applies to
the case in which more than two wrinkle types
(eight in this instance) are correlated, was sig-
nificant with a p⬍0.001 in each case. The
magnitude of intraclass correlations ranged
above 0.80; the correlation is considered highly
significant when greater than 0.70 to 0.80.
D
ISCUSSION
The Wrinkle Assessment Scale was an easy,
consistent, and reliable tool for the assessment
of deep facial wrinkles. The scale correlated
well with an objective profilometry measure-
ment of the wrinkle depth.
The most accurate description of the photo-
graphed lines and creases in our wrinkle scale
F
IG
. 10. Wrinkle Assessment Scale of corner of the mouth lines.
Vol. 108, No. 6 /
CLASSIFICATION OF FACIAL WRINKLES
1745
is probably furrows, not folds or wrinkles. How-
ever, furrows is not a commonly used and un-
derstood term, hence our rationale behind the
selection of mimetic wrinkles to differentiate
these deeper wrinkles, furrows, or creases from
generalized elastosis or folds. The etiology of
mimetic wrinkles or furrows is rather simple
and does not differ from that of the wrinkles or
creases in the fabric of one’s gloves or shoes.
Smooth when new, the fabric develops grooves
at sites of long-sustained stress. There is no
chemical or architectural alteration, purely a
conformational change.
25
Wrinkles occur with
relaxation of the skin caused by receding pa-
pillae and degeneration of elastic and collagen
fibers at the dermal-epidermal junction. This
degeneration starts as early as age 30 and in-
creases with time, regardless of care and
protection.
The thickness of the living dermis can be
determined by either ultrasound
26,27
or xerora-
diographic technique. Skin thickness increases
linearly up to the age of 20 years and decreases
linearly with age subsequently. Depending on
race, genetics, and location of measurement,
the thickness of the dermis will vary. For exam-
F
IG
. 11. Wrinkle Assessment Scale of marionette lines.
1746
PLASTIC AND RECONSTRUCTIVE SURGERY
,November 2001
ple, dermal thickness in the medial forearm
varies from 0.6 to 1.0 mm in women and from
0.8 mm to 1.2 mm in men. In the lateral arms
or legs, Tan et al.
26
found a mean dermal thick-
ness of 1.32 mm, on the chest of 1.62 mm, and
on the back of 2.50 mm.
In the face, the dermal thickness increases
from lids (~ 0.2 mm), to corners of the mouth
(~0.4 mm), to nasolabial folds (~ 0.6 mm), to
forehead and glabellar dermis (~0.8 mm).
10
For comparison, a 30-gauge needle has an
outer diameter of 0.3 mm, and a 26-gauge
needle has a diameter of 0.45 mm.
The Wrinkle Assessment Scale is intended to
bring objective and comparable measurements
into the field of aesthetic medicine. Aside from
the standard of collagen injections, new injec-
tion or filler alternatives arrive on the market
every 6 months. Other resorbable filler mate-
rials such as hyaluronic acids (Restylane,
1
Hy-
laform
9
), autologous collagen (Autologen
12
),
allogeneic collagen matrix (Dermalogen,
12
F
IG
. 12. Wrinkle Assessment Scale of the labiomental crease.
Vol. 108, No. 6 /
CLASSIFICATION OF FACIAL WRINKLES
1747
AlloDerm
11
), dextran microspheres (Revi-
derm), polymethylacrylate particles (Der-
malive), and others have gained increased pop-
ularity. All claim to last longer than collagen,
but none have shown any statistically convinc-
ing proof. On the other hand, long-term per-
sistence of artificial products (Artecoll,
10
Soft-
form) may also cause problems after poor
placement and subsequent dislocation.
The Wrinkle Assessment Scale should be an
excellent tool in the hands of every aesthetic
surgeon or dermatologist to objectively assess
the short-term and long-term effects of an in-
jected product and to establish a real price-
value relationship for patients.
Gottfried Lemperle, M.D., Ph.D.
302 Prospect Street
La Jolla, Calif. 92037
glemperle@aol.com
A
CKNOWLEDGMENTS
We are indebted to Paul Clopton, M.S., Research Service,
VA Medical Center, San Diego, Calif., for his invaluable sta-
tistical work. Joe de Lellis, Senior Engineer at San Diego
Magnetics, San Diego, Calif., performed the measurements of
the impression molds.
F
IG
. 13. Wrinkle Assessment Scale of horizontal neck folds.
1748
PLASTIC AND RECONSTRUCTIVE SURGERY
,November 2001
F
IG
. 15. The Surfanalyzer provides a profile of each im-
pression mold. The depth is measured from a baseline con-
necting the adjacent skin surface.
F
IG
. 16. Silicone impressions of a glabellar fold before second
treatment and 6 weeks and 3 months after a second treatment.
10
F
IG
. 17. The depth of three impressions molds after three
treatments of the same glabellar fold measured by CEREC
computer imaging.
23
TABLE III
Classification of Facial Wrinkles
Facial Wrinkle Class Description
Horizontal forehead lines
Glabellar frown lines
Periorbital lines
Preauricular lines 0 No wrinkles
Cheek lines 1 Just perceptible wrinkle
Nasolabial folds 2 Shallow wrinkles
Radial upper lip lines 3 Moderately deep wrinkle
Radial lower lip lines 4 Deep wrinkle, well-defined edges
Corner of the mouth lines
}
5 Very deep wrinkle, redundant fold
Marionette lines
Labiomental crease
Horizontal neck folds
TABLE IV
Significance of the “Live”Study of 689 Ratings of 76
Wrinkles by Nine Observers
Wrinkles Different Ratings Percentage Significance
Glabellar frowns 11 out of 191 5.8 p⬍0.001
Nasolabial folds 14 out of 192 7.3 p⬍0.001
Radial lip lines 5 out of 114 4.4 p⬍0.001
Marionette lines 20 out of 192 10.4 p⬍0.001
TOTAL 50 out of 689 7.3 p⬍0.001
No lip lines grade 0 were excluded.
TABLE V
Intraclass Correlations in the Wrinkle Assessment Scale
According to the Ratings of Eight Observers of 130 Facial
Wrinkles on 80 Photographs*
Wrinkles nMean SD Intraclass Correlation
Glabellar frowns 20 2.872 1.538 0.828
Nasolabial folds 40 2.451 1.293 0.921
Radial lip lines 30 1.762 1.281 0.904
Marionette lines 40 2.098 1.211 0.923
TOTAL 130 2.250 1.342 0.894
* There is 89.4 percent agreement among the eight observers.
F
IG
. 14. Masked observer’s classification sheet of the four
most bothering lines.
Vol. 108, No. 6 /
CLASSIFICATION OF FACIAL WRINKLES
1749
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TABLE VII
Validation of the Wrinkle Scale in Comparison with the
Measurements from Silicone Impressions of Facial
Wrinkles
Wrinkle Score I
Mean Depth of
Impressions
(mm)
Proposed Margins
(mm)
Glabellar
folds
1 0.115 ⬍0.20
2 0.225 0.21–0.30
3 0.320 0.31–0.40
4 0.460 0.41–0.50
5 0.565 ⬎0.51
Nasolabial
folds
1 0.060 ⬍0.20
2 0.290 0.21–0.40
3 0.485 0.51–0.60
4 0.650 0.61–0.80
5 0.940 ⬎0.81
Marionette
lines
1 0.140 ⬍0.20
2 0.300 0.21–0.40
3 0.450 0.41–0.60
4 0.575 0.61–0.80
5 0.840 ⬎0.81
Radial lip
lines
1 0.100 ⬍0.10
2 0.150 0.11–0.20
3 0.295 0.21–0.30
4 0.350 0.31–0.40
5 0.415 ⬎0.41
TABLE VI
Intraclass Correlations between Wrinkle Measurement on
40 Impression Molds and Judgments from Photographs of
the Same Wrinkles
Molds nMean Ratings SD
Intraclass
Correlation
Glabellar frown 10 2.337 1.264 0.828
Nasolabial folds 10 2.637 1.314 0.872
Radial lip lines 10 2.097 1.278 0.884
Marionette lines 10 2.423 1.541 0.828
TOTAL 40 2.380 1.309 0.870
1750
PLASTIC AND RECONSTRUCTIVE SURGERY
,November 2001
