As lip-augmentation procedures become more popular, validated measures of lip fullness become more necessary for quantifying outcomes.
With this in mind, a team of researchers led by Wm. Philip Werschler, M.D., associate clinical professor of medicine/dermatology at the University of Washington, set about developing a scale for rating lip fullness that would accurately assess clinically meaningful differences. What they developed was two: The initial Allergan Lip Fullness Scale (iLFS) and the revised Allergan Lip Fullness Scale (LFS), the latter of which was expanded to include photographs of lips as well as lips from various ethnicities.
Validating the Lip Fullness Scale
The iLFS, a four-point photographic scale with verbal descriptions, was validated by eight physicians rating 55 live subjects during two rounds conducted in a single day. The subjects did self-evaluations, as well. The team then developed and validated the revised LFS, a five-point scale with a broader range of lip presentations. It was validated by 21 clinicians in two online image-rating sessions during which they used the LFS to rate overall, upper- and lower-lip fullness in 144 three-dimensional images. Physician inter- and intra-rater agreement, subject intra-rater agreement (iLFS) and subject-physician agreement (iLFS) were evaluated. During the first online rating session, raters ranked 38 pairs of 3D before-and-after images as “clinically different” or “not clinically different.” The median LFS score difference for different pairs was calculated to determine the clinically meaningful difference.
According to Dr. Werschler, the iLFS was composed of Caucasian women, while the LFS included — at the request of the Food and Drug Administration — African-American, Hispanic and Asian women.
“The LFS is the only validated scale for lips that includes actual photographs of lips, rather than computer-morphed digital images, and also includes African-American females — a demographic group that no other scales include,” Dr. Werschler tells Cosmetic Surgery Times. “The LFS is a clinically useful, validated and expanded scale designed for assessing lip fullness across a wide variety of races and ethnicities and goes beyond those scales previously designed for clinical trials, or computer generated morphs. To date, the LFS is the only published scale that includes African-Americans with marked to very marked lip fullness.”
Dr. Werschler says no monies were paid for the preparation of the manuscript, though he did receive compensation for development of the LFS.
The study was published online March 24 in Aesthetic Surgery Journal.