title: A validated brow positioning grading scale.
abstract: BACKGROUND
  One of the first areas to show facial aging is the periorbital region, where brow malposition contributes to the overall appearance of aging. Movement and positioning of the brows are also sex specific. Men may desire a low brow, whereas women may prefer high, arched brows.
  
  
  OBJECTIVE
  To develop the Brow Positioning Grading Scale for objective quantification of eyebrow position and to establish the reliability of this photonumeric scale for clinical research and practice.
  
  
  METHODS
  A 5-point photonumeric rating scale was developed to objectively quantify positioning of eyebrows at rest. Nine experts rated photographs of 35 subjects twice with regard to positioning of the eyebrow in comparison with morphed images. Inter- and intrarater variability was assessed by computing intraclass correlation coefficients.
  
  
  RESULTS
  Bubble plots (bivariate scatter plots) demonstrated linearity in judgment by the experts. The test-retest correlation coefficients were acceptable for each expert.
  
  
  CONCLUSIONS
  The 5-point photonumeric scale generated spans the positioning of the eyebrow for which patients commonly seek correction. The scale is well stratified for consistent rating.
authors.affiliation: Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada. alastair@carruthers.net
authors.forename: Alastair
authors.initials: A
authors.lastname: Carruthers
authors.forename: Jean
authors.initials: J
authors.lastname: Carruthers
authors.forename: Bhushan
authors.initials: B
authors.lastname: Hardas
authors.forename: Mandeep
authors.initials: M
authors.lastname: Kaur
authors.forename: Roman
authors.initials: R
authors.lastname: Goertelmeyer
authors.forename: Derek
authors.initials: D
authors.lastname: Jones
authors.forename: Berthold
authors.initials: B
authors.lastname: Rzany
authors.forename: Joel
authors.initials: J
authors.lastname: Cohen
authors.forename: Martina
authors.initials: M
authors.lastname: Kerscher
authors.forename: Timothy Corcoran
authors.initials: TC
authors.lastname: Flynn
authors.forename: Corey
authors.initials: C
authors.lastname: Maas
authors.forename: Gerhard
authors.initials: G
authors.lastname: Sattler
authors.forename: Alexander
authors.initials: A
authors.lastname: Gebauer
authors.forename: Rainer
authors.initials: R
authors.lastname: Pooth
authors.forename: Kathleen
authors.initials: K
authors.lastname: McClure
authors.forename: Ulli
authors.initials: U
authors.lastname: Simone-Korbel
authors.forename: Larry
authors.initials: L
authors.lastname: Buchner
mesh_terms: D004954:Esthetics / Q000145:classification*; D005138:Eyebrows / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D008297:Male; D015233:Models, Statistical; D015203:Reproducibility of Results; D015361:Rhytidoplasty / Q000379:methods*; D015595:Skin Aging / Q000502:physiology*; D016896:Treatment Outcome