title: Heterogeneity of crow's feet line patterns in clinical trial subjects.
abstract: BACKGROUND
  Patterns of crow's feet lines (CFLs) vary among individuals.
  
  
  OBJECTIVE
  To characterize distribution and predictors of CFL patterns.
  
  
  METHODS
  Patterns of CFLs (full fan, lower fan, central fan, and upper fan) were evaluated at maximum smile and at rest from photographs of subjects with moderate-to-severe CFLs. Relationships between CFL pattern and severity, age, gender, and subject-reported outcomes were explored.
  
  
  RESULTS
  Evaluations of 2,699 photographs from 1,392 subjects were conducted; 1,389 and 1,310 had evaluable CFL patterns at maximum smile and at rest, respectively. Lower-fan, central-fan, and full-fan patterns were identified in 28.4% to 34.7% at maximum smile and 27.7% to 33.9% at rest; upper fan was found in ∼5%. The pattern distribution of CFLs demonstrated a relationship to baseline CFL severity, age, and gender; full-fan and lower-fan patterns were more common in severe versus moderate CFL at maximum smile; full fan increased with age. Lower fan was more common in males. Subjects with full fan at maximum smile were most dissatisfied with their appearance and perceived themselves to look older versus other patterns.
  
  
  CONCLUSIONS
  Baseline CFL severity, age, and gender may predict fan pattern. Patterns may progress with age from central to lower fan or full fan. Pattern heterogeneity of CFLs suggests that tailored treatment may be warranted.
authors: *Manhattan Eye, Ear and Throat Hospital, New York, New York; †Department of Dermatology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina; ‡Division of Dermatology, University of California at Los Angeles, Los Angeles, California; §Allergan, Inc., Irvine, California.
authors: Michael A C
authors: MA
authors: Kane
authors: Sue Ellen
authors: SE
authors: Cox
authors: Derek
authors: D
authors: Jones
authors: Xiaofang
authors: X
authors: Lei
authors: Conor J
authors: CJ
authors: Gallagher
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000008:administration & dosage; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D003357:Cosmetic Techniques; D003430:Cross-Sectional Studies; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012649:Self Concept; D015595:Skin Aging / Q000187:drug effects*; D011795:Surveys and Questionnaires
chemical_list: D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A