title: Creation and Validation of a Photonumeric Scale to Assess Volume Deficiency in the Infraorbital Region.
abstract: BACKGROUND
  The eyes are particularly important aesthetic features of the face and revitalization of the infraorbital region has become a focus of aesthetic treatments. Published infraorbital scales to date have limitations in that they have been descriptive, subjective, or have used computer-generated images. Thus, there is an unmet need for a validated scale based on actual images.
  
  
  OBJECTIVE
  To develop a practical photonumeric scale that respects the complex anatomy and age-related changes occurring in the orbital area.
  
  
  METHODS
  The Allergan Infra-oRbital Scale (AIRS) was developed through a multistep process in collaboration with 16 physicians (plastic surgeons, dermatologists, and aesthetic physicians). Scale development involved both online photographs and live assessments of subjects. Interrater and intrarater reliability was assessed using intraclass correlation coefficients (ICCs).
  
  
  RESULTS
  The final AIRS showed intrarater and interrater ICCs of 0.78 to 0.86 and 0.91 to 0.98 for live validation and 0.76 to 0.82 and 0.86 to 0.91 for online validation, respectively, demonstrating robust validity.
  
  
  CONCLUSIONS
  The AIRS can be considered a photonumeric scale that accurately describes volume loss in the infraorbital region. It has been validated and is appropriate for use in research or for everyday clinical use for both live and photographic assessment.
authors.affiliation: *Centre Chirurgical Niforos, Lyon, France; †Shape Clinic, Sydney, Australia; ‡The Gatehouse, Cheshire, United Kingdom; §Skin Concept, Munich, Germany; ‖La Jouvence, Neuchâtel, Switzerland; ¶Private Practice, Milano, Italy; #Division of Dermatology, University of California at Los Angeles, Los Angeles, California; **Collins Therapeutic Consulting Ltd, Gloucestershire, United Kingdom; ††Surrey, United Kingdom; ‡‡Allergan plc, Marlow, United Kingdom.
authors.forename: François
authors.initials: F
authors.lastname: Niforos
authors.forename: Steven
authors.initials: S
authors.lastname: Liew
authors.forename: Raj
authors.initials: R
authors.lastname: Acquilla
authors.forename: Patricia
authors.initials: P
authors.lastname: Ogilvie
authors.forename: Marva
authors.initials: M
authors.lastname: Safa
authors.forename: Massimo
authors.initials: M
authors.lastname: Signorini
authors.forename: Derek
authors.initials: D
authors.lastname: Jones
authors.forename: Jan
authors.initials: J
authors.lastname: Hawthorn
authors.forename: Caroline
authors.initials: C
authors.lastname: Collins
authors.forename: Graeme
authors.initials: G
authors.lastname: Kerson
authors.forename: Myooran
authors.initials: M
authors.lastname: Sithamparanathan
mesh_terms: D000328:Adult; D000368:Aged; D002610:Cheek / Q000033:anatomy & histology; D004954:Esthetics; D005143:Eyelids / Q000033:anatomy & histology; D005145:Face / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010781:Photography; D015203:Reproducibility of Results; D015595:Skin Aging / Q000473:pathology*