The modified Fitzpatrick Wrinkle Scale: a clinical validated measurement tool for nasolabial wrinkle severity assessment.

BACKGROUND: The number of existing wrinkle assessment scales makes it difficult to compare the efficacy of cosmetic techniques in rejuvenating photoaged skin. A single and simple assessment scale that reliably quantifies wrinkle depth is needed. OBJECTIVE: The objective was to validate the Modified Fitzpatrick Wrinkle Scale (MFWS) as a nasolabial wrinkle severity assessment tool. METHODS AND MATERIALS: The MFWS comprises three main classes, in which definitions are based on a set of reference photographs and descriptions, and three interclasses, in which definitions are based only on descriptions. Assessors were trained to apply this scale to volunteers and study patients by using photographs of nasolabial wrinkles either alone or with descriptions. Inter- and intraassessment reliability coefficients were calculated using weighted kappa statistics. RESULTS: In patients, the combined intraassessor reliability from both sides of the face was 0.71 (95% confidence interval [CI], 0.68-0.74) when only photographs were used and 0.79 (95% CI, 0.76-0.82) when descriptions were added. Interassessor reliability for the photographs alone was 0.65 (95% CI, 0.62-0.68) and 0.74 (95% CI, 0.69-0.79) for photographs plus descriptions. CONCLUSIONS: The MFWS is a reliable method for quantitative assessment of nasolabial skin folds, with good inter- and intraassessor reliability. Including descriptions with the photographs increased reliability.

Non-surgical radiofrequency facelift.

There has been considerable interest in using non-ablative methods to rejuvenate the skin. The ThermaCool TC (Thermage Inc.) is a radiofrequency (RF) device that has been introduced to induce tightening of the address the problem of skin via a uniform volumetric heating into the deep dermis tightening, resulting in a 'non-surgical facelift'. Radiofrequency produces a uniform volumetric heating into the deep dermis. Twenty treatment areas in 17 patients were treated to evaluate the efficacy and safety of RF treatment to the brow and jowls. The technique was found to produce gradual tightening in most patients, and there were no adverse effects.

Nonablative skin resurfacing.

Nonablative skin resurfacing technologies produce a controlled thermal dermal wound while protecting the epidermis. Although sophisticated measuring techniques demonstrate that most nonablative technologies result in epidermal thickening, deepening of the rete ridges, and dermal neocollagenesis, improvements resulting from nonablative techniques are not as significant as those from ablative procedures.