Development and Validation of a Photonumeric Scale for Evaluation of Transverse Neck Lines

Abstract

BACKGROUNDA validated scale is needed for objective and reproducible comparisons of horizontal neck lines before and after treatment in practice and clinical studies.OBJECTIVETo describe the development and validation of the 5-point photonumeric Allergan Transverse Neck Lines Scale.METHODSThe Allergan Transverse Neck Lines Scale was developed to include an assessment guide, verbal descriptors, morphed images, and real subject images for each scale grade. The clinical significance of a 1-point score difference was evaluated in a review of multiple image pairs representing varying differences in severity. Interrater and intrarater reliability was evaluated in a live-subject rating validation study (N = 297) completed during 2 sessions occurring 3 weeks apart.RESULTSA difference of ≥1 point on the scale was shown to reflect a clinically significant difference (mean [95% confidence interval] absolute score difference, 1.22 [1.09–1.35] for clinically different image pairs and 0.57 [0.42–0.72] for not clinically different pairs). Intrarater agreement between the 2 live-subject rating validation sessions was substantial (mean weighted kappa = 0.78). Interrater agreement was substantial during the second rating session (0.73, primary end point).CONCLUSIONThe Allergan Transverse Neck Lines Scale is a validated and reliable scale for rating of severity of neck lines.

Microfocused ultrasound in combination with diluted calcium hydroxylapatite for improving skin laxity and the appearance of lines in the neck and décolletage

“…Recent research has shown slightly greater esthetic improvements when patients are treated in this manner in the neck area . Results were very consistent between the independent evaluators and observed with three different validated grading scales (one for necklines and two for the décolletage), illustrating the robustness of the treatment results. The Merz Aesthetics scale offers a further advantage relative to other scales by providing a dynamic assessment (ie while contracting the breast area by pulling the arms together toward the medial line) in addition to a static assessment.…”

“…At the first visit and before the treatment, subjects underwent a pretreatment evaluation by the investigator. Three scales were used to assess skin laxity and wrinkling in the neck and décolletage area at baseline: the Merz Aesthetics Décolleté wrinkles at rest scale, the Fabi‐Bolton chest wrinkle scale, and the Allergan transverse neck lines scale . The Merz and Fabi‐Bolton scales are both validated five‐point scales for the décolletage area.…”

“…The Fabi‐Bolton scale considers wrinkles at rest only and uses grades from 1 to 5, whereas the Merz scale considers both dynamic and at rest wrinkles as well as pigmentation changes and uses grades from 0 to 4 . The Allergan scale is validated to assess horizontal necklines with grading ranging from 0 to 4 …”

“…Three scales were used to assess skin laxity and wrinkling in the neck and d ecolletage area at baseline: the Merz Aesthetics D ecollet e wrinkles at rest scale, 10 the Fabi-Bolton chest wrinkle scale, 11 and the Allergan transverse neck lines scale. 12 The Merz and Fabi-Bolton scales are both validated five-point scales for the d ecolletage area. The Fabi-Bolton scale considers wrinkles at rest only and uses grades from 1 to 5, 11 whereas the Merz scale considers both dynamic and at rest wrinkles as well as pigmentation changes and uses grades from 0 to 4.…”

Treatment of Horizontal Neck Wrinkles with Hyaluronic Acid Filler: A Retrospective Case Series

“…4–6 But horizontal neck wrinkles are not entirely caused by aging, as they are often observed in children and young adults. 7,8 Importantly, age-related skin laxity can worsen these wrinkles. 1,2,7 Frequent bending of the neck to look at cell phones, tablets, or books could also cause wrinkle development in the young.…”