Abstract
BACKGROUND: Anatomical differences in facial aging and aesthetic needs of Asian and Caucasian individuals have led to disparate clinical rejuvenation strategies using filler augmentation for midface volume deficits. Therefore, the Asian Midface Volume Deficit Severity Scale (AMVDSS) by LBTD (Lanzhou Biotechnique Development Co, Ltd) was developed to objectively assess midface volume deficits and clinical outcomes of Asian individuals. METHODS: Four observers independently rated randomized photographs (front, left and right 45°, left and right 90°) of 65 patients during two sessions with a 2-week interval using the AMVDSS. RESULTS: All participants were Asian (18 male and 47 female participants; mean age, 40.9 years; range, 20-76 years). Interobserver agreement was substantial to almost perfect for the left (weighted κ, 0.778-0.907) and right (weighted κ, 0.774-0.938) during the first session; it was almost perfect for the left (weighted κ, 0.844-0.907) and right (weighted κ, 0.805-0.876) during the second session. Interobserver agreement was 76.9% to 90.8% and 76.9% to 93.9% for the left and right, respectively, during the first session; it was 84.6% to 90.8% and 81.5% to 87.7% for the left and right, respectively, during the second session. Intraobserver agreement was "almost perfect" for both the left (weighted κ, 0.950; 95% confidence interval [CI] 0.923-0.977) and right (weighted κ, 0.954; 95% CI 0.928-0.980). Exact intraobserver agreement was 95.0% (range, 90.8-100.0%) for the left; it was 95.4% (range, 94.9-96.9%) for the right. CONCLUSIONS: The AMVDSS by LBTD could be used to reliably assess midface volume deficits or volume changes after dermal filler injections. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.