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The Rainbow Scale for the Assessment of dermatochalasis of the female upper eyelid: A validated scale.

  • Author Footnotes
    # These authors contributed equally to this work.
    J.J. Mooij
    Footnotes
    # These authors contributed equally to this work.
    Affiliations
    Medical faculty, Erasmus University Medical Center, Rotterdam, the Netherlands
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  • Author Footnotes
    # These authors contributed equally to this work.
    L.S. van de Lande
    Footnotes
    # These authors contributed equally to this work.
    Affiliations
    Craniofacial Unit Great Ormond Street Hospital for Children and UCL Great Ormond Street Institute of Child Health, London, UK
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  • S.M.W. Pool
    Affiliations
    Department of Plastic Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
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  • H.P.J.D. Stevens
    Affiliations
    Department of Plastic Surgery, Velthuis Clinic, Rotterdam, the Netherlands
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  • B. van der Lei
    Affiliations
    Department of Plastic Surgery, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands
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  • J.A. van Dongen
    Correspondence
    Corresponding author. Dr J.A. van Dongen, MD, PhD, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht. Phone: +31619594029
    Affiliations
    Department of Plastic Surgery, University Medical Center Utrecht, Utrecht, the Netherlands

    Department of Plastic Surgery, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands
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  • Author Footnotes
    # These authors contributed equally to this work.
Published:November 21, 2022DOI:https://doi.org/10.1016/j.bjps.2022.11.004

      Abstract

      Background

      Degeneration of the connective tissue of the upper eyelids results in dermatochalasis, which can be treated by upper eyelid blepharoplasty. Many guidelines for the fabrication of photographic evaluation material exist, a homogeneous weighted-validated photographic scale to assess and grade these photographs however does not exist yet.

      Objectives

      The aim of this study was to construct and validate a photographic scale for the assessment of the degree of female upper eyelid dermatochalasis.

      Methods

      A 5-point scale was fabricated using Adobe Photoshop and validated using an online survey distributed three times amongst a panel of seven plastic surgeons. The photographs of 16 female subjects were included for validation. Intra- and inter- observers agreement were calculated using the weighted Kappa coefficient.

      Results

      Each panelist completed the survey three times. Mean intra-observer agreement was 0.89 (0.75–1.00). Mean inter-observer agreement was 0.85 (0.71-0.96) for survey 1, 0.80 (0.58-0.96) for survey 2 and 0.91 (0.81-0.96) for survey 3.

      Conclusion

      The Rainbow Scale for the assessment of dermatochalasis of the female upper eyelid has been validated with a high level of intra- and inter-observer agreements in an online fashion. It allows for improving communication between surgeon and patient as well as quick scientifically sound evaluation of the aesthetic impact of blepharoplasty.

      Keywords

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