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Published in: Aesthetic Plastic Surgery 5/2021

01-10-2021 | Face Rejuvenation | Original Article

Preauricular Aging: A Three-Point Grading System to Guide Treatment in Facial Rejuvenation

Authors: O. Friedman, O. Artzi, O. Haran

Published in: Aesthetic Plastic Surgery | Issue 5/2021

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Abstract

Background

Aging affects the face in all its dimensions. However, more has been published about the improvement of the periocular, midface, and perioral aging changes. We believe the profile view, particularly the preauricular area, is of great value when assessing the need for facial contouring procedures, as well as their effectiveness.

Objective

To develop and evaluate a classification based on the aging changes around the preauricular area, which aims to provide an objective direction to the appropriate treatment method.

Methods and Materials

All patients who attended the clinic for different aesthetic procedures between June 2019 and January 2020 were photographed. Two non-treating dermatologists and two non-treating plastic surgeons were asked to evaluate the perceived aging of the preauricular area using a three-point grading system. The assessment of each photograph was made once by each evaluator, and the inter-rater correlation was calculated.

Results

A total of 158 profile pictures of the preauricular area of 158 patients were evaluated by two non-treating dermatologists and two non-treating plastic surgeons. The inter-rater correlation was excellent at 0.942. The mean grading system of the patient samples was 1.42, with a standard deviation of 0.9 and a variance of 0.001.

Conclusions

The preauricular area is often overlooked and undertreated. Our results demonstrate an excellent inter-rater correlation between plastic surgeons and dermatologists at assessing the degree of aging in the area. This relatively hidden lateral area can serve as a test point, evaluating response to selected treatment before proceeding to full-face intervention. We suggest using a simple three-point scale to help guide treatment of the preauricular area and as part of our holistic approach to facial rejuvenation.

Level of Evidence IV

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.
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Metadata
Title
Preauricular Aging: A Three-Point Grading System to Guide Treatment in Facial Rejuvenation
Authors
O. Friedman
O. Artzi
O. Haran
Publication date
01-10-2021
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 5/2021
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-021-02255-x

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