2.3. Grading of under‐eye wrinkles

For evaluation of under‐eye wrinkles, a modified photonumeric grading scale was developed (Figure 2), as there was no established wrinkle grading scale specific to the under‐eye area. Based on the numbers of fine, moderate, and deep wrinkles, the scale ranged from 0 to 4 (0: no wrinkles, 4: numerous distinct fine and moderate wrinkles with numerous deep wrinkles).

The grading scale of under‐eye wrinkles was developed for the evaluation of under‐eye wrinkles. Grade 1 (GR 1): a few distinct, fine wrinkles; Grade 1.5 (GR 1.5): a few distinct, fine wrinkles with one or two moderate wrinkles; Grade 2 (GR 2): numerous distinct, fine wrinkles with a deep wrinkle confined to the medial side; Grade 2.5 (GR 2.5): numerous distinct, fine wrinkles with a few moderate wrinkles; Grade 3 (GR 3): numerous distinct, fine wrinkles with a deep wrinkle on both medial and lateral sides and/or indistinct bag under eyes; Grade 3.5 (GR 3.5): numerous distinct, fine wrinkles with three or four deep wrinkles and/or distinct bags under eyes. Grade 0 (no wrinkles) and Grade 4 (numerous distinct, fine, and moderate wrinkles with numerous deep wrinkles) are not shown in the picture