Background:
A growing body of literature aims to describe abdominal aesthetic goals in order to tailor surgical and non-surgical treatment options to meet patient goals. We aimed to integrate lay-person perceptions into the design of a novel professional aesthetic scale for the abdomen.
Methods:
An iterative process of expert consensus was used to choose 5 domains -1) abdominal muscle lines, 2) abdominal shape, 3) scar, 4) skin, and 5) umbilicus. A survey was developed to measure global and domain-specific aesthetic preferences on 5 abdomens. This was distributed through Amazon Mechanical Turk to 340 respondents. Principal component analysis was used to integrate survey data into weights for each of the scale's sub-questions. Attending plastic surgeons then rated abdomens using the final scale, and reliability and validity were calculated.
Results:
The final scale included eleven sub-questions - hourglass shape, bulges, hernia, infraumbilical skin, supraumbilical skin, umbilicus shape, umbilicus medialization position, umbilicus height position, semilunar lines, central midline depression, scar - within the 5 domains. Central midline depression held the highest weight (16.1%) when correlated to global aesthetic rating, followed by semilunar lines (15.8%) and infraumbilical skin (11.8%). The final scale demonstrated strong validity (Pearson r=0.99) and was rated as easy to use by 7 attending plastic surgeons.
Conclusion:
The final scale is the first published professional aesthetic scale for the abdomen that aims to integrate lay-person opinion. In addition, this analysis and survey data provide insights into the importance of eleven components in overall aesthetic appeal of the abdomen.