Lemperle scale: severity of nasolabial folds
Quick facts
- Definition
- A visual scale of nasolabial fold severity, in grades from 0 to 5.
- Use
- Record the starting state and compare progress over time.
- Grades
- 0 no fold; 1 barely perceptible; 2 shallow; 3 moderately deep; 4 deep; 5 very deep.
- Area
- Nasolabial fold (smile lines).
- Limitation
- Subjective assessment that depends on standardized photos and lighting.
The Lemperle scale is a visual classification that describes the severity of the nasolabial folds, the creases that run from the side of the nose to the mouth. It assigns grades from 0 to 5, from a face with no fold to a very deep fold. It was designed to give a common language to those who assess and follow the nasolabial fold (smile lines).
What are the grades like?
| Grade | Description |
|---|---|
| 0 | No visible fold |
| 1 | Barely perceptible fold |
| 2 | Shallow fold |
| 3 | Moderately deep fold |
| 4 | Deep fold with a well-defined edge |
| 5 | Very deep, wide fold with a redundant crease |
The descriptors vary slightly between publications; what matters is always using the same version in the clinic.
How do you use it in routine practice?
The scale is useful for tracking progress, for talking to the patient about severity and for standardizing internal reports. It does not define management: folds of the same grade can have different causes, such as volume loss in the midface, tissue ptosis or a static wrinkle from photoaging.
What are the limits?
The scale is subjective. The reading changes with lighting, angle and expression, and two assessors can differ by a grade. It also does not measure skin quality or bone support, which weigh in the decision. For the skin, there are other classifications, such as the Glogau scale.
For the practice of the procedure at an overview level, see nasolabial fold filler.
In Harmy
The Nasolabial Fold point lets you mark the ml and intensity of the area and see the projection. The projection is illustrative and does not equal a grade on the scale.
Also called: Lemperle Wrinkle Severity Scale.
Frequently asked questions
What is the Lemperle scale used for?
It gives a common language to the severity of the nasolabial fold and lets you record the before and after with the same criteria, both in the clinic and in research.
Does the scale tell you how much product to inject?
No. It only rates the severity of the fold. Volume and technique depend on a full assessment, at the discretion of the qualified professional.