Development and validation of the Chinese version of the Clinician-reported submental fat rating scale

Background: Excess submental fat (SMF) is a common facial aesthetic concern, and assessment scales play a crucial role in its evaluation. Existing SMF scales are based on Caucasian populations, although genetic background significantly influences SMF distribution. Therefore, this study aimed to develop and validate a 5-point Chinese version of the Clinician-Reported Submental Fat Rating Scale (CR-SMFRS). Methods: The study included 150 volunteers, and captured photographs from the frontal, oblique, and lateral views were combined for each participant. A 5-point scale with descriptive criteria was primarily designed. Internal validation involved three experienced plastic surgeons, while external validation was conducted on 50 live volunteers by six additional raters. Intra- and inter-rater reliability were assessed. Results: A 5-point grading system with descriptive criteria was developed and validated as the Chinese CR-SMFRS. Internal validation demonstrated a good intra- and inter-rater consistency. During external validation, intraclass correlation coefficient values for each rater exceeded 0.850, indicating high intra-rater consistency. Moreover, the inter-rater reliability showed good consistency. Conclusion: The Chinese version of the SMF rating scale is a reliable tool for clinical use.