Diagnosis reports AIPE

The AIPE (Aesthetic damage impact/impairment assessment) method was developed by Dr. Juan Antonio Cobo Plana (Forensic Medicine Specialist, director of Aragón Forensic Medicine Institute, in Spain). This novel analytical method allows an objective analysis, even though there is a subjective component associated with the damage evaluation. It consists in straight/direct questions about aesthetic damage perception. The answers are based on the lesion visibility (or not) and if it may cause personal or professional repercussion/impairment.

Initially, the professional identifies the lesion visibility and its repercussion on social, affective or professional levels. Scores are numeric and follow a linear logic: 1 – it is not possible to visualize the lesion; 2 – the professional observes a very discreet lesion (however, he/she may not be able to describe it properly); 3 – the professional clearly observes a lesion (and it may have variable degrees of repercussion).

On a daily basis, these situations may be translated into: the professional does not observe the lesion (in this situation, the lesion is classified as “non relevant”, meaning there is no damage); the professional hardly observes the lesion (a slight degree damage); or the professional clearly observes the lesion (in this situation, the damage may be classified into moderate, medium, important, very important and truly important).

At score 3, the defect visual impact may be: moderate (a tendency to gaze at the lesion, however not being able to describe it), medium (the professional is able to describe the lesion, even though it is not emotionally appealing to him/her), important (the lesion is emotionally appealing but it does not alter interpersonal relationship between the professional and the lesioned person), very important (the lesion leads to an intense emotion and may alter interpersonal relationship between the professional and the lesioned person), truly important (the lesion leads to an intense emotion and deeply alters interpersonal relationship between the professional and the lesioned person).

Following this analysis, the professional may assess, for each aesthetic damage category, an impact damage level: poor, slight, moderate, severe and very intense.

Based on the final score provided by the software, Cobo Plana (2010) divided the categories into: a) non-relevant lesion, zero point; b) slight lesion, between 1 and 6 points; c) moderate lesion, between 7 and 12 points; d) medium lesion, between 13 and 18 points; e) important lesion, between 19 and 24 points; f) very important lesion, between 25 and 30 points; and g) truly important lesion, between 31 and 50 points. In Europe (Portugal and Spain), the final score is transformed into indemnity reparation/restitution for the impaired individual.

It is important to understand that aesthetic damage evaluation may be performed after the lesion final aspect is achieved, when the self-reparation process is completed and it is no longer possible to improve the aesthetic condition by means of a plastic surgery procedure. Age, gender and occupation may not interfere in the assessment.

References: research articles corroborating the AIPE method.

Bouchardet FCH, Cobo Plana JA. Utilización del método “AIPE” em la valoración del perjuicio estético y su aplicación em la legislación Brasileña civil e penal. Revista Portuguesa do Dano Corporal 2011; 22:167-181. Bouchardet FCH, Criado del Río MT. Propuesta de una Guía para la Valoración Médico-Legal de la Alteración Estética: Daño Estético/Deformidad. Revista Portuguesa do Dano Corporal 2010; 21:119-130. Cobo Plana JA. La valoración del daños a la personas por accidentes de tráfico. Barcelona: Bosch 2010; 5:635-706. Fernandes MM, Cobo Plana JA, Bouchardet FCH, Crosato EM, Oliveira RN. Validação de instrumento para análise do dano estético no Brasil. Saúde em Debate. Rio de Janeiro. V.40, N.108, p. 118-130, jan-mar 2016. Rouge D, Blanc A, Telmon N, Ster F, Gavroy JP, Costagliola M. Evaluation du dommage esthétique de la face: la method des distances. Rev Fr Dommage Corpor.1996;22(4):363-74.