How to Perform a Facial Evaluation for Cosmetic Rejuvenation

Paradigms in cosmetic surgery are changing. Cosmetic rejuvenation is no longer just filling a wrinkle. The approach to the patient must take into account all the factors that led the patient's skin to its present condition, the patient's medical and surgical history, as well as the physical and psychological state of the patient. A thorough consultation and evaluation of the patient are necessary, plus a frank discussion of the patient's own cosmetic concerns and goals. Such an evaluation and discussion lead to greater patient satisfaction with cosmetic surgery procedures.

Instructions

Seat the patient in a comfortable chair in a quiet, well-lit room, with the patient's feet resting comfortably on the floor.

Ask the patient about personal and family medical and surgical history, previous cosmetic procedures, present state of health, allergies and any prescribed or over-the-counter medications. Ask the patient about outcomes of and satisfaction or problems with previous cosmetic procedures.

Give the patient a hand-held mirror and ask her to tell you about her cosmetic concerns and goals.

Take note of the patient's general appearance, mood and behavior. Assess the patient's motivation for desiring a cosmetic procedure.

Ask about the patient's expectations of the outcome of cosmetic procedures. Evaluate how realistic and attainable her cosmetic goals are.

Assess the patient's skin and overall condition, noting sun damage, laxity, wrinkling and any precancerous or cancerous skin growths.

Ask the patient to make facial expressions, like raising her eyebrows, furrowing her brows, squeezing her eyes shut, smiling, frowning and turning down the lip corners to determine any asymmetry or weaknesses in musculature.

Explain clearly to the patient what can be realistically achieved with the procedures you offer. Explain about potential benefits, risks and side effects of such treatments. Explain what limitations the patient may have before and after the procedure, such as sun exposure and daily activities. Ask the patient what impact an adverse effect of a cosmetic procedure would have on her.

Decide if the patient is a suitable candidate for the cosmetic procedure, both physically and psychologically, then design a treatment plan and discuss it with the patient.

Take pre-procedure photographs in full frontal, 45 degree and profile views. For the full frontal view, take photographs with the patient's face fully relaxed and using the muscles of facial expression -- raising the brows, furrowing brows, squeezing eyes shut, wrinkling the nose, smiling and frowning. Ask the patient to make each facial expression with maximal muscle contraction (as strongly as she can).

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