Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Part 2 Surgical Procedures and their Complications
- Section 17 General Surgery
- Section 18 Cardiothoracic Surgery
- Section 19 Vascular Surgery
- Section 20 Plastic and Reconstructive Surgery
- Chapter 90 Breast reconstruction after mastectomy
- Chapter 91 Facial rejuvenation
- Chapter 92 Liposuction
- Chapter 93 Facial fractures
- Chapter 94 Flap coverage for pressure ulcers
- Chapter 95 Muscle flap coverage of sternal wound infections
- Chapter 96 Skin grafting for burns
- Section 21 Gynecologic Surgery
- Section 22 Neurologic Surgery
- Section 23 Ophthalmic Surgery
- Section 24 Orthopedic Surgery
- Section 25 Otolaryngologic Surgery
- Section 26 Urologic Surgery
- Index
- References
Chapter 91 - Facial rejuvenation
from Section 20 - Plastic and Reconstructive Surgery
Published online by Cambridge University Press: 05 September 2013
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Part 2 Surgical Procedures and their Complications
- Section 17 General Surgery
- Section 18 Cardiothoracic Surgery
- Section 19 Vascular Surgery
- Section 20 Plastic and Reconstructive Surgery
- Chapter 90 Breast reconstruction after mastectomy
- Chapter 91 Facial rejuvenation
- Chapter 92 Liposuction
- Chapter 93 Facial fractures
- Chapter 94 Flap coverage for pressure ulcers
- Chapter 95 Muscle flap coverage of sternal wound infections
- Chapter 96 Skin grafting for burns
- Section 21 Gynecologic Surgery
- Section 22 Neurologic Surgery
- Section 23 Ophthalmic Surgery
- Section 24 Orthopedic Surgery
- Section 25 Otolaryngologic Surgery
- Section 26 Urologic Surgery
- Index
- References
Summary
Facial rejuvenation is a broad term that relates to restoring facial structures to a more youthful appearance. Generally, facial rejuvenation is categorized as non-operative or operative.
A thorough preoperative assessment and understanding of patient desires are important in order to optimize outcomes and to create realistic expectations of various treatment modalities. As with any initial patient encounter, a comprehensive history and physical should be performed. Since facial rejuvenation is performed electively, patients with significant comorbidities such as smoking, diabetes, and clinically significant bleeding states should be excluded in most circumstances. A basic psychological assessment that evaluates a patient's motivations for surgery should also be obtained. Adequate time should be allowed for questions and decision making focusing on the patient's specific concerns. Some plastic surgeons also incorporate the use of photographic software that can simulate the effect of specific procedures.
Skin quality is often the first characteristic that is noted on consultation. The general quality of the skin, including elasticity, wrinkles, and actinic damage is assessed.
It is beneficial to divide the face into thirds when examining a patient so as to systematically evaluate the entire face. In the upper third, or the periorbital zone, the forehead, brow, eyelids, and upper midface are evaluated. A complete investigation must include brow position, forehead height, glabellar creases, excess skin or wrinkles (crow’s feet) in the temporal region and in the upper and lower eyelids, and evaluation of the lateral canthal position and lower lid tone. The middle third , or perioral zone, is generally referred to as the lower face; an examination includes the nasolabial folds, the angle of the mouth, the upper and lower lips, chin, nose, and ears. Evaluation of the lower third of the face, the neck zone, includes an assessment of the neck with regard to platysmal banding, excess skin, as well as the jawline, submandibular gland, and digastric muscles.
- Type
- Chapter
- Information
- Medical Management of the Surgical PatientA Textbook of Perioperative Medicine, pp. 636 - 638Publisher: Cambridge University PressPrint publication year: 2013