from Section 20 - Plastic and Reconstructive Surgery
Published online by Cambridge University Press: 05 September 2013
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.
To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Find out more about the Kindle Personal Document Service.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.