Facial assessments: identifying the suitable pathway to facial rejuvenation.
OBJECTIVE
There are now numerous ways in which a patient can rejuvenate their facial appearance, including various types of expensive, invasive, surgical procedures, and an ever increasing gamut of products that can be inserted or injected beneath the skin to restore a youthful look to the face. The importance of facial assessments in identifying the most suitable treatment option is discussed here.


RESULTS
Before a patient commits to any one of these corrective options, it is the responsibility of the physician to conduct a thorough assessment of the patient's face. All of the facial characteristics should be examined closely: underlying bone and musculature, shape, proportion, and features including folds, wrinkles, fine lines, volume deficits and changes in pigmentation. The degree of ptosis in the facial tissues should be assessed by light palpation. Following assessment of the face, digital photographs should be taken of the patient's full face and profile, allowing the physician to indicate areas, on a visual display, that need correction and there are now computer programs which can 'morph' the features of a facial photograph, providing an approximation of the post-treatment result. Shape and proportion are neglected facets in the assessment of the face prior to corrective treatment. A treatment or technique which rejuvenates a 'thin' face may not work so successfully on a 'round' face and vice versa. Most importantly, the physician should aim to understand the patient's objective and subjective perceptions of their face and ascertain the results that are desired by the patient before evaluating what can be achieved. Appropriate corrective options can then be discussed in detail, highlighting the risks, side effects, costs, invasiveness, logistics and anticipated outcomes of each.


CONCLUSIONS
A comprehensive assessment of the patient's face allows the physician to formulate a regimen of treatments that will reach or exceed the expectations of the patient.
Weinkle
S
S
Mohs Surgery/Skin Cancer, University of Florida, Tampa, USA. sweinkle@aol.com
D003357:Cosmetic Techniques; D005145:Face; D006801:Humans; D008060:Lipodystrophy / Q000628:therapy; D015595:Skin Aging; D012880:Skin Pigmentation