Skip to main content

Advertisement

Log in

Evaluating the Cosmetic Patient: Understanding which Patients Benefit from Minimally Invasive Procedures versus Those that Require Surgery or Lifting Procedures

  • Cosmetic Dermatology (JF Sobanko, Section Editor)
  • Published:
Current Dermatology Reports Aims and scope Submit manuscript

Abstract

Cosmetic consultations are rising steadily, and the armamentarium available to the treating physician varies widely from minimally invasive procedures to invasive surgery. Due to the diverse age ranges and varied aesthetic presentations of patients, no single approach is possible or suited for everyone. When choosing a particular procedure, a number of factors are taken into consideration such as the age of the patient, expectations, degree and duration of the expected outcome, cost, and overall experience of the treating physician. In this article, the face and neck areas have been divided into three zones and the discussion focuses on the treatment options available, highlighting in particular the scenarios in which surgical intervention is recommended versus non-invasive or minimally invasive procedures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Montagna W, Carlisle K. Structural changes in aging skin. Br J Dermatol. 1990;122 Suppl 35:61–70.

    Article  PubMed  Google Scholar 

  2. Lapiere CM. The aging dermis: the main cause for the appearance of “old” skin. Br J Dermatol. 1990;122 Suppl 35:5–11.

    Article  PubMed  Google Scholar 

  3. Henderson JL, Larrabee Jr WF. Analysis of the upper face and selection of rejuvenation techniques. Otolaryngol Clin N Am. 2007;40(2):255–65.

    Article  Google Scholar 

  4. Langsdon P, Petersen D. Management of the aging forehead and brow. Facial Plast Surg. 2014;30(4):422–30.

    Article  CAS  PubMed  Google Scholar 

  5. Dorizas A, Krueger N, Sadick NS. Aesthetic uses of the botulinum toxin. Dermatol Clin. 2014;32(1):23–36.

    Article  CAS  PubMed  Google Scholar 

  6. Fedok FG. Advances in minimally invasive facial rejuvenation. Curr Opin Otolaryngol Head Neck Surg. 2008;16(4):359–68.

    Article  PubMed  Google Scholar 

  7. Miller PJ, Wang TD, Cook TA. Rejuvenation of the aging forehead and brow. Facial Plast Surg. 1996;12(2):147–55.

    Article  CAS  PubMed  Google Scholar 

  8. McKinney P, Mossie RD, Zukowski ML. Criteria for the forehead lift. Aesthet Plast Surg. 1991;15(2):141–7.

    Article  CAS  Google Scholar 

  9. Friedman O. Changes associated with the aging face. Facial Plast Surg Clin N Am. 2005;13(3):371–80.

    Article  Google Scholar 

  10. Frankel AS, Kamer FM. Chemical browlift. Arch Otolaryngol Head Neck Surg. 1998;124(3):321–3.

    Article  CAS  PubMed  Google Scholar 

  11. Scheinfeld N. The use of apraclonidine eyedrops to treat ptosis after the administration of botulinum toxin to the upper face. Dermatol Online J. 2005;11(1):9.

    PubMed  Google Scholar 

  12. Hwang K. Surgical anatomy of the upper eyelid relating to upper blepharoplasty or blepharoptosis surgery. Anat Cell Biol. 2013;46(2):93–100.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Moses JL. Blepharoplasty: cosmetic and functional. In: McCord CD, Tantenbaum M, Nunery W, editors. Oculoplastic surgery. 3rd ed. New York: Raven; 1995. p. 285–318.

    Google Scholar 

  14. Leclère FM, Alcolea J, Mordon S, et al. Long-term outcomes of laser assisted blepharoplasty for ptosis: about 104 procedures in 52 patients. J Cosmet Laser Ther. 2013;15(4):193–9.

    Article  PubMed  Google Scholar 

  15. Rohrich RJ, Pessa JE. The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. Plast Reconstr Surg. 2007;119(7):2219–27.

    Article  CAS  PubMed  Google Scholar 

  16. Wan D, Amirlak B, Rohrich R, Davis K. The clinical importance of the fat compartments in midfacial aging. Plast Reconstr Surg Glob Open. 2014;1(9):e92. Great explanation of the integration of relatively novel anatomic concepts into aesthetic practice. 

    Article  PubMed Central  PubMed  Google Scholar 

  17. Gierloff M, Stöhring C, Buder T, et al. Aging changes of the midfacial fat compartments: a computed tomographic study. Plast Reconstr Surg. 2012;129(1):263–73.

    Article  CAS  PubMed  Google Scholar 

  18. Alghoul M, Codner MA. Retaining ligaments of the face: review of anatomy and clinical applications. Aesthet Surg J. 2013;33(6):769–82. Comprehensive review of the current understanding of the facial retaining ligaments and their relationship to the facial fat pads.

    Article  PubMed  Google Scholar 

  19. Jones D. Volumizing the face with soft tissue fillers. Clin Plast Surg. 2011;38:379–90. A systematic explanation and approach to volumizing the face with injectable fillers.

    Article  PubMed  Google Scholar 

  20. Pontius AT, Chaiet SR, Williams 3rd EF. Midface injectable fillers: have they replaced midface surgery? Facial Plast Surg Clin N Am. 2013;21(2):229–39. A good article approaching rejuvenation of the midface with both non-surgical and surgical techniques.

    Article  Google Scholar 

  21. Sebaratnam DF, Lim AC, Lowe PM, et al. Lasers and laser-like devices: part two. Australas J Dermatol. 2014;55(1):1–14.

    Article  PubMed  Google Scholar 

  22. De Menezes M, Rosati R, Baga I, et al. Three-dimensional analysis of labial morphology: effect of sex and age. Int J Oral Maxillofac Surg. 2011;40(8):856–61.

    Article  PubMed  Google Scholar 

  23. Narasimhan K, Stuzin JM, Rohrich RJ. Five-step neck lift: integrating anatomy with clinical practice to optimize results. Plast Reconstr Surg. 2013;132(2):339–50.

    Article  CAS  PubMed  Google Scholar 

  24. Frodel JL. Evaluation and treatment of deformities of the chin. Facial Plast Surg Clin N Am. 2005;13(1):73–84.

    Article  Google Scholar 

  25. Wise JB, Greco T. Injectable treatments for the aging face. Facial Plast Surg. 2006;22(2):140–6.

    Article  CAS  PubMed  Google Scholar 

  26. Hyun MY, Li K, Kim BJ, et al. Novel treatment of neck wrinkles with an intradermal radiofrequency device. Ann Dermatol. 2015;27(1):79–81.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Firas Al-Niaimi declares that he has no conflict of interest.

Jason D. Bloom has received compensation from Pharmaceutical Project Solutions, Inc., Merz Aesthetics, and Galderma for service as a consultant; has received honoraria from Merz Aesthetics and Galderma for service as a trainer; and has received payment for service on speakers’ bureaus from Merz Aesthetics, Galderma, Solta Medical, Inc., ThermiAesthetics, and Zeltiq Aesthetics, Inc.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jason D. Bloom.

Additional information

Al-Niaimi is a Consultant in Dermatologic Surgery and Lasers, Sk;n Clinics London, and holds a MSc, MRCP and EBDV.

Bloom is Director of Facial Plastic & Reconstructive Surgery, Main Line Center for Laser Surgery and holds a MD.

This article is part of the Topical Collection on Cosmetic Dermatology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Al-Niaimi, F., Bloom, J.D. Evaluating the Cosmetic Patient: Understanding which Patients Benefit from Minimally Invasive Procedures versus Those that Require Surgery or Lifting Procedures. Curr Derm Rep 4, 49–55 (2015). https://doi.org/10.1007/s13671-015-0101-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13671-015-0101-x

Keywords

Navigation