ABSTRACT
Even in our youth-obsessed culture, cosmetic surgery is always elective. Facial rejuvenation may improve a patient’s quality of life, but there is no such thing as a life-saving facelift. So it is important that anyone considering facial rejuvenation (or any other cosmetic procedure, for that matter) undergo a complete
medical evaluation that includes a thorough medical history and physical examination. This evaluation should focus on the patient’s cardiopulmonary health to determine whether they are fit enough to undergo an extended operation under anesthesia. The type of anesthesia will vary according to the scope of the procedure (see the section, “Anesthesia”), and the length of the surgery will depend upon the type of procedure (or procedures, if the patient elects to combine multiple cosmetic procedures into a single operation) and the skill of the surgeon. Some of the “better” plastic surgeons may take twice the time to perform the same procedure, whereas others may achieve a “better” outcome in half the time-there is no proven correlation between operative time and the quality of outcome. Each surgeon will have his/her own norm, but the expected length of the procedure should play into the preoperative evaluation. Similarly, a patient’s hematologic/ coagulation axis (including renal and liver diseases) and blood pressure control can have an impact on the outcome of facial surgery (see the section, “Complications”) and should be carefully evaluated prior to surgery.
