ABSTRACT
Table 88-2 Fitzpatrick’s Classification of Facial Wrinkling (Perioral and Periorbital)
CHOICE OF PROCEDURE n Complete physical examination
• Static versus dynamic rhytids • Associated skin conditions • Skin thickness • Fitzpatrick skin type classification: Scale of a patient’s ability to tan (Table 88-3)
Table 88-3 Fitzpatrick Skin Type Classification
• Hypopigmented or hyperpigmented skin • Extent of photodamage (Glogau classification)
n The surgeon and patient must decide together: • Which aspects of facial appearance are most distressing • Realistic treatment goals • Acceptable downtime
n Patients must understand: • Nonoperative facial rejuvenation can restore a more youthful appearance. • Nonoperative facial rejuvenation is not as powerful nor as long lasting as operative
techniques. n Resurfacing techniques
• Cause dermal collagen reorganization and new collagen deposition Reduce actinic damage Improve dyschromias Restore a more youthful appearance
n Fillers • Augment depressions in the soft tissue • Mask the appearance of fine lines and wrinkles
TIP: In general, deeper and more aggressive resurfacing techniques create longer downtime, erythema, edema, and time to reepithelialization, but more dramatic results. The patient and surgeon need to be willing to accept multiple treatments or less dramatic results if faster recovery is desired.
