Periorbital Assessment Methods

A cosmetic surgeon must possess a thorough understanding of facial anatomy, including aesthetic proportions and the aging process. They should also be knowledgeable about the various rejuvenation procedures available to address correctable issues, while keeping in mind their indications, effectiveness, and limitations. Although the clinical examination may appear straightforward, it requires meticulous attention to details. The comprehensive assessment begins with a patient interview and history taking, followed by a physical examination and standard photography before discussing treatment options with the patient. During the history-taking process, patients are encouraged to express their perception of disharmony in their appearance and their expectations from rejuvenating procedures. A comprehensive history should also include a psychological assessment of the surgical candidate, as well as a review of their past medical and surgical history, and any allergies or medications they may be taking. A thorough physical examination should begin with a general assessment of the skin and proceed in a cephalocaudal order, noting details about the forehead and hairline, eyebrows, upper and lower lids, midface and malar area, facial bones, and finally an ophthalmological examination. This chapter will cover the most important considerations for preoperative assessment of facial cosmetic candidates.