Aging Population

Currently, baby boomers—born between 1946 and 1964—are the most powerful consumers in the world of aesthetic and cosmetic treatments, with more each year spending millions on cosmetic and aesthetic procedures. In the United States, baby boomers now make up 51% of the total population, with 12,000 people turning 50 every day (one every 8 seconds). This trend will continue, with the number of Americans older than 55 years growing by 60% in the next 20 years.

Facial Aging Process

As we age, our skin matures (chronologic aging). This is generally accelerated because of a process known as photo-aging. Photo-aging refers to premature aging from sun exposure, smoking, and genetic predisposition. Healthy skin is defined as skin that is smooth, firm, glowing, clear of blemishes and vascular lesions, and plump with natural moisture. Unhealthy skin is defined as skin that is uneven, blotchy with pigmentation, poor in tone and elasticity (thin), leathery, dull, and covered with age spots, telangiectases, fine lines, and wrinkles. These unwelcome changes are brought about by the pull of gravity and the cumulative damage to DNA, collagen, and cell membranes by free radicals produced from normal cellular metabolism, environmental elements, and sun exposure. (Also see the discussion of aging skin in Chapter 59, Skin Peels.)

For centuries, we have strived to slow down the aging process in an attempt to look and feel younger. The facial rejuvenation process aims to achieve the following goals.

During the past decade, much progress has been made in the field of noninvasive facial rejuvenation. The list of noninvasive facial rejuvenation techniques has grown considerably in response to the aging baby boomer’s demand for procedures that combine safety, efficacy, predictability, and, of course, minimal downtime. The following noninvasive facial rejuvenation techniques are the most widely performed and sought-after procedures:

Even more recently, cosmetic physicians have begun combining rejuvenation techniques in an attempt to provide better and longer-lasting results. Depending on the patient’s concerns and goals, most facial rejuvenation procedures can be performed in concert to provide patients with excellent, long-lasting results. Indeed, when combined, these procedures offer far superior results compared with the results from any single procedure.

Without question, aesthetic medicine is the most exciting and rapidly growing field of medicine today. Given this staggering growth, it is more important than ever for providers to constantly seek education opportunities to keep up to date with recent advances in technology and new procedures in aesthetic medicine. This section of the text provides an overview of the most popular and sought-after cosmetic rejuvenation procedures available today. Those who want to enter the field of aesthetic medicine are strongly encouraged to undergo intensive hands-on clinical training with an experienced aesthetic physician.

Initial Cosmetic and Aesthetic Assessment Visit

Regardless of the reason for the initial visit, it is essential that a full evaluation be made of the overall health status. The general health history questionnaire can be used for an overview, but specific questions should then be asked about the skin (Fig. 46-1). It is important to determine exactly what it is the patient is concerned about because another procedure may be more appropriate than what the patient has requested.

Figure 46-1 Aesthetic Services Patient Profile form.

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