| THE MUlTIETHNIC AgEINg FACE | aRTicle
in the united states will be of non-european descent (1). as surgeons, no longer are we only addressing patients from different ethnic backgrounds, but more importantly, patients, who share a mixture of different ethnic traits. Fanous and Yoskovitch have presented a new
T
PAUL J. CARNIOL, M.D. F.A.C.S., is a plastic surgeon in Summit, New Jersey. He is a Clinical Professor at the New Jersey Medical School -the University of Medicine and Dentistry of New Jersey located in Newark, NJ, U.S.A., and President of the American Society of Cosmetic Laser Surgery.
Contact information: 33 Overlook Road, Suite 401 Summit, New Jersey, NJ 07901, USA tel: 001 (908) 598-1400 email:
pcarniol@gmail.com
classification of races based on racial skin differences and features (2). This new classification divides races into three founding races: Caucasoid, African, and Asian; and six subraces or categories: Nordics, Europeans, Mediterraneans, Indo-Pakistanis, Africans, and Asians. Patients of ethnic mixtures may exhibit both Caucasian and non-Caucasian facial features with regards to skin, soft tissue, cartilage, bone structure, and healing. Facial plastic surgeons, dermatologists, plastic surgeons, and other medical providers must understand the aesthetic variability among these diverse patients in our population. The goal of facial plastic surgery is to achieve a natural
result while maintaining a balance and harmony between facial features. Aesthetic goals may vary widely among patients of both Caucasian and non-Caucasian origin as well as patients from different ethnic backgrounds. Cultural differences may influence not only the interaction with the physician, but also the way results are interpreted after the surgery. It is helpful to have some knowledge about the cultural differences between different ethnic groups during the cosmetic surgery process. For most patients preoperative discussion should
KEYWORDS ageing; blepharoplasty; chemical peel; ethnic; Fitzpatrick skin classification; ptosis; rejuvenation
focus on a realistic and a desired postoperative result that reshapes, and refines rather than attempt to alter and change the ethnicity of the patient. However, it should be noted that some patients will desire a change in the ethnicity of their appearance as a goal of surgery. It is important that physicians spend time during the consultation period understanding the needs and expectations of the patients, and in addition, perform a detailed facial analysis. and physical exam. It is important to thoroughly explain the surgical procedure, anticipated results and variation of these results. The consultation should include addressing type of anesthesia, postoperative recovery process, limitations, risks, and postoperative instructions. Some physicians believe that computer imaging may be helpful in communication, displaying potential outcomes, and presenting limitations of the treatment. Computer imaging should not be used to guarantee or assure a surgical result. Attempts to radically change ethnic features may result
in a disruption of facial balance and symmetry. Regardless of ethnic or variety of multiethnic traits, the results of ageing-face surgery should focus on achieving a natural,
he mulTieThnic populaTion is one of the most rapidly growing demographic segments of north america. according to the 2000 united states census, 29% of the population is non-caucasian and by 2056, greater than 50% of the population
patients of ethnic
mixtures may exhibit both caucasian and non-caucasian facial features.
refreshing, soft, and unaltered appearance, while refining the different facial features. The goals of the treatment must be understood and agreed between the surgeon and the patient before any treatment or surgery. Understanding the ageing process as it relates to the
multiethnic face is the first step in patient evaluation. A detailed facial analysis and physical examination will help establish a basis of understanding and education for patients interested in cosmetic surgery. This phase is perhaps the most important in determining which features will benefit the most from any treatment or surgery. As always, concerns of healing and complications should be included in the pretreatment consultation. It should be noted that some complications may be more prevalent in patients with certain ethnic traits.
Facial ageing Knowledge and understanding of the ageing face has evolved in the past three decades. Ageing is a complex, and constantly changing process, which affects the entire human body throughout life. The ageing process is affected by both genetic and acquired factors. There exist many genetic ageing theories, which include DNA changes, decrease in hormone production, free radical damage, and autoimmune events. Diseases, nutrition, smoking, and sun exposure also influence and can
prime-journal.com | March 2011 ❚ 49
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