Pre-Aesthetic Examination: The Golden Rules of Clinical Evaluation

What is the purpose of the examination?

The pre-aesthetic examination has three goals: to get to know the patient, to analyze the face, and to establish a safe plan. Getting to know the patient means understanding their expectations, motivations, social environment, and psychosocial status. Analyzing the face means mapping the layers, symmetry, mimic dynamics, and potential risk areas. A safe plan means building decisions such as procedure, dosage, sequence, and timing on these two pieces of information.

Disruption of this sequence is the main reason for regret in aesthetics. In clinics that operate with "procedure first, then plan," the results predictably remain average. In clinics that operate with "plan first, then procedure," the results make a difference.

Standard photo protocol

Applying a fixed photo protocol for every patient is one of the most valuable habits in aesthetic medicine. Photos taken with neutral expression, smiling, frowning; from five basic angles (front, semi-profile, profile) and under constant light; create a reliable reference point for both the patient and the physician in the years to come.

Photography is also the language of communication with the patient. Because when the patient looks in the mirror, they see a three-dimensional and moving face; while we evaluate a two-dimensional and static frame. The photo protocol is indispensable for these two perspectives to meet at some point.

Medical history and contraindications

A complete medical history is taken before an aesthetic procedure. Autoimmune diseases, pregnancy-lactation status, allergies, anticoagulant use, past infections, previous procedures, and products used are meticulously recorded. Some conditions constitute absolute contraindications, while others are included in the plan.

Active infection, active herpes lesion, uncontrolled hypertension, some advanced autoimmune conditions, and a history of previous permanent fillers in the treatment area; require us to postpone some treatments or to turn to a completely different strategy.

• Pregnancy / lactation period — some procedures are postponed.
• Anticoagulant or antiplatelet therapy — increases injection risk.
• Active skin infection — postpones all regional procedures.
• History of herpes labialis — prophylactic antiviral is recommended.
• Autoimmune disease activation — requires clinical decision.
• Previously applied permanent filler — mostly prevents new procedures.