B. Vectors and Severity
Assess the patient’s real needs regarding vectors and procedures needed to meet patient expectations. This is the moment where the physician should decide and make clear if, given the level of expectation, the patient is a candidate for a single or combination treatment. In 2005, Marten and Connell28 described ways of evaluating severity and different patient needs before facelift.
Through different facial positions, the severity of the loss in one specific vector (horizontal, vertical, or projection) needs to be identified to decide if MFU-V alone is the perfect indication as each procedure corrects a different vector (Figures 2 A–C).
One way of assessing involves using the severity scales for face, neck, and chest aging, and other areas such as knees, buttocks, and anterior and posterior thighs.28-33 According to patient self-assessment scores, the necessary treatment intensity or frequency, the number of treatment lines, or number of repeated treatments, or if the severity indicates that more than one procedure is indicated, can be discussed (Figures 3 A,B).