Aesthetic medicine is a medical specialty that deals with the construction and reconstruction of the psycho-physical balance of an individual. It is aimed at prevention and correction of aesthetic disadvantages that can lead to development of various pathological or psychophysical disorders over time.
A check-up by an aesthetic medicine specialist can be seen as the next step in the evolution of the standard internal medicine check-up. The objectives of such check-up are: assessment of biological age, prevention of disorders caused by aging and improvement of psychophysical abilities.
Aesthetic medicine in its nature is not only corrective, but primarily preventive.
n the preventive phase, doctors teach patients how to recognize and accept their given physical structures, how to nourish and treat their body according to the rules of hygiene of life which includes proper nutrition, physical activity, psychological and behavioral well-being and proper cosmetic treatment. In the corrective phase the program relies exclusively on applying official methods and techniques: medical, surgical, kinesitherapeutic, thermal and cosmetic treatments.
- general and targeted medical history relevant for aesthetic medicine
- standard patient examination
- psychological review - a series of conversational tests designed to assess the overall psychological state of the patient
- morpho-anthropometric assessment: getting acquainted with patient's body weight over the past, his ideal body weight, lean mass, total body water assessment using various methods of body composition analysis such as plychometrics and impedance measurements that allow for detection of causes related to body weight and application of appropriate local treatments based on those assessments. An assessment can be also used to determine diet plan and restore normal metabolism and body weight.
- postural assessment: used to detect imbalance in body posture in relation to the surface, in a static or dynamic situation, through direct observation and using the podoscope
- assessment of physical capacity: measuring patient's capacity in performing certain activities. The maximum use of oxygen, strength and articulation flexibility is also assessed with use of goniometer.
- angiological evaluation – Doppler probe of 7.50 mgh
Facial check-up or skin check-up
Preventing and controlling skin aging is an essential need that should not be neglected nowadays. It affects the psychological and physical condition of a person regardless of age. In order to maintain a satisfactory skin appearance throughout the years, it is imperative for people to know their skin and maintain appropriate hygiene. With this intent, Carlo Alberto Bartoletti (Rome) and Gaston Ramette (Paris) set up a medical methodology in nineteen seventies – skin assessment with created with the purpose of getting to know skin defense mechanisms and diagnosing skin biotypes (exm. skin prone to seborrhea, dry skin due to dehydration and/or insufficient lipid presence on the surface, sensitive skin – especially to atmospheric conditions). An individual response to sun exposure is assessed and the functional balance and the degree of aging of the skin is then stabilized. The specialist then offers cosmetic advice for appropriate skin care (cleaning, hydration, sun protection) with the purpose of balancing potential imbalances found in the check-up.
Also, during the treatment period, control measurements are conducted to continuously monitor skin condition parameters. This is achieved with the use of pharmacosmetic substances and cosmetic supplements, if necessary.
Facial skin check-up
The check-up starts with taking patient's medical history and gaining insights into their general hygiene habits, potential skin disorders, use of medication, subjective attitude towards their skin etc. The objective skin examination is an ordinary visual examination, conducted using cold light and Wood's lamp. General assessment shows us the color and reveals the presence of elementary lesions, if any. Targeted assessment refers to the color, luminosity and potential presence of comedos, microcysts, skin stains, couperosis (reddening with enlarged blood vessels of the face, especially in people with light skin), redness, rosemary, wrinkles, skin depression (scarring), acne scarring, erythema (skin peeling).
The Wood lamp detects the presence of comedos (in yellow or orange color, depending on the degree of fat oxidation), hyperpigmentation that cannot be detected with bare eye, and scales (in dermatology, Wood lamp is used to confirm the diagnosis of vitiligo, psoriasis and pityriasis versicolor). Touch and palpation examination according to the corrective methodology of traditional medicine allows for examination of smoothness, fatness, granulosis, roughness, thickening, elasticity and skin tonus. Epiluminescence dermatoscopy is non-invasive technique that allows pigment testing inside and outside of the cell. Is used for differential diagnosis of pigment lesions.
Measurement of facial skin parameters
Skin measurements are conducted with the use of devices designed in laboratories for dermatologic purposes. In late seventies Ramette and Bartoletti formulated the first protocol for skin check-up , which includes: temperature measurement, sebometry, corneometry, pH measuring, lactic acid test and testing for dermographism, as well as the newest method of skin imaging that allows the capture of a three-dimensional skin image.
pH evaluation is performed with the use of electrode and the result of this measurement shows the level of skin acidity.
Sebometry shows the amount of fat on the surface of the skin with the use of a medical device called sebumeter. The measurement time is 30 seconds and it is controlled by the chronometer located on the device. The normal values measured by sebumetry in the area of the forehead range between 100 and 200, in the area of the cheekbones between 60 and 160, and in the beard area between 60 and 100.
Level of hydration (moisture) of the skin is determined with the use of an instrument called corneometer. The method is called corneometry. Normal hydration values range from 95 to 105.
The 15% lactic acid (Ramette) test confirms or disproves the diagnosis of sensitive skin. Dermographism is useful in determining the degree of skin irritation.
What are the indications for this assessment?
Regardless of age, skin condition assessment is important for determining appropriate cosmetic products for use, and the goal is to prevent the appearance of aging skin signs, especially those caused by atmospheric factors. The assessment should preferably be made in the younger age, just after puberty, in order for one to learn their skin type and its defense mechanisms early and start applying the appropriate preventive treatments.
The assessment should also be made once again during the menopause when fat production is reduced due to hormonal changes. This is the best time to repeat the assessment and modify care and beauty routines, if necessary. In younger age the assessment should be done every two years, and after entering menopause annual check-ups should be introduced. Questionnaires, clinical examinations and parameter measurements help develop personalized educational programs in cosmetic care, modified according to biotype and phototype of an individual, which include advice on how to properly protect, defend and maintain skin in good condition with the use of personalized cosmetics, and that is, according to the EU definition, its precise purpose.