Why Is Patient Selection So Important? Perfect surgical technique applied to the wrong patient produces poor results. On the other hand, adequate technique on the right patient produces remarkable transformations. Patient selection is probably the most important — and most neglected — factor in facial surgery success. This includes not only medical aspects (general health, anatomy), but also psychological (expectations, motivations) and practical (recovery availability, postoperative support).
“Knowing when not to operate is as important as knowing how to operate.”
- — Dr. Robério Brandão
The Ideal Candidate
For [Modern Face techniques, the ideal candidate typically presents:
Ideal Candidate Characteristics )) } Note that not all criteria need to be perfect. Evaluation is holistic — compensations can be made in some areas if others are particularly favorable.
Contraindications
Contraindications ))} )) }
Red Flags: Psychological Warning Signs Beyond medical contraindications, there are warning signs suggesting the patient may not be an appropriate candidate regardless of their anatomy:
🚩 Another person’s photo as “goal”
Patient bringing celebrity or other person’s photo saying “I want to look like this” may have unrealistic expectations or dysmorphia.
🚩 Multiple surgeries with dissatisfaction
History of several cosmetic surgeries with persistent dissatisfaction suggests the problem may not be surgical.
🚩 Third-party pressure
Patient coming due to partner, family or social media pressure rarely satisfied. Motivation must be internal.
🚩 Specific event as trigger
“Want to do before wedding/divorce/promotion” may indicate transient emotional motivation. Reflection period recommended.
🚩 Disproportionate complaints
Patient seeing minimal flaws as severe may have body dysmorphic disorder. Psychological referral before surgery. Identifying these signs requires in-depth conversations, multiple consultations when necessary, and willingness to refuse surgery when indicated.
Systematic Assessment: The SPE-M System Modern Face Institute developed the SPE-M system for standardized facial surgery candidate evaluation:
S — Skin
Quality, elasticity, photoaging, thickness. Impacts technique choice and prognosis.
P — Ptosis
Degree and location of ptosis. Midface? Lower? Cervical? Defines necessary technique.
E — Bone Structure
Malar projection, mandibular angle, chin. Defines the “canvas” we work on.
M — Musculature/Mimic
Platysmal hypertonia, bands, dynamic asymmetries. Influences functional and aesthetic result. SPE-M evaluation is taught in detail in Modern Face Institute mentorship programs.
Frequently Asked Questions
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Consultation Guide
Essential questions to ask your surgeon during the first meeting.
Contraindications
A detailed look at when surgery might not be the best option.
For surgeons: Master the art of patient assessment in our [advanced surgical mentorships.
Learn Patient Selection in Practice
Mentorship programs include real case discussion, including indications, contraindications and refused cases.
View Mentorship Programs