Special considerations in Asian patients

The approach to rejuvenation of the Asian neck and body requires a thorough understanding of key anatomic and physiologic traits and familiarity with the intrinsic and extrinsic aging process. As a group, Asians have a smaller frame and body weight, shorter stature, and short, muscular legs. Cutaneous racial differences include: decreased terminal body hair, reduced sweating, fewer leg veins, increased incidence of keloid formation, and higher epidermal melanin content that predisposes to postinflammatory hyperpigmentation (PIH). Histologically, the dermis of Asian skin is thicker, and wrinkling is delayed by approximately 10 years as compared to age matched Caucasian counterparts. ¹ Photoaging in Asians is frequently characterized by pigmentary disorders such as solar lentigines and seborrheic keratoses on the head and neck.² The neck also ages differently in Asians compared to Caucasians. Poikiloderma of Civatte is uncommon, and platysmal neck bands in Asians are less problematic. Finally, differences in cultural aesthetic goals also exist. In Asians, there is a greater focus on toning and tightening of the body rather than performing procedures such as breast augmentation, liposuction, and abdominoplasty. Below, we will review various minimally-invasive rejuvenation methods and highlight special considerations when treating the Asian patient.