Standard Evaluation of the Patient: The Merz Scale

Fig. 3.1

a–g The Merz scale: upper part of the face

Volume loss of the mid face: The Merz Scale is a validated [3] and globally accepted tool for proper assessment of the infraorbital hollow, upper and lower cheek fullness, and nasolabial lines (Fig. 3.2a–d).

Fig. 3.2

a–d The Merz scale: mid face

Lines, wrinkles, depression of the corners of the mouth, and changes in lip volume and lip shape, with increased sagging of the skin of the jawline, are important indicators of age and have an important role in aesthetic aspect of the patient [4]. The Merz Scale is a validated and globally accepted tool for proper assessment of jaw lines, lip wrinkles , lip volume, marionette lines and oral commissures. (Fig. 3.3a–g).

Fig. 3.3

The Merz scale: lower part of the face

Sagging of the neck is an important indicator of age and has an important role in aesthetic aspect of the patient [5]. The Merz Scale is a validated and globally accepted tool for proper assessment of the change in neck volume (Fig. 3.4).

Fig. 3.4

The Merz scale: neck

Irregular surface pigmentation, prominence of superficial veins and tendons, thinning of the dermis, and loss of subcutaneous fat are important indicators of age of the hand [6].

The Merz Scale is a validated and globally accepted tool for proper assessment of the change in ageing of the hand (Fig. 3.5).

Fig. 3.5

The Merz scale: hands

3.1 Application of the Merz Scale

In these pictures is shown a good improvement of the infraorbital hollow obtained with injection of 0.05 cc of hyaluronic acid along the tear trough (Fig. 3.6a, b, c, d), (Fig. 3.7a, b, c), (Fig. 3.8a, b, c, d, e), (Fig. 3.9a, b, c, d), (Fig. 3.10a, b, c, d, e, f, g, h), (Fig. 3.11a, b, c, d, e, f), (Fig. 3.12, a, b, c, d, e, f), (Fig. 3.13a, b, c, d, e) and (Fig. 3.14a, b, c, d, e).