For Patients - Dr. Matthew Kienstra, MD

Pre-Screening Evaluation

We offer a pre-screening evaluation for patients who live outside of Springfield. If you are from Arkansas or other surrounding areas, we know that the decision to undergo facial cosmetic surgery is important and we want to save you from making an unnecessary trip to our office if there are obvious reasons you may not be a candidate. If you are interested in using this service, please continue to read below.

Realistic Expectations

It is important that you understand what facial plastic surgery can and cannot do. Facial refinement can have a profound impact on your appearance, but it will not change your whole life. It is intended to make you look better, not different. If you feel that facial cosmetic surgery is the answer to your problems, proceed with caution. If you have a healthy attitude about yourself and about surgery, you will most likely be very pleased with your results.

General Health

You should provide us with a complete medical history, to ensure that you are healthy and that surgery will be a safe option. If there are any questions about the state of your general health, we require you to get clearance from your medical doctor prior to surgery.

Pre-Screening Evaluation Instructions

The pre-screening evaluation is NOT considered a surgical consultation or medical opinion and does not guarantee that you are a good surgical candidate. Its purpose is to identify any factors that would prevent you from having surgery.

Begin your pre-screening evaluation:

  1. Take photos. The necessary photos need to be head shots from the bottom of the neck to the top of the head, not full body - 1 Frontal View (face forward view), 2 Lateral Views (right and left side views), 2 Oblique Views (right and left ¾ views), and 1 Basal View bottom of nose (FOR RHINOPLASTY EVALUATIONS).
  2. Print and complete these Medical History forms.
  3. Send the completed forms and photographs to our office by mail or by email. Also feel free to include any further questions you may have.
  4. Our office will contact you via e-mail with the results of your pre-screening evaluation.

Important Note:

Photos should be taken with a zoom lens, using good lighting and a solid color background. (A normal point and shoot wide angle lens will distort the face and nose too much for an accurate evaluation.) Any portrait studio (Olan Mills, JC Penney, etc.) should be able to provide these shots and at a relatively low cost.

Mailing Address:

Kienstra Facial Plastic Surgery
Attention: Pre-Screening Evaluation
1965 S. Fremont, Suite 120
Springfield, Missouri 65804