We
only get one chance at a first impression, and the person
who projects the best self-image makes the best impression.
In today's competitive society, people recognize the
importance of self-improvement, whether it is for social
or professional reasons. Exercise, skin care and nutrition
are important but can only do so much. Real structural
change requires more. In a sense, cosmetic surgery offers
a second chance - the opportunity to defy both the calendar
and genetics. Here I have compiled some of the most
successful techniques used to achieve this goal.
Rejuvenation Techniques
Facelift (rhytidectomy)
Over the past few years, the term facelift has become
a topic of increased interest and discussion. The cumulative
effects of time, gravity and heredity show on any face.
The facelift operation itself, also known as rhytidectomy,
is performed to correct double chins and sagging jowls.
The modern-day, long-lasting facelift operation, involves
the permanent removal of undesirable accumulations of
fat. As well, sagging muscles and connective tissue
are repositioned and re-supported.
Because excess fat is now removed in the operation,
patients no longer need to lose weight before surgery.
In fact, for people who previously had chubby cheeks
or a fat neck, one of the benefits of facelift surgery
is an apparent loss of weight following surgery. The
overall effect is a younger, fresher and more vibrant
(yet natural) appearance.
Often lumped under the term facelift are a group of
operations designed to rejuvenate faces that show signs
of aging. These include blepharoplasty (eyelid surgery),
brow and forehead lift, mid-face lift, and skin resurfacing,
among others.
48 year old woman before and after
facelift, browlift, and chin augmentation
Blepharoplasty
Americans stress eye contact and believe that they
can judge a person?s character by what they see in their
eyes. While people talk most about facelifts, the most
popular age reversing operation among my patients these
days involves the eyelids. Heavy, ?hooded? (drooping)
upper eyelids and baggy lower eyelids make people look
tired, old, and certainly past their prime. The surgical
correction known as blepharoplasty can remove the fatty
pouches that cause these unfortunate problems. When
present, skin that has become stretched over the years
can also be removed. Upper eyelid drooping, which sometimes
partially obscures vision, is corrected by removal of
excess skin, muscle and fat. Incisions follow natural
contour lines in the upper eyelids, and in the lower
lid can be made on the inside, so there is no scar at
all. In some cases, circles under the eyes can be filled
in and the lids tightened.
Brow and Forehead Lift
A pleasing eyebrow shape and arch is associated with
youth and beauty. On the other hand, an unfavorable
eyebrow shape and angle can make a person look tired,
worried or angry. The brow and forehead lift, in addition
to lifting the eyebrows back to where they belong, smoothes
out a deeply furrowed and pinched forehead. I prefer
the high-tech endoscopic method, which is a big improvement
to older more invasive surgery, because it requires
only very small incisions within the hair. A tiny video-connected
scope is then passed under the skin; the tissues are
released, repositioned, and secured into position. With
this advanced procedure I no longer make the old fashioned
long incision across the top of the head and never remove
scalp or hair. The benefits are brighter, more open
eyes, a fresher, and more pleasant and alert demeanor.
Mid-Face Lift
The mid-face is the area immediately below the eyes,
next to the nose and above the lips. It is left behind
by the facelift discussed above, which benefits the
jowls, under the chin, and the neck. The mid-face lift
corrects sagging in this important area in the center
of the face, helps circles under the eyes, and enhances
cheekbone definition. I perform the mid-face lift with
the only incisions in the scalp and inside the mouth
under the lip. In other words, it can be done with no
facial scars. The mid-face lift can be done alone or
in combination with any of the other facial rejuvenation
procedures.
Botox
Botox is used for the treatment of frown lines, forehead
furrows, "crow?s feet", and lines and wrinkles
of the lower face. Botox has proven to be a very popular
nonsurgical cosmetic treatment. The type of lines and
wrinkles that respond to Botox injections are those
caused by muscles?specifically those muscles that contract
during facial expressions such as frowning or squinting.
It works by relaxing the muscles that cause the lines
so wrinkles smooth out. There is no downtime, and patients
can immediately resume normal activities.
Skin Resurfacing
Skin resurfacing uses either a laser or special chemicals
to smooth the skin, reduce wrinkling, and even out the
complexion. I personally use the newer Erbium: YAG laser,
which has proven to be a kinder and gentler alternative,
with much faster recovery than the CO2 laser.
Some people prefer to correct one thing at a time --
what one of my patients once called "weeding the
garden." Others want a more dramatic improvement;
they have as much done as necessary and feasible at
once so as to achieve maximum benefits. It is an individual
choice, and one of the reasons a thorough consultation
with a well-qualified, experienced, sympathetic plastic
surgeon is so important. I have found that video imaging
assists in creating plans for facial surgery that meet
each individual's specific needs and desires.
Breakthroughs in anesthesia methods and monitoring
devices have made it possible for all of these operations
to be performed on an outpatient basis. This is a positive
step because patients feel more comfortable and heal
faster in this environment. In addition, outpatient
procedures reduce expenses overall.
Techniques for the Body
Body Contouring Surgery
In the months leading up to the summer, I see an influx
of women seeking to re-contour their figures. They are
usually trying to plan ahead, getting their ?problem
areas? taken care of well in advance of spring and summer's
more revealing clothing styles.
According to statistics kept by the prestigious American
Society of Plastic Surgeons, Liposculpture, more commonly
known as liposuction, has become the most frequently
performed cosmetic surgery procedure. I choose to perform
the tumescent form of liposculpture, which can be done
on an outpatient basis.
In liposculpture, a combination of saline (saltwater)
and local anesthetic is first flooded into the areas
to be contoured. Working through tiny incisions just
large enough to fit the thin liposculpture vacuum tube,
fat cells and some fluid are then gently swept away
by suctioning back and forth under the skin. Liposculpture
is truly a matter of sculpting the human form; it effectively
removes unwanted fat from areas that are often resistant
to diet and exercise. These can include the neck, upper
arms, chest, sides, abdomen, thighs, hips, knees and
ankles.
Other procedures for figure improvement include abdominoplasty
(tummy tuck), breast lift, breast reduction, and--last
but not least--cosmetic breast surgery. Saline implants,
which have now replaced silicone gel implants, are used
both to enlarge and to enhance shape. Following surgery,
many of my patients are particularly happy that the
tops of their bathing suits fit as well as the bottoms.
Any of the procedures described in this article can
potentially help to improve physical appearance and
enhance self-image. But no matter what procedure you
choose, be sure to do your homework and choose a qualified,
experienced plastic surgeon.