08/7/2000

Cosmetic Surgery

Have you ever considered a nip here or a tuck there to hide signs of aging? Many people do. One of my colleagues, also a professional writer, looked into some of the wrinkles involved. Many of the treatments and procedures she describes below were certainly news to me!

Neither she nor I are making any recommendations, mind you. Personally, I plan to stick with exercise. On a weighty matter such as this, I have no desire to be on the cutting edge. (Sorry, I couldn't resist.)

Cosmetic Surgery
By Frances Chamberlain

Growing older is inevitable and so are crow's feet, baggy eyes, drooping eyelids and other signs of "character." For a certain number of people, these normal changes in facial structure are no big deal, but for an increasing percentage, plastic surgery has become a popular way to stall the aging process, at least superficially.

The most common type of plastic surgery done today involves the eyes and removes sagging skin and fat from the upper and/or lower eyelids. It is one-day surgery, leaving little or no scarring, and tends to heal quickly.

The browlift, another facelift procedure, reverses the impact of gravity and aging as the eyebrows drop from their youthful position to a lower position nearer the edge of the upper eyelid. Deep grooves in the forehead just above the nose, plus drooping eyebrows, can make a person look tired or angry even when they are not.

Dense hair, which helps to hide the scar, and skin that has not been damaged by sun, makes this surgery more successful. Although it is usually done with an incision in the hairline, it is also possible to use an endoscope, a small round tube with a fiberoptic light, which allows the surgeon to operate through tiny incisions.

For many, a simple browlift or eyelift may not be enough. A complete facelift uses surgery to correct the changes that occur in aging and can improve the total appearance of one's face. Weight loss, effects of gravity, smoking and other factors can cause facial skin to sag. A successful facelift can turn back the clock from 5 to 10 years, creating a younger, happier, healthy look.

This surgery is best done if the patient is at a body weight that is normal or slightly under. They need to have strong facial bony features (chin, cheekbones). If you have not been a smoker or allowed your skin to be damaged by sun, then your chances at successful surgery are even better. It's important to be realistic about what a facelift can do. If you are not the ideal body weight, or have damaged skin, the results may be an improvement, but not as dramatic as you had hoped.

Some people now resort to glycolic acid rejuvenation peels, or other anti-aging facial techniques, procedures that can be performed by highly skilled technicians in a day spa. These procedures carry less risk, post-operative care and healing time, of course, because they are not surgery. "The glycolic treatment can be helpful on its own, or in conjunction with a face lift," explained Melissa Curtin, owner of Elysian Fields Day Spa in Washington, Conn. "Glycolic comes from sugar cane, has the smallest molecular structure and can penetrate the skin the deepest. It sloughs off dead cells, giving you a smoother, softer appearance. It cleanses clogged pores, reduces scarring, sun damage, and age spots."

Other popular options to improve one's appearance and postpone the effects of normal aging are collagen injections and liposuction. Collagen is a simple technique of injecting a highly purified protein from the skin of cattle into a depression in the skin, thus smoothing out little wrinkles.

However, since 20 percent of the general population is allergic to collagen, a skin test must be performed first and the patient must wait one month for a reaction before proceeding with treatment. Collagen can smooth out scars caused by acne, those due to trauma or surgery, or simply the fine wrinkles that occur with aging.

The material, which contains local anesthesia, is injected into the area to be treated. There might be some redness, but life is back to normal the next day. The major drawback to collagen treatments is that they are not permanent; follow-up injections are needed every 6 to 24 months.

Another increasingly popular technique for changing not just the shape of the face, but of the whole body, is liposuction. Although we may think of thighs or tummies, buttocks or arms, first, liposuction can also be helpful for the face and neck, thus complementing or improving other plastic surgery or facial treatments.

Today, instead of suction lipectomy, patients can receive even more benefits from unltrasound-assisted lipoplasty (UAL), the tumescent technique and the super-wet technique. The best candidates are those who are normal weight with firm, elastic skin. You should have realistic expectations about liposuction; it is not an alternative to diet and exercise, but simply an aid to remove stubborn pockets of fat that don't respond to other weight-loss procedures.

Ann Hodgman, a Washington, Conn. resident who underwent liposuction on her face, upper and lower abdomen, hips and thighs, said the recuperation time for this was much greater than she had anticipated. "The results are not dramatic, except perhaps to the person who has liposuction," she said. "People may underestimate the recovery period, and although I was really pleased with the results, it was also more painful than I expected. Follow-up procedures, like wearing a full girdle, a cuff on her neck and rolling her stomach with a rolling pin every day, were key to her recovery and the success of liposuction, she added.

Liposuction can be done in an outpatient facility, or for larger amounts of fat, in a hospital setting. It can be done under local anesthesia, depending on the complexity of the procedure. These are all important things to discuss with your physician ahead of time. You must select someone who has the advanced surgical skills to perform such procedures and prepare for a longer period of convalescence.

All of the above techniques carry varying degrees of risk, which should be discussed with your plastic surgeon. They also carry the potential to change your face and body image, to make you feel good about the way you look (although it's wise not to believe in miracles.) Be realistic, do your research, talk to a lot of people, consider, honestly, your reasons for having plastic surgery and if it's all feasible, enjoy the wonderful advantages of a more youthful looking body!

Editor's Note: Frances Chamberlain is a freelance journalist from Connecticut whose work appears frequently in the New York Times. She also contributes to a number of other publications and Internet sites, and has often done syndicated columns for national health newsletters. Frances earned her MALS from Wesleyan University and has taught creative writing and journalism throughout Connecticut during the past 15 years. She did not undergo liposuction in her research for this article but, like many others, is always curious about ways to turn back the clock!

Please send questions or comments to bbruno@snet.net.