Cosmetic Surgery Offers a Second Chance

By David M. Metzner, MD

Published on August 01, 2006

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, doctors no longer advise patients 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, and skin resurfacing, among others.

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 because it requires very small incisions within the hair; a tiny video-connected scope is then passed through this incision. Using this advanced procedure, doctors are able to avoid making long incisions across the top of the head. Also, this technique removes no scalp or hair.

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 new 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 and Reconstructive 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.