The Baby Boomers' Menu of Cosmetic Surgery Options
Stress, parenting, career, and lifestyle--they take their physical tolls on our faces and bodies. From the deepening frown line on our foreheads between our brows and the crow's feet multiplying around our eyes, to the loss of tight, taut contour around our cheeks and necklines, the lives we lead show on our faces. Especially ex-smokers find that while they have changed their ways, the signs of their habit, including fine lines along their lips and eyes, continue to plague them.
The needs of the Baby Boomer generation have spurred a whole new dimension in plastic surgery. This menu of options covers the special requests of people in their 30s to 50s, who do not need extensive procedures but rather subtle refreshers to fight the physical signs of stress, parenting, careers, and lifestyles.
The Upper Face
There is a new option to address the frown lines that can make us look tired, angry, and old. It's called the endoscopic brow lift. This approach, compared to the traditional open technique, is much less invasive. Instead of making the long incision from ear to ear necessary with the traditional technique, the incisions for the endoscopic technique are shorter. Surgeons make approximately three to four vertical incisions at the hairline and perform the entire procedure through a scope (a tube with a TV camera). Through this scope, the entire brow can be released, elevated, and the muscles causing the furrows can be separated from the other tissues. It can be done much more precisely with the scope because this surgical tool magnifies everything four to five times its normal size.
The advantages of the endoscopic brow lift include the following:
- it is less invasive.
- there is less risk of hair loss, and less risk of sensory nerve damage causing numbness around the scalp.
- For patients who have a high hairline, a variation of the procedure, called a modified anterior hairline approach, can be performed along with the endoscopic procedure.
The potential risks and complications of the endoscopic brow lift are nerve injury or brow drooping. Infections and hematomas are rare, but do occur. Early recurrence can occur if surgeons don't fixate the brow properly. The best candidates are middle-aged and younger patients who have low hairlines and minimal to moderate brow ptosis (drooping). A man who has severe brow drooping might be a better candidate for the open approach.
The mid-cheek lift is a facial rejuvenation procedure that corrects the changes that occur in the mid-face, around the cheeks and lower eyelids. The mid-cheek lift is designed to correct the natural loss of skin elasticity around the middle of the face that can occur with aging. (Skin that was once tightly fitted around the cheeks often begins to droop with aging, causing a more tired, hollow appearance.) The fat pad, which once rested on the cheekbone and added to our youthful glow, descends. The folds between the nose and mouth become more pronounced as the skin above them sags.
The best candidates for the mid-cheek lift are younger patients, between 30 and 40 years old, who don't have a lot of laxity in their lower face and neck. These people typically have some sagging of their cheek fat pad. Potential risks of the cheek lift are distortion of the outside portion of the eye, nerve injury around the sides of the eyes, asymmetry between the left and right cheeks, and prolonged postoperative swelling.
Laser resurfacing is yet another option in the boomers' arsenal. Laser skin resurfacing with ultra-pulsed CO2 and Erbium lasers offers the versatility of refining wrinkles around the entire face or focusing on small areas of lines, such as those around the eyes or lips. This is an ideal approach to use on smokers who get these types of lip lines that cause lipstick to run. The laser precisely erases the wrinkles, without leaving behind the bleached appearance of spot facial peels.
Laser skin resurfacing with either laser can be done in conjunction with face-lifts. The best candidates for the laser have sun-damaged skin, with a lot of skin pigmentation changes and fine wrinkles, which would not be improved by skin lifting procedures. Older patients with deeper wrinkles are better candidates for CO2, while younger patients with finer surface wrinkles and sun damage are good candidates for the Erbium laser. Risks associated with laser resurfacing are pigmentation changes, scarring, and infection.
Doing Your Homework
Experience counts when it comes to choosing a surgeon to perform these procedures. Lack of experience and/or inappropriate in-office operating facilities can put patients in danger. There are organizations that provide accreditation to qualifying physicians' in-office facilities. Accrediting organizations include the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Association for Accreditation of Ambulatory Plastic Surgery Facilities (AAAAPSF), and the Accreditation Association for Ambulatory Health Care (AAAHC).
Patients should also look at the doctor's experience in performing the specific procedures they request. Ask to see before-and-after photos by that surgeon or to talk with patients. Other aspects of a surgeon's background that are important are his or her professional memberships.
Plastic surgery is more than surgery. In addition to nonsurgical rejuvenation procedures, the surgeon you choose should offer pre-and postoperative skin care by a certified medical aesthetician. The in-office aesthetician works with the surgeon to achieve the ultimate results for patients. Patients can prolong the effects of procedures, such as neck lifts, facelifts, and peels, by taking care of their skin for the long term. Your surgeon, too, should a commitment to helping you achieve that goal by offering the newest in skin care regimens, facials and light peels, which are at higher concentrations than those offered at salons because they are offered under the guidance and watchful eye of a plastic surgeon.
Dr. Lawrence Korpeck is board certified by the American Board of Plastic Surgery. He is a distinguished fellow of the American College of Surgeons and is an active member of both the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgery. Dr. Korpeck is also a member of the North American Lipoplasty Society.
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