Healthy Aging

healthy aging

Cosmetic Surgery: Lowdown on the Uplift

Readers of this column know that as we age, we have a great multitude of changes from that teenager or 20-something that we once were.  Many of the changes are for the better.  And if we play an active role in our health (the purpose of these articles) we can in fact have aging with grace and physical health.  The one thing we cannot do is turn the clock back to that time when we looked our best.  This is because aging takes it toll on all our systems, including our skin and features (or to put it more bluntly – “our looks.”)

In a society that features the trim and beautiful male and female on television, magazines, and movies, “looks” are important.  All of us are left to wonder why we not only don’t look like the younger person we once were but also why we can’t look like those we see in the media – some of whom are older than we are.  There are two simple reasons for this.  One is that aging does alter us. Although it is normal to develop wrinkles and creases in places where we used to have smooth tight skin and deposits of fat where they weren't earlier, this does not make anyone feel especially better.  The other factor is genetics.  Some people will look far more youthful than others of similar age for the simple reason their genes make it that way – chances are their parents had the same response to aging.  Aging changes are a result of thinning of the skin, loss of skin elasticity, exposure to harmful ultraviolet radiation, smoking, and repeated facial expressions such as frowning, squinting, smiling, etc. that get ingrained in the face because the skin cannot “bounce back” from these natural expressions.    

The face and head are where this transformation draws the most attention, although the fat tissue is a major problem in the waist and belly area.  When the normal cosmetic changes begin to develop we are left with three decisions.  First, accept the new look for what it is – the new you.  Second, try to do everything possible short of surgery to combat the changes; for example, a different diet, exercise, host of beauty/moisturizing potions, vitamins, and staying inside and/or using sunscreen every day when outside.  The third strategy is to approach the changes surgically.

In 2008, the last year in the United States that statistics are available (see plastic surgery statistics at, over 10 million cosmetic procedures were performed.  Most were non-surgical, but about 2 million were surgical.  Of note, this seems to be a particular choice for the female of our species, since only 8 percent were performed on men.  I am not sure what to make of this since men and women both have similar cosmetic changes in their bodies from aging.  Could it be that men just don't care what they look like — something their spouses might easily believe?

The face in both genders has lines, wrinkles, loose skin, double chins, sacks under the eyes, and on and on.  Each of these can be approached by what is generically referred to as "facelift" surgery.  The surgery should be performed by a board-certified plastic surgeon who performs many of the procedures, since it is as much art as it is science and one wants a good artist who is practiced at it.  The procedure is generally done in an outpatient setting and takes 2-4 hours.  Involved are a number of incisions in out-of-the-way places like scalp line, behind the ears, and under the chin.  Excess skin and fat are removed and the remaining skin is tightened.  This is all done under sedation with local anesthesia or with general anesthesia.  Time to return to normal is variable, but most patients stay under wraps, so to speak, for a couple of weeks and it can be three months before the maximal benefit of the surgery is reached.  The results are long-lasting, up to 10 years, unlike the result with non-surgical approaches such as Botox® injections that last a matter of months.

There can be complications to this surgery, just as with all surgery.  These tend to be in a small percentage of patients and vary from transient mild problems like bruising or blood collection in small areas to severe (very rare) complications like infection and losing facial tissue through a process called necrosis.  The point is bad things can happen when the intent was to transform you to a more attractive guise.  When contemplating surgery, a very candid discussion with the surgeon about the risks and benefits is required.  Because this type of surgery is cosmetic and not medically necessary, it is not covered by insurance and the costs should be added into the decision-making process.

The bottom line is that how one looks is one important factor in how one feels about aging.  Healthy aging requires a positive self-concept to do all that is required to be as healthy as possible.  In some people it is important to address the cosmetic changes that come with aging.  Because it is an entirely elective decision that can bring both self-confidence in most, but disappointment in a few, surgery should not be entered into until there is a full understanding of the benefits and risks.  Maybe this is really why men don't do it often - we are afraid of the risks or too cheap to pay for it!

Cosmetic surgery

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