Under The Knife

By Valerie Lemke

May 15, 2009 5 min read


What you need to know before that nip and tuck

Valerie Lemke

Creators News Service

"I don't want to look too perky, just rested and ready to go." It is the often-stated wish of plastic surgery candidates, including those age 65 and above.

With today's longer, healthier life comes a desire to look your best regardless of age, with mature Americans opting for cosmetic surgery in increasing numbers. But is a good plastic surgery outcome possible at age 65 and after?

"The capacity of the skin to regenerate diminishes with age," admitted Dr. Julio Garcia, a board-certified cosmetic surgeon and member of the American Academy of Anti-Aging Medicine in Las Vegas.

As we age, a loss of collagen and elastin proteins, as well as glyco-amino-glycans, an acid which holds things together in the skin like grouting between tiles, causes it to wrinkle and sag.

"Some people's skin will show these signs of age earlier than others," Garcia said. "Sunbathing, smoking, tanning booth visits and poor skin care accelerate aging. In addition, fair skin ages faster than dark skin, and men with thicker skin and people with oily skin wrinkle less."

The longevity of cosmetic procedures also gets shorter as we age, Garcia said. "If you have a facelift at age 50, the procedure will last about 10 years. At age 65 you can expect improvement for five to seven years, but you'll be five to seven years older before you need another one, so you're always ahead of the game."

Dr. Scott Mosser, a board certified plastic surgeon in San Francisco, concurred with Garcia that the facelift is the most efficacious cosmetic surgery for a younger, more refreshed look, and both doctors report it is the procedure most requested by their mature patients.

"Seniors often report they want a facelift because they see a disconnect in the way they feel and the way they are treated," Mosser said. "They feel good inside, but people are responding to them as though they are tired and disinterested."

Mosser did note reluctance among seniors to undergo surgical procedures, however. About one-third of his senior patients request non-surgical procedures such as Botox and fillers.

"Maybe part of this is a misperception between being old chronologically and old physiologically. Fifty-year-old patients with a number of medical situations aren't suited for surgical procedures, while many seniors are physiologically quite young and are good candidates for a facelift if they make a connection with a capable and ethical surgeon," Mosser said.

Both Garcia and Mosser agreed there are several smaller surgeries, including an eyelift and a forehead lift, that are less invasive and less expensive, but for the best return on your investment the facelift is superior to other procedures.

When should you consider cosmetic surgery? Garcia believes there comes a day that patients, including seniors, realize they need something and he gives them a way to gauge when that time comes. "If your looks bother you seven days a week, it's time to consider a facelift. At that point, it's never a bad idea," he said.

Mosser also offers patients an internal test when they go to visit a doctor. "After a consultation, a patient should walk out of a doctor's office feeling comfortable," he said. If not, the search should continue for a good match. "I also advise surgery candidates to put themselves in the hands of a plastic surgeon certified by the American Board of Plastic Surgery. The onus is on the public to know the doctor has proper credentials in place."

The surgeon needs to be comfortable, too, said Garcia, who always suggests a patient talk with two doctors before making a decision.

"We turn down 25 percent of the people who come to see us," said Garcia. "They have the wrong motivations: They just got a divorce, lost a job or they're depressed. Or some patients want too much done. We've all seen bad jobs --where a face looks like a flat board. The surgeon's duty is to explain what should be done and what should not be done and then explain how it will be done.

"Patient and doctor need to have an emotional bond. Every patient should feel more confident following cosmetic surgery and when they do their quality of life is better, too."

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