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In the past, cosmetic surgery was the territory of the wealthy and privileged, and people would whisper about so and so “having a little work done.” No more.
Baby boomers have discovered cosmetic surgery and are willing to pay the price to stave off the aging process. Wrinkles. Brown spots. Red spots. Drooping jowls. One day they look “tired,” a few days later, they look “rested.”
Statistics from the American Society of Plastic Surgeons bear out the fact that
millions want to stop the hands of time. Over 8.7 million cosmetic plastic surgery procedures were performed in 2003, up 33 percent from 2002. Botox injections were the top procedure with over 2.8 million procedures done in 2003, a 157 percent jump from 2002 and 267 percent from 2000.
While over 1.7 million cosmetic surgical procedures were performed in 2003, up five percent from 2002, non-invasive cosmetic procedures rose 43 percent to seven million.
Women make up the majority, 86 percent, of cosmetic plastic surgery patients, with 35-50 year olds the largest age group at
45 percent.
Shows such as “Extreme Makeover” and “The Swan,” have taken cosmetic surgery out of the operatory and into the family room.
Dr. Frank Simo, Facial Plastic and Cosmetic Surgery Center, divides his practice between reconstructive plastic surgery and cosmetic surgery. He believes that these shows have prompted interest in the cosmetic procedures. “They have brought this to the forefront and opened a lot of people’s eyes to what we do. These ‘baby boomers’ are working their way through the population, and there’s not only an increased interest in facial cosmetic surgery, but also an increased number of those who are candidates.”
Simo says his most common procedure was rhinoplasty, “primarily because you’re able to improve any kind of breathing problem you might have and refine the appearance of the nose. Plus, you might get some help from insurance which usually doesn’t pay for cosmetic procedures.”
Eyelid surgery was the next most requested followed by “some type of combination of rejuvenative procedure like a face, neck or forehead lift. The vast majority of us don’t need an extreme makeover, just a little improvement.”
Dr. Timothy Jones of the Genesis Cosmetic Surgery Center says the most popular procedures he performs on women are liposuction, followed by breast surgery, then eyelid surgery.
He echoes the “baby boomer” theory. “They are driving most of this. They’ve grown up and have been the leaders in promoting wellness and fitness and trying to stay active as they get older.”
Dr. Terry Myckatyn, instructor of plastic and reconstructive surgery at Washington University School of Medicine says he performs most types of cosmetic and reconstructive surgery, including liposuction, “tummy tucks” and contouring procedures.
“The techniques have improved causing cosmetic surgery to become more mainstream,” he says. “Plus, a larger number of recognizable people are having these procedures done.”
When one discovers a line, spot, or sag, procedures abound for a fix without undertaking a full face-lift to get that “fresh” look.
These non-invasive, non-surgical procedures include injections of Botox, collagen or any of the new hyaluronic acids such as Restylene; pulsed light technology for redness and sunspots; or a radiofrequency technology called ThermaCool to smooth wrinkles. This, incidentally, was featured on “Oprah.”
Dr. Tamara Ehlert, facial plastic surgeon, says the biggest trend is toward these procedures “that have no down time and are not necessarily obvious to anyone.”
 Dr. Tamara Ehlert of Facial
Plastic and Cosmetic Surgery. |
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She says, “The newer fillers made from hyaluronic acid last longer than collagen, four to six months as opposed to two or three. These work well on the nasolabial groove from the nose to the corner of the mouth, and the ‘marionette’ lines at the corners of the mouth.
Botox targets the squint lines between the eyes, above the nose and between the eyebrows.
Ehlert also advocates using good products and light peels. “It’s amazing how much better you can look. And with these procedures, the right thing on the right spot can make all the difference.”
Men are not immune from the desire to look “less tired.”
Jones says liposuction tops the list for men followed by rhinoplasty, then eyelid surgery. “Men are also more interested in neck lifts. They don’t like loose skin on their neck.”
Simo says he is seeing “two to three men for every ten women. Smile lines and creases are more acceptable in men than women. Eyelid surgery and forehead lifting are the most common procedures we do. Men have different needs.”
The pressure to look good drives both men and women to “uplift” their appearance.
“The men in the corporate world know they’re getting competition from younger workers who could move up the ladder behind them,” Simo says. “We’re a very image conscious society and hiring and promoting people has as much to do with how they look as their performance. It may be shallow, but it’s true.”
Ehlert agrees. “There’s a lot of interest in maintaining the competitive edge in the job market. They are either looking for a job or want to maintain their position without
having a young person come in and take it away.”
Cosmetic surgery entails much more than getting a consultation and scheduling the procedure. It means one, maybe two, counseling visits.
“The first thing we do is try to find out where they perceive their problem to be,” Simo says. I do not want to hear them say, ‘Doctor, what would you do with me?’ I want to know what they see, where their problems are and what bothers them the most.”
Jones says he wants to be sure that he can meet the patient’s expectations. “If you don’t do that, they’re not going to be happy, and if a patient is not happy, the doctor won’t be happy, so it’s essential we have an open line of communication.”
Myckatyn says he is aware of his responsibilities and will not act on someone’s temporary whim. “I think we’re very sensitive to that and that’s why we make sure we have two or three consultations so we know that they have reasonable expectations and demonstrated that they will be compliant with instructions.”
And what if someone is unhappy?
“It doesn’t happen much,” MycKatyn says. “And I think that’s because of the screening. If they’re unhappy and we’ve delivered what we discussed preoperatively, then we try to understand and be empathetic to what they wanted, while at the same time being clear that is what they wanted, show them the pictures and our notations.”
Not all patients are candidates for cosmetic surgery, and physicians have to turn down their requests, which is not easy.
“It’s hard for doctors to say no,” Simo says. “We are preprogrammed to try and help people and do whatever we can, but there are people who are bad candidates for surgery. Those with heart disease, for instance, and those who are obese. Then there are those who have an unrealistic expectation of what you can do for them.”
MycKatyn says he never operates on a smoker unless it is reconstructive surgery. “Results are almost uniformly worse in smokers, and we will turn them down unless they quit. Also, if a person is anxious about something that may not be reasonably corrected by surgery, we will often turn them down.”
Developing good skin habits early in life by staying out of the sun and hydrating the skin can lesson the probability of major surgery. While each woman is different, many start with non-invasive procedures in their early 30s, and wait until the late 40s or early 50s before having a face-lift, if necessary.
Whatever the choice, remember the objective is not to stun, but to have your friends say, “Have you lost weight? You look wonderful!” |
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