The Brave New World of Cosmetic Surgery - Cosmopolitan Magazine

Home » Doctor Article » The Brave New World of Cosmetic Surgery – Cosmopolitan Magazine

More and more women (men too) are choosing to have various features
refashioned or readjusted – but cosmetic surgery, like any operation,
is serious business. To bring you up-to-date on what can be done,
what risks you run, and what’s new in the field, here’s a timely
summary of techniques that have the potential to change your looks
forever.

TAKING YEARS OFF YOUR FACE

Surgeons used to erase signs of aging by pulling and tightening
the skin – leading to jokes about Hollywood beauties who underwent
so many face lifts that they had to sleep with their eyes open.
Now many doctors operate on underlying muscle and tissue to reduce
sagging and smooth creases from the inside out. They say this technique,
called the SMAS-platysma face lift (it’s named for the muscles involved),
lasts several years longer than skin-only procedures:

In the traditional operation, the surgeon makes incisions all
around the hairline, separates the skin from underlying fat and
facial muscle, pulls it up and back, trims the excess, and sutures
the skin in place. In the SMAS-platysma face lift, surgeons go two
layers deep instead of just operating on the top layer. They tighten
muscles and fibrous tissue beneath the skin of the face, chin, and
neck. It’s somewhat like the difference between making a bed by
neatening the spread, and pulling up the sheets and blankets as
well.

In recent years, some women have begun getting face lifts in their
late thirties and early forties instead of waiting until after fifty,
when more work is needed and skin is less resilient. “It’s a lot
easier to take a bit of skin from under someone’s chin at thirty-nine
than to take out the turkey wattles at fifty-nine,” says John M.
Goin, M.D., a Los Angeles plastic surgeon.

A new wrinkle in face lifts is the use of suction-assisted lipectomy
(liposuction) on the neck and jowls. “With this technique,” says
a New York City plastic surgeon, “we can obtain a cleaner contour
of the neck and cheek lines.”

Blepharoplasty, the operation to remove the fat and excess skin
that cause droopy folds above the eye and bags below, is often done
at the same time as a face lift. Incisions follow the natural crease
lines of the lid, so they are difficult to spot.

Sunglasses must be worn for about two to three weeks after surgery
because eyes are swollen, bruised, sensitive to bright light, and
prone to tearing.

Another procedure, used when eyebrows have descended or there
are deep wrinkles in the forehead, is to make an incision in the
scalp, two or three inches above the hairline, and pull the forehead
up. This restores the level of the eyebrows and smooths the wrinkles.
It’s a simple operation that can be done on an outpatient basis.
Anyone who already has a high forehead, however, might be cautious
about opting for this procedure, since it will pull the hairline
back even farther.

Though a face lift leaves temporary swelling and bruises it’s
possible for a vigorous patient to be up and about fairly soon.
One San Francisco businesswoman met a new man for drinks in a cocktail
lounge a week after an operation to have the lower part of her face
and neck lifted. “I had little sutures all over, but I wore my hair
so it covered them and just prayed that the wind wouldn’t be blowing
when we left!”.

NICER NOSE

“I hate a nose that looks like a nose job,” says Peter McKinney,
professor of clinical surgery at Northwestern University Medical
School. He believes it’s far better to remove small amounts of bone
and cartilage than to do too much and have regrets. “It’s very difficult
to build a nose back up-much easier to take a little more off later,”
he says.

The goal, according to John E. Sherman, assistant clinical
professor of plastic surgery at New York’s Mount Sinai School of
Medicine and attending surgeon at Beth Israel Medical Center, is
to end up with “a straight nose that is in balance with the rest
of the face, as opposed to the old ‘manufactured’ nose that was
overly reduced, with a pinched tip.”

During this procedure, called rhinoplasty, the surgeon works through
an incision inside the nose to sculpt, removing bone and cartilage.
After surgery, the nose is covered with a protective splint for
a week to ten days. Postoperative bruises around the eyes fade gradually
over two to three weeks, swelling of the nose s