Spotlight Magazine
April 1997

Plastic Surgery Update

by Mordcai Blau, M.D., P.C.

State of the Art Facelift

Public awareness of the possibilities offered by advanced surgical techniques has, in the last decade, produced an explosive interest in plastic surgery. Its popularity has also been greatly increased by the availability of antibiotic drugs, which minimize the risks of infection.

By far the most popular surgical interventions are facelifts and other corrective procedures that can be performed at the same time to great advantage. They have been proven effective in removing the signs of aging caused by the loss of tone of the facial muscles and of collagen in the skin and by environmental damage done by smoking or over-exposure to the sun.

The most advanced technique, the comprehensive facelift, has been proven superior to the “classical” method as well as the two-layer facelift. The newest method keeps skin, muscles and cheek fat together while lifting them to create a smooth surface. This technique has the very significant advantage of preserving the natural relationship between skin, muscle and fatty tissue. By avoiding the disruption caused by older methods, normal blood circulation is maintained in the skin flap that is being repositioned. The comprehensive facelift also allows the surgeon to exert a stronger pull without giving the face a tight, drawn, “operated on” look. The result is a more natural, younger and fresher look.

During the preliminary consultation, the surgeon will first carefully listen to the prospective patient’s wishes. He will then explain to the candidate in detail what procedures are medically advisable and what results can be reasonably expected. Most surgeons will show the patient before-and-after surgery photographs of similar cases. Such photos give the candidate a pretty good idea of what can be achieved. The plastic surgeon will also draw attention to alternatives and risks. Providing full information enables the patient to get into a positive frame of mind that is an important element in assuring the success of elective surgery.

The procedure can be safely accomplished in the surgeon’s office-based facility under local anesthesia applied by a qualified physician or an anesthesiologist. It is the method preferred by the overwhelming majority of patients. Only a small minority opt for general anesthesia and short hospitalization.

In the minds of most people, surgical procedures are connected with pain. Surprisingly, as a rule, facelifts cause virtually no pain, merely a feeling of tightness, particularly behind the ear and under the chin, a discomfort that may linger for two or three weeks. Recovery is usually rapid. After two days of rest, patients can gradually resume their home routine and in two weeks or more are usually back at work and play.

Scars are naturally of great concern to patients. Much depends on the individual. Some patients heal better than others, and some scars are more pronounced than others. As a rule, however, scars tend to fade, although they never disappear entirely. Fortunately, in a comprehensive facelift the incisions are made in places where subsequent scars are not conspicuous: inside the ear, behind the ear and under the chin.

How many years can a skillful plastic surgeon take off your face? No definite figure can be quoted as each case is different and much depends on how much damage the face has suffered. Each patient is different and obviously the results vary from patient to patient depending on age and skin type. But there is no doubt that after a facelift the patient will look rejuvenated. Not only that – plastic surgery is capable of restoring the natural harmony of the face that aging and ecological damage often distort. It is therefore often advantageous to combine a facelift with other procedures such as forehead and eyebrow lift, removal of bags under the eyes, upper eyelid correction and neck surgery.

Eyelid correction is often indicated because the skin around the eye is twice as thin as that of the face, has fewer oil glands and weaker internal support. It is here that the signs of aging make their first unwelcome appearance in the form of “crow’s feet.” Exposure to sun. stress, fatigue, worry and smoking compound the damage caused by aging.

There is more to plastic surgery than meets the eye. It is, of course, gratify¬ing to be told that one looks radiant, and people often get the impression that the person who has undergone plastic surgery has lost weight. For a patient who doesn’t entertain unreasonable expectations, a facelift will also pay a psychological dividend. She, or he, will step out to face the world with greater confidence and an enhanced self-esteem. A good facelift makes you look as good as you feel and feel as good as you look.

Tumescent Method Liposuction

In the last few years we have been employing a new method that is being accepted enthusiastically by most plastic surgeons worldwide: tumescent liposuction. There are three major differences between this method and the old method: less bleeding, less pain and aesthetically improved results.

The most common areas for liposuction are “saddlebags” in the female and “love handles” in the male, Other areas are the knees, hips, waist, tummy, arms, male breasts, chin and neck. The surgery is ideal for certain people who have local accumulation of fat, and not for general obesity. The surgery is done in our office-based facility. Bruising and the major swelling subsides in a few weeks. Most people return to work after one week.

Shaping the Nose

The fear of being rejected in a job interview, in a love relationship, or by society has long been a reason why many individuals sought plastic surgery of the nose, rhinoplasty by its medical name. In a sense, a misshapen nose is more of a physical disability than the loss of smell because the nose is vital for the harmonious appearance of the face, particularly in profile. And “profile” means not just “side view” but implies character and personality. Both are of crucial significance to how society and one’s personal environment judge the individual.

In 16 years of practicing plastic surgery, I have performed more than a thousand rhinoplasty surgeries. Most patients that come to my office want a more aesthetic nose, without bumps, hooks or deviations, which blends more harmoniously into the face. For the face to look beautiful, the size of the nose must be proportionate to the whole. Studies by psychologists and sociologists confirmed popular wisdom that a better-looking person stands a better chance in life.

The operation is done entirely from inside the nose. The results depend to an even greater degree than in other types of plastic surgery on the surgeon’s skill. My experience as a painter and sculptor has proven to be a great advantage. The operation takes from 30 minutes to one hour. As a rule, the patient can go back to routine activities after a week. All of these procedures can be easily accomplished in the comfort of the plastic surgeon’s office under local anesthesia administered by a qualified physician or anesthesiologist. As always, it’s important to consult with your physician. He will evaluate your case, listen to your expectations, carefully explain the procedure – and any possible risks and complications – and the results which con be realistically anticipated.