TIMING IS EVERYTHING   

So many of Life's decisions rise or fall on the basis of "timing". As all of us progress through life, most of us can handle the What and the How. It's the When which seems to befuddle us. Certainly decisions related to cosmetic surgery are no different. Many of my patients struggle not so much with a decision over what particular cosmetic surgical procedure to undergo as when to undergo that particular cosmetic surgical procedure. The when may relate to very practical considerations such as when to undergo a particular cosmetic surgical procedure in order to impact as little as possible upon employment or to recover from that cosmetic surgical procedure, in terms of bruising, swelling, etc., by a certain date. Or the considerations may be of a more philosophic nature such as when to undergo a particular cosmetic surgical procedure in the course of one's life so that it produces the most desired benefit at a time when that desired benefit will be most appreciated, either by the individual undergoing that cosmetic surgical procedure or by those with whom that individual interacts on a regular basis. While the following article may not answer the question "When?" for you, in the event you are considering a cosmetic surgical procedure, hopefully the following article will provide you food for thought in that regard.


Timing of certain cosmetic surgical procedures is a function of normal human development and/or physiologic function. For example, Rhinoplasty, or nose reshaping, really should not be undertaken before the nose achieves its full growth, anywhere from 16 to 18 years of age. Common sense dictates that the reshaping of any body part, particularly an aspect of facial anatomy, probably should be delayed until that body part has "matured", in terms of growth, and consequently is stable, in terms of appearance. On the other hand, Bilateral Breast Reduction, which, as the name implies, is designed to reduce overly large breasts, can be undertaken at any time during a woman's adult life (again, 18 years of age or older). But, if that woman anticipates breastfeeding any present or future children, she may want to delay Bilateral Breast Reduction until she has established her family and is beyond her breastfeeding years. While several Bilateral Breast Reduction procedures are designed to preserve the lactating ability of breasts, any woman who undergoes a Bilateral Breast Reduction, no matter what technique is employed for the procedure, runs the risk of losing her breastfeeding ability.


Most of those patients of mine who are considering facial cosmetic surgery, particularly "Facelifts", seem to fall into two groups. The first group consists of those individuals who want to look their best throughout their lives and, therefore, are willing to undergo facial cosmetic surgery on a repetitive basis, as needed. The second group consists of those individuals who are willing to commit to one "Facelift" (and perhaps related surgery) but no more. Often individuals in the second group ask me when, in the course of their lives, such surgery will prove most effective in terms of providing them the benefits such surgery is able to provide for as long as possible and at a time in their lives when they are old enough to warrant such surgery but young enough to enjoy the benefits of such surgery. This second group of individuals assumes that each of us ages in direct relationship to our age, that is with each passing year we add a certain number of wrinkles to our face and a certain number of gray hairs to our head, etc. In fact, such is not the case. We tend to age in "spurts". Our appearance may seem to remain static for the longest time and, suddenly, in a relatively short period of time, even only a few months, our appearance changes dramatically, perhaps in conjunction with illness or stress. If you don't believe me, just review photographs of yourself over the past several years and I'm sure you'll come to the same conclusion. Therefore, a "Facelift" which is undertaken just prior to an age "spurt" is not going to produce benefits which are as long lasting as is one which is undertaken just subsequent to an age "spurt". Trying to predict when a "Facelift" will prove most beneficial in the course of one's life is impossible.


However, a "Facelift" undertaken during one's 40s often is much more beneficial than is one undertaken during one's 50s or 60s. My own experiences certainly confirm the foregoing. Cosmetic problems involving the face and neck, such as a fatty neck, if addressed earlier rather than later in life, produce an improvement in appearance which carries through to later years. Even though the aging process isn't reversed by the correction of that cosmetic problem, I think most of us would agree that individuals who are reasonably attractive to begin with (either because they had the good sense to pick the right parents or because they underwent facial cosmetic surgery) continue to remain reasonably attractive as they age. Therefore, the individual who undergoes serial facial cosmetic surgery as needed not only ends up looking as good as he/she can look throughout his/her entire life but also probably undergoes a somewhat lesser surgical procedure every time he/she undergoes facial cosmetic surgery, because the problems addressed at each surgical procedure are not as severe as they might become were such surgery delayed until they are well beyond the point of easy correction. While this last remark may sound self-serving, it is a statement of fact and one with which most plastic surgeons who, like me, undertake cosmetic surgery with some regularity would agree.


For more information about this and other cosmetic and non-cosmetic surgical procedures, please call The Pittsburgh Institute of Plastic Surgery at 1-800-321-7477 or The Plastic Surgery Information Service at 1-800-635-0635.





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Dr. Richard T. Vagley, a Board Certified Plastic Surgeon, is Medical Director of The Pittsburgh Institute of Plastic Surgery and a Contributing Editor of Outpatient Surgery Magazine.

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