Are you ever too old for facial plastic surgery? Age, per se, is not a factor, says James E. Zins, M.D., Chairman of Plastic Surgery at Cleveland Clinic. What is most important, he says, is physiologic age — “how healthy you are, how healthy your skin is and the degree to which aging and environmental factors such as sunlight and smoking have damaged your skin.”
He explains that assessing physiologic age is a matter of conducting a thorough patient history and physical exam to determine a patient’s health and to identify any factors that could preclude surgery or require special precautions —issues that are common in an older population. For instance, chronic smoking can compromise function of tiny blood vessels in the face and interfere with proper healing. Because of this, smokers typically are not good candidates for face lifts.
Most patients who use the anti-blood clotting agent warfarin (Coumadin®) cannot undergo surgery because the drug increases the risk of serious bleeding. Chronic aspirin use is common in older adults, and although it does not preclude surgery, it too can cause bleeding. Therefore, patients have to stop taking aspirin approximately 10 days before and after surgery and be monitored closely for bleeding problems.
One big concern among older patients is a sagging chin, says Dr. Zins, a problem that is resolved with a traditional facelift, which uses incisions around the ears. But for various reasons, including cost, potential complications and length of recovery, older patients (80 and above) typically avoid a facelift. The good news is that less invasive surgical options that effectively correct a sagging chin and improve the neckline are available.
“The result is not quite as dramatic as that from a facelift,” says Dr. Zins, “but most patients are glad to have the option and are happy with the results.”
Botox® and injectable fillers -- such as collagen and Restylane® -- are effective non-surgical solutions to temporarily smooth wrinkles around the eyes, brow, nose and mouth. These agents generally work better in a younger population. However, older patients still have an array of non-surgical options to refresh and rejuvenate skin.
“We have prescription and non-prescription topical medications that can improve skin quality and manage age spots, and we have an assortment of resurfacing tools — chemical peels and many types of lasers — that can be used to improve skin quality,” says Dr. Zins.
Before choosing a plastic surgeon, Dr. Zins recommends researching your plastic surgeon thoroughly. Make sure he or she is board-certified and ask around to gauge his or her reputation in the community. Finally, arrange for a consultation and interview the plastic surgeon. “You should interview the doctor,” says Dr. Zins. “If you are not comfortable with his or her explanations, you should seek another surgeon. There is absolutely nothing wrong with a second opinion.”
WEB EXTRA! Anti-Aging Protein – Since Ponce de Leon thought he discovered the fountain of youth in St. Augustine, Florida, there has been a fascination with looking and staying young. But can we really slow the aging process? While one group of Cleveland Clinic researchers is trying to find a way in the lab, another thinks it can be found — on the dance floor. View or download this video podcast at
http://www.clevelandclinic.org/healthedge/video/anti_aging_protein.mp4.
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This document was last reviewed on: 3/1/2007
