“You may not be able to turn back the clock, but you can wind it up again!” – UnKnown.
The term plastic surgery evokes a number of negative emotions and stereotypes. I blame that to the patients and doctors who took the needle too far and performed surgeries or treatments that we all make fun of. The Art is when the surgery is performed with finesse and expertise that people focus on appreciating the new you.
The practice of plastic surgery exists since 600 BC and indeed like many other things India gave to the world - The first reconstructive surgery was performed by Sushruta in India. He is considered the father of Indian medicine and also the father of Plastic surgery. His teaching of anatomy and therapeutic strategies has been described in Sushruta Samiha. His technique of Nose reconstruction can be traced throughout the literature from his depiction within the Vedic period of Hindu medicine to the era of Tagliacozzi during Renaissance Italy to modern-day surgical practices.
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The primary aim of Plastic surgery was to Reconstruct, Restore or Enhance the appearance of the target area. As science and experience have evolved – today the field is plastic surgery is capable of much more. A Plastic Surgeon indeed is able to preserve basic human functions – such as movement of muscles, reconstruction of veins, etc.
Is it only for the young? Absolutely not. Over the last 26 years of my practice – I have performed surgeries on patients as young as 1-month-old and the oldest patient I saw was 97 years old. Age is not a contraindication for any surgery be it Reconstructive or Aesthetic/Cosmetic surgery.
One would say, why bother after 60. It’s time to retire. Rather plastic/cosmetic surgery for older people – over 60 is fairly routine in most developed nations and is also catching up in India. The only prerequisite is the basic health of the patient. They should not have any major underlining issues. Specifically talking about the healthier, active lot. They indeed want to overcome the challenges of ageing and embrace the opportunities available to them to continue living an efficient, energetic and prettier life.
Over the years, I have come across thousands of patients, I can categorise them on five brand buckets.
1. Ones who want to look fresh and energetic
Ageing causes a lot of changes in the face of a person. The years of sun exposure causes pigmentations, wrinkles, age spots etc. Often people complain of tired and haggard looks despite having good sleep or living healthy. They want their undereye bags reduced, wrinkles reduced, skin improved. Women obviously being more concerned than men undergo more procedures than men. Depending on the individual’s problem, there are different procedures to reduce wrinkles such as fillers, neuromodulators, lasers and finally facelift, neck lift and eyelid lift that can take years of their face.
An interesting report was published in 1994 by M Goodman Min a journal of Aging Studies. He interviewed several women from 29 to 75 years and concluded that younger women were mostly concerned about the appearance of their bodies, whilst the older women were preoccupied with their faces. In particular, the older women disliked wrinkles and drooping skin and had undergone facelifts, chemical peels, and chin tucks.
2. Very Common is a Career Boost
I had a 62 years old male wanting to have a facelift surgery. During the detailed consultation, I asked his reasons to undergo such a procedure. He said he was a professional all his life and has years of wisdom and knowledge but has lost opportunities to younger looking people. He was fit, a regular gym visitor and he wanted to get back in the race and hence he wanted to look younger. Any well-performed procedure significantly increases one’s self-confidence, they no longer feel threatened by younger competitors.
On the other hand, people who are in media and glamour industry such as Bollywood has an obligation to look good, people expect them to have a certain superwoman/man image. These senior Bollywood personalities spend a lot of resources on their aesthetics – from Hair transplant to a facelift or even tummy fat removed – is fairly common.
3. Fitness freaks
60 is the new 40. I have seen many people in their 60s who can run a marathon, weight lift or cycle for hours. They are fitter than an average 30-year-old. Years of hard work in the gym pays back in old age. This lot does not mind seeking help in getting their hair back or gaining a few years through a facelift laser treatments, simple fillers and botox injections. Given the sagging skin due to age, they also go for treatments that can help them get a trimmer and aesthetic torso such as = Liposuction, Vaser Liposculpting, etc. I once had a patient who at the age of 60 wanted some loose skin tucked away so his photo shoot appears immaculate.
4. A New Start
This is indeed common reason in patients irrespective of age. I have had many patients who want to start something new either in their career, business or relationship. People in this bracket are open to a more extreme procedure, as they are typically looking for a major transformation. However, patients over 60 are more, as they are the ones who typically have made their livelihood and can afford the cost of plastic surgery.
5. Limited by injury or ways of life
Reconstructive plastic surgery is entirely a different spectrum that is performed on a need basis. I have operated on several people in their 80s and 90s who were bedridden and suffering from pressure sores and chronic wounds. The key thing is to make the procedure simple and safe and yet solve the problem. Technologies like VAC (Vacuum-assisted Closure) help to shrink the wounds, however large and deep, and allow simple closure methods.
Skin cancer, accidental injuries, burn wounds are some of the conditions I have performed plastic surgery for the millennia’s.
Rhinophyma or Potato nose is a very unusual problem elderly people face. The sebaceous glands of the nose skin are enlarged and thickened causing lumpy growth or enlargement of the tip of the nose. This is best treated by ablative laser or radiofrequency.
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