Making changes for image and health

Making changes for image and health

What used to be an almost taboo subject, cosmetic surgery, is
coming out of the closet, and more and more people are taking
advantage of its benefits.
What used to be an almost taboo subject, cosmetic surgery, is coming out of the closet, and more and more people are taking advantage of its benefits.

Years ago, comedienne Phyllis Diller openly joked about her many facelifts, while other celebrities, who no doubt had had some procedure or other, kept their mouths shut.

Now people appear on shows such as “Extreme Makeover,” discounting the embarrassment factor to reap the monetary benefit of having someone else foot the bill to cosmetic benefit of improving their looks.

Last year, nearly 11.9 million surgical and non-surgical cosmetic procedures were performed in the United States, a 44-percent increase over 2003. According to information recently released by the American Society for Aesthetic Plastic Surgery (ASAPS), the number of non-surgical procedures, such as laser hair removal, chemical peels and microdermabrasion, increased by 51 percent, and surgical procedures increased by 17 percent.

A. J. Matthews, M.D., a plastic and reconstructive surgeon in Gilroy, said that in his practice, procedures are “seasonal:” some times of the year certain procedures may be more popular – or at least more requested – than others.

Overall, he said, he sees more requests for what he calls “body contouring.”

“Liposuction, tummy tucks, breast reductions and augmentations, breast lifts, all procedures that shape the torso and lower body, that’s what I probably do most,” Matthews said.

While his three-year practice has grown, Matthews said he believes the growth is as much word-of-mouth referrals as an increase in awareness and acceptance.

“I’m sure there’s some of both,” he said. “But while television shows that focus on cosmetic surgery can be good for business, in that they make people aware of options that are available, they can also set up false expectations.”

An important part of what he does is talking to patients beforehand, learning their reasons behind an interest in a particular procedure, and determining what their expectations are, Matthews said.

“I can only work with what I have to work with,” he said. “On some of these television shows, the makeover candidate not only has cosmetic surgeons involved in the makeover, but also expert hairdressers, makeup artists, aestheticians, the whole makeover team.”

But, he dismisses the idea that cosmetic surgery in general is frivolous.

“When I have a patient who has worked and saved money and focused on her children to raise them, and then, when they are grown, wants to spend some money on herself, on mitigating in some way the effects bearing children had on her body, I feel good that I can help her with that,” he said. “Just as I feel good to do reconstructive work on someone who has been injured or someone who has had cancer.”

Melody Lynd, M.D., who practices in San Jose, said she “does a lot of breast work,” although she does do facial work and other body contour work.

“I guess some women come to me initially because I’m a female,” she said. “I do a lot of breast work, reconstructive work, as well as augmentations and reductions.”

Lynd agrees with Matthews that whether the surgery is cosmetic or reconstructive, it is important that the patient understands what will happen during and after the procedure, possible complications and the limitations of the procedure. And that the patient has support before and after the surgery.

“Many times, I bring them both in, the patient and spouse or significant other,” said Lynd. “I really like that when (the partner) is supportive. Patients need support, especially during the healing process. I remember one patient where I was doing my fellowship, and her husband was totally opposed to the procedure. She was in tears.”

A good plastic surgeon, Lynd said, will not show up only on the day of the surgery.

“I spend a lot of time with my patients,” she said. “Before the procedure, after the procedure. I call the night of surgery to check on the patient and sometimes do a house call if I need to.”

Jennifer Tate of Morgan Hill was getting ready for a procedure to remove extra skin from her eyelids, called blepharoplasty. A dermatologist is performing the surgery, and Tate said she expects to be “out and about” after just a few days.

“Basically, they cut out an inch’s worth of skin and then stitch the area back together,” she said. “I’ve been toying with the idea for over two years. I’m in control of my diet and exercise, my physical well-being, but this is something I can’t control. I’m tired of looking like my eyes are partially closed; my left eye in particular just seems to want to stay closed. I’m tired of my eyes looking tired.”

Tate said the procedure would cost her about $2,500.

Doing your homework is important, Tate said.

“I’m not worried (about the procedure),” she said. “You really need to know who’s doing it; it’s very important that you really trust the person, to know exactly what will happen during the procedure.”

Two weeks before and after, Tate said, she cannot have any aspirin or aspirin products. She also must abstain from alcohol and take vitamin K, get lots of rest and exercise.

“All of that, being healthy, too, will help me heal faster,” she said.

Afterwards, she’ll have to keep ice on the swelling for 48 hours, 10 minutes on and 10 minutes off. Her husband, Steve, was supportive in her decision to have the procedure and will help her while she is recuperating.

“It’s important to have that support,” she said. “You need to have that support, both emotionally and physically.”

Thomas Zewert, M.D., who practices in Hollister, agrees that support is important for these patients. He, like Matthews and Lynd, believes it is very important to spend time with the patient before the procedure.

“Pathology-wise, there can be depression, someone who goes through a divorce or major life crisis, that might do something they normally wouldn’t do,” he said. “I ask a lot about people’s personal lives.

“For example, is it (the surgery) for themselves or is there external pressure from a family member, friend, significant other. I think there’s a lot of common sense that needs to be applied, and I spend a tremendous amount of time with this.

“Related to this is expectations. Unfortunately, it sometimes doesn’t do us any good to have shows like the ones we see on television. Some are responsible, some are borderline … Once I feel I would not be helping the patient, I can’t do that. I lose a good number of patients who say, ‘Dr. X says he can do this for me.’ ”

All three doctors agree that it is vital for patients to check out the surgeon before they decide to go through the procedure. Some doctors have “before and after” pictures of patients; some will give prospective patients’ numbers to former patients who are willing to talk about their surgical experiences.

One important question to ask is if the doctor has general surgical training.

“The only way to be 100 percent sure you won’t have complications is not to get on the table,” said Matthews, who trained in San Francisco, New York City and Minneapolis. “That possibility always exists. And, if it happens, you want a doctor who knows how to deal with it. Training is very important.”

Board certification is very rigorous and is a good way for patients to be sure a doctor is qualified to deal with complications, should they arise.

“The American Board of Medical Specialties, an American Medical Association- sponsored organization, creates the boards for all specialties and certifies the boards,” Zewert said. “There is one board for plastic surgeries that the American Board of Medical Specialties certifies, and that is the American Board of Cosmetic Surgery.”

Ninety percent of the total cosmetic procedures last year were performed on women – women received nearly 10.7 million procedures. The top five surgical procedures for women last year, according to ASAPS, were liposuction, breast augmentation, eyelid surgery, tummy tuck and facelift.

Men last year received 1.2 million procedures, or 8 percent of the total, an 8 percent increase over last year, according to ASAPS. The top five surgical procedures for men last year were liposuction, eyelid surgery, rhinoplasty, male breast reduction and hair transplant.

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