When is plastic surgery appropriate for teenagers?

There are plastic surgery operations that are appropriate for patients at any age of life, be it young or old. In fact, certain procedures are indicated or best done if the patient is younger rather than older. Some of this helps avoid emotional scars from teasing by classmates and friends at an early age. An example of this is the ear tuck (otoplasty). A child with prominent ears usually is very aware that the ears are unusual. A parent can be sure that by the time the child mentions it they have already felt some of the criticism just mentioned. It is currently normal to perform the ear tuck operation before a child starts full-time in school, but is old enough to cooperate in the recovery period.

Another example would be a rhinoplasty (nose surgery). Many teenagers have their nose operation after they have finished their growth. This then allows them to finish high school and enter college feeling very good about themselves and confident in their appearance. Just as a person would not let his/her vision go uncorrected, or their dental work untreated, there are certain operations in plastic surgery that are best done for the young person. However, there are other procedures that are really best delayed until an older age unless circumstances are just right. These differences can best be explained by a consultation visit and a discussion with Dr. Lipton.

What Is Ear Tuck (Otoplasty)?

An ear tuck (otoplasty) is one of the operations that is commonly done for children. This is usually done before the child actively starts in school, but also at a time when he/she can cooperate with the recovery process. Almost every child we treat has at some point been teased about their prominent ears. Usually, children are very cooperative and anxious to have the surgery. Pain is not severe. If there is severe pain it usually indicates a need for Dr. Lipton to evaluate its cause.

The operation is done in the operation room with the patient asleep. It generally takes several hours. There is a bandage after surgery to protect and pad the ears. This will be worn for a week. To prepare for the surgery and get ready for the recovery period, the patient should obtain several headbands that will cover the ears for protection after the surgical dressing is removed. These can be the type that is used for winter sports such as skiing or the type that ladies wear for fashion accessories. The ears will be protected for approximately 6 weeks after surgery to prevent an accidental brush coming from behind and tugging the ears forward.

Hearing is not affected by this surgery. For adults considering otoplasty, more flexibility is possible. Often the surgery can be done under local anesthesia in the office. This helps keep the cost down because otoplasty is considered cosmetic surgery if done for an adult. Also, bandaging is not as extensive for adults as they are less vigorous than children.

What kind of results can I expect and how long will they last?

Just as all surgery is customized to the individual patient, so too are the results. People should expect a natural, harmonious and attractive result that blends with their natural body shapes and contours. Attention should be directed not at a surgical result, but to the person themselves! This has been described as emphasizing words ending in “er” and avoiding words that end in “t”. Realistically it may be impossible to make anyone perfect, but just about anybody can be made better.

A deformed, crooked nose cannot be made straight but can be made much straighter. Every person who has surgery should realize that their surgical results will be a marvelous improvement and also that all people are a little different from one side of the body to the other so that no result can be absolutely perfect. In case you are interested, start looking at the faces in magazines, or even better some of their candid shots, and it will be surprising how many of these supposedly perfect images carry flaws when closely examined. The permanence of results varies with surgery performed and the patient. A person who has his/her nose corrected would expect the results to be permanent. Of course, if they have an injury, all of this could change.

Eyelid surgery will keep the puffiness from returning, but every now and then a few fine wrinkles or “crow’s feet” will show up many years down the road. These can often be corrected with a much smaller surgery. In fact, that pretty much sums up the nature of what a patient can expect. By initially reshaping and optimizing the foundations, any touch-ups that are needed, either early or years later, are simpler, less extensive and less costly.

If a man is planning liposuction around the middle, the operation can take just as long as it does for a lady but recovery can be shorter. Usually, there is less swelling if the area for treatment is limited to the middle and does not include the hips, thighs or knees. Since men have not had the muscle stretch associated with children, the tummy tuck for a man requires removal of loose, hanging skin and not muscle reconstruction. Most men having this have had large weight gain and weight loss so there usually is a lot of tissue for removal and recovery for this is just as long or longer than for the ladies.

Is Plastic Surgery Different For Men?

Yes, men are different, even regarding plastic surgery. The overall summary in men’s care for the plastic surgeon is to avoid a result that looks operated or, even worse, over operated. For men, we want to leave them looking natural and vigorous, not artificial. As an example, in nasal surgery, a man will usually want a strong chiseled look rather than the turned up “bobbed” look of a younger girl. Regarding face-lifting, men are usually trying to eliminate a double chin. They are not trying to achieve a tighter look that most ladies prefer for optimizing their cosmetics. This is an advantage for the men because the surgery can be less involved and recovery more rapid.

Around the eyes, men are trying to get rid of lower eyelid puffiness and upper eyelid drooping. Again cosmetics are not their goal. The men want to look rested and healthy. As a note of caution, many men have a less well-developed idea of just exactly what they want from surgery. This has led many plastic surgeons to be extremely cautious when dealing with the male patient.

In our practice, the solution to this seems simple. Have the necessary consultation, use several preliminary visits to really define the goals and then avoid the over operated look. While plastic surgery is no guarantee that a man will get that big promotion, it can help leave a person looking young and physically fit. No doubt the first impression is very much made by a person’s appearance.

How long until I can get back to work?

Plastic surgery is fortunately done in areas of the body that do not have the lingering, severe pain of many other types of surgery. Usually, pain after surgery can be described as achy rather than searing or intense. Patients typically are able to control their discomfort with prescription medicines that can be taken by mouth rather than by injections. By the time a person returns to work 1 to 2 weeks after the surgery, they are usually able to be comfortable with the nonprescription medications. This is the type that is most commonly used for headaches and such. Usually, pain is most noticed in the immediate periods after surgery once any local anesthetic has worn off. After the patient makes it over this initial hump, the recovery seems to settle down into a very manageable stage very quickly.

If intense pain is experienced, this indicates the need to see the doctor for evaluation. It can signal the start of an infection or the presence of bleeding. More than pain, it takes a bit longer for the patient to get used to the change in his/her appearance of body image and become comfortable with that change. Patients will often protect or guard this area for much longer than the pain exists until a change is incorporated into their everyday lives.

How long will it take?

How long it will take can be divided into three categories. First, How long will it take to get ready for the surgery? Second, How long will the actual operation take? Third, How long does it take to recover?

First, and most important, is the preparation for any type of surgery. It is imperative that the surgeon knows the patient well, including the patient’s likes and dislikes. A person’s medical history is very important, even in plastic surgery. For example, a person taking just one aspirin a day for the health of his/her heart can have an increased chance of bruising or difficult bleeding after surgery.

As for the time actually spent operating, many people are surprised to learn that the plastic surgery procedures typically take hours, rather than minutes of the surgeon’s time. When patients stop to think about that, they are usually reassured after they discover just how many steps of surgery will be hidden beneath a fine line of surgical scarring.

Despite the hours in surgery, many patients can go home the same day. If the surgery will be long or the recovery a bit difficult, we urge the patient to stay overnight. This isn’t routine or available everywhere. The surgical recovery, while initially rapid and allowing the person to return to work, really takes months to develop and refine the final result. Bruising and swelling are usually gone between one and two weeks. Depending on the type of job a person has, this will allow them to return to work quickly. There is seldom severely restrictive recovery preventing a person’s return to usual employment. No doubt most people take much longer than this to incorporate the surgical result and its care into their routine lifestyle. A person is justifiably cautious in this early period to protect their good result. I, for one, am certainly glad about that! The swelling will usually be gone in a few weeks. However, refinement in procedures like liposuction and nose surgery will take months to finally show themselves.

How much surgery should I have at once?

Cosmetic surgery procedures are often combined with other operations in the hospital. While the patient is asleep and recovering from one, it is often not much more difficult to recover from cosmetic surgery as well. Valid recent research indicates that cosmetic surgery can safely and effectively be performed in combination with other surgery. Many cosmetic operations take several hours each, so it is reasonable to expect that the overall procedure may take many hours rather than a few short minutes. Nonetheless, this is still safe. Of course, cosmetic surgery will not be performed If some difficulty or complication arises with the first operation causing the surgery to be shortened. Sometimes the patient requires an extra night in the hospital and a longer recovery period than would be expected from one operation alone. Usually, this does not prove to be two or three times the recovery time, but rather just a small increase in time.

What can plastic surgery do for me?

Most people want to know what exactly they will get from the operation. Usually, this is best defined as an improved body image. A person’s satisfaction with themselves is termed self-esteem. The main component is the body image which has several subsets including appearance, physique, hair color and style, and how this adds to and blends with one’s total appearance. A person should be able to expect to wear makeup easier and use less makeup postoperatively.

Many patients say that children have asked them if they feel sad or angry before surgery. We intend to eliminate those comments. Be aware that friends may not realize that surgery has been done. No doubt they will suspect some change, but may initially ask if a patient has had a new hairstyle or a change in makeup. Some people will ask if the patient has lost weight. This may even happen if the surgery has involved the face and neck area. Think of it as a little change on the outside that can lead to a big change on the inside.

No doubt what is on the inside is really most important. But we also know what is on the outside can have a direct impact on how a person feels about themselves, and how other people will react to a person. Your surgery should improve your appearance without drawing attention to itself. Remember, the idea is not to create the new nose, but rather to improve or enhance the one you have and want to have.

Is there “plastic” in plastic surgery?

Rarely are synthetic plastics used. The title “plastic” comes from a Greek word meaning to mold or shape as in sculpture or art. The skin has elasticity and can be shaped and molded artistically.

What does Dr. Lipton actually do?

Many things. Correct the foundation as well as the overlying skin. For example, eyelids that are baggy will have the excess fatty tissue underneath the skin removed as well as shaping the skin. For chin and neck surgery, as done in a facelift, the inner muscle sling is tightened. In nasal surgery, the underlying bone structure and cartilage is shaped to allow the surface skin to drape naturally. Recovery is usually rapid and minimally painful because surgery seldom enters areas of the body causing disability.

Patients are always evaluated completely, both medically and surgically. It is determined if the surgery will actually help the patient or is unnecessary. Is the patient a good candidate because he/she is medically health? Should the patient change or improve anything before surgery: weight, smoking, hair or teeth? The surgery always involves a cut in the skin to allow for trimming or shaping. This means there will always be a scare somewhere. The scars are planned to be hidden after healing is complete. They are camouflage with makeup or hair.

Despite what you hear from the cosmetic industry, there is no potion, cream or medicine that can shrink the skin back to its youthful contour. Psychology Today magazine did a study which showed that a lot of people feel that Mother Nature could have done a better job. People approach this just as they would any other physical problem that they might be born with: like crooked teeth, lousy eyesight or poor hearing. Can you imagine a nearsighted person refusing to get glasses because they are “unnatural” Have you ever heard of someone boast that their crooked teeth give them “character?” Do you have any friends who tell you that their hearing problem is part of their “personality?”

What about my spouse?

It is best if the spouse knows in advance, because they WILL know eventually! Remember, it is difficult to achieve balance as a spouse. Think of these conversations.

Me: “How about cosmetic surgery, dear?” Spouse: “Excellent idea, I have been meaning to suggest it. I can’t wait.” (trying to be supportive) Thought: He doesn’t like me as I am.

Now consider that conversation versus this one.

Me: “How about plastic surgery, dear?” Spouse: “Oh no! I love you the way you are.” (Trying to be supportive) Thought: He won’t let me be all I can be.

Am I too young or too old for plastic surgery?

There are operations appropriate for any age. We will let you know if and what procedures are right or wrong for you. Biologic age is more important than chronologic age. We evaluate the total patient, not just the area in question. Here are some good guidelines.

Young (age 7) – Ear Tuck (Otoplasty) is the correction of protruding ears typically done around the first grade before the child is subject to criticism from his/her classmates.
Teenage (14-18) – Rhinoplasty, the correction of a nasal deformity, is often done in the teenage years, once the growth is completed and the patient’s appearance will be maximally improved. For some people this is about the time their braces come off their teeth.
Early Adult (30s – 40s) – Tummy tucks are often done after the family is completed and there are no more children expected. Liposuction is also popular.
Middle Aged (40s) – Eyelids (Blepharoplasty) are corrected just as the baggy tissue begins to form around the eyelids. This is usually when it becomes difficult to apply makeup.
The 50’s – The average age for a facelift (Rhytidectomy) has changed to the early 50’s. This way the early results are most noticeable and later touch ups are small.

Why have plastic surgery in this area?

Here are five good reasons to have plastic surgery in the area.

  1. Quality: Fully accredited operating room (“not office”). Highly trained medical staff in all phases of surgery and recovery.
  2. Friendly: names and faces you know or can easily find out about. Easily available when you need them.
  3. Convenient: Not just the day of surgery, but the night or weekend after. For example, what if immediate attention is needed. Office appointments suit the working schedule as well.
  4. Cost Effective: Our surgery center has lower prices for cosmetic surgery because of lower overhead. A major consideration is the patient’s own valuable time, especially travel for follow-up visits. We intend to be lower in price than in larger cities. If we are not, tell us. There must be a reason.
  5. Discrete: If you wish or need even if the surgery is done close to home.

Why have a consultation?

A consultation is a quick way to find out what plastic surgery can do for you. During the consultation you will find out if the time is right for you. If necessary, Dr. Lipton will suggest ways to make the surgical results better for the patient – evaluate medical conditions such as diabetes or high blood pressure, stop smoking, lose weight, adjust hair or make-up, see your dentist or dermatologist. Plastic surgery is a big decision, but Dr. Lipton and the staff will do everything they can to make sure it is the right one for you. We will usually visit with each patient several times before surgery to be sure all plans are thorough and all questions are answered.

Does insurance pay for plastic surgery?

The specialty of plastic surgery is actually plastic and reconstructive surgery. Insurance will cover surgery considered reconstructive. Reconstructive surgery involves treatment for skin cancers, breast reconstruction after breast cancer and nasal surgery to improve breathing or correct damage from injury.

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