Nipntucks Sooner or Later?
June 23rd, 2009
Today is injection day at my office. Botox ® and Restylane ® fillers will be injected to help reduce the effects of aging. Generally Botox ® is injected around the eyes and forehead to reduce wrinkles. The filler materials are injected into the lower face and lips to counter the aging changes. These do wonders with little or no down time, but they are temporary fixes. Eventually, surgical measures will need to be considered, to maintain a youthful appearance to the face.
Facial rejuvenation surgery will improve many of the same conditions which injections improve, but provide the patient with a more long-lasting change. Forehead lift surgery reduces the need for botox ® and face lift surgery acts to reduce the need for Restylane ®. So when is the time to consider these surgeries?
As a general guideline, patients often consider surgery when the annual expense for injections reaches 10% of what surgery would cost. Most rejuvenation surgery lasts at least 10 years before the aging process catches up. However, most surgery lasts significantly longer, before signs of aging return. If you are spending more than 10% on these quick fixes, you most like likely would benefit from the surgery.
There are certain conditions where surgery is not an adequately remedy. In fact, crows feet are very difficult to treat with surgery. Botox is best for these fine lines around the eyes. Similarly, injections are well-suited as a remedy for thin lips. It is my opinion that the surgical option for thin lips looks too artificial or “done.” Finally, the fine lines on the lips respond well to injections without the skin bleaching that is often cased by deep chemical peels or laser resurfacing. As with any cosmetic procedure, I encourage my patients to understand their choices.
Stars Not Scars
June 20th, 2009
Sky News report of a Belgian teenager getting a facial tattoo is remarkable. The teenage girl claims she asked for three stars on her face, but ended up with more than 30 after she fell asleep at the tattoo parlor. She is now stuck with the permanent marks prominently displayed on her face. Even with the best laser removal, there will most likely be some form of scarring of her face and shadows from incomplete ink removal.
Tattoos are a cultural phenomenon. Traditional cultures in the South Pacific have utilized this permanent skin marking for centuries. It is an integral part of who they are. Tahitian tattoos frequently will chronicle a person’s life journey, including particularly notable events. Maori mokos are a sign of social status worn on the face. These are the cornerstones of social acceptance. Captain Cook’s discovery of this practice and subsequent introduction into the western world is relatively recent when compared to these ancient Polynesian traditions. The recent appearance in our pop culture during the past 10 years, can only be described as a fashionable fad. It is hardly part of our cultural fabric and tradition.
The real problem arises when tattoos are chosen outside a real tradition or cultural significance. In the West, relatively little thought is generally given to the ramifications of a tattoo. They may often be chosen on a whim, due to peer pressure or possibly consent given under the influence of chemicals. Ask any World War II veteran about their tattoo and you will usually hear a story of alcohol consumption as part of the ritual. However, for the soldiers, these occasions served as a symbol of their military service and a bond of fraternity.
The young lady who ended up with stars on her face is an extreme example of bad judgement and while certainly tragic, I am skeptical of her story. It is very difficult to fall asleep as she reports, when facial skin is stimulated in this way, unless she was medicated or intoxicated. The account given by the tattoo technician doesn’t match her story, so the actual sequence of events is unclear. None the less, she must live with the consequences.
Tattoos are a personal choice. Just like any cosmetic surgery procedure, really. The long-term implications must be weighed within the society and culture you reside. Gang tattoos are no exception. This was brought home to me while I was removing gang related tattoos as a volunteer, free of charge. The tattoos symbolized the membership in a gang. The people I saw were those trying to break away from gangs. Any visible signs of gang association hindered them in their goal to get a job and start a fresh life. Once the telltale markings were removed, they had a much greater chance at life outside the gangs. Removal is painful and very expensive lasers are needed to lighten the tattoo ink. Several visits are required, making the final bill to remove a tattoo costing several hundreds of dollars.
Unless culturally consistent (Tahitian life event tattoos or Maori mokos), the long term connotation and denotation meanings must be carefully weighed before making any long term or permanent physical changes.
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