You’re Not Your Mother’s Fifty

Looking into the mirror do you see the visage of the fierce, confident, beautiful, sexy woman you are? Does your neck and skin display the woman you feel inside? Jowls and lax skin creep into a picture where it doesn’t belong.  You don’t feel it, you don’t live that life, and you sure as hell don’t have to look it. While patients flock to plastic surgeons to boost their self-confidence and improve their image by enhancing their breasts, nipping noses, tucking tummies – necks and our skin are more often ignored or forgotten about until we hit that age of menopause. It is around that time that the neck and our skin is one of the first places we start to show signs of age.

Menopause

Hot flashes, night sweats, the changes can be rather overwhelming. Menopause can drink dry the youthful feelings in women, throwing additional stresses at women as they age. Dr. Roberta Gartside, a plastic surgeon and owner of New Image Plastic Surgery, explains that “as we age our skin’s supportive tissues, collagen and elastin, break down in our system causing our skin to lax and sag”. It is the changes in our skin that tends to be the most visible signs of aging as we are always presenting our face to the world, our family and friends and ourselves in the mirror. 

Estrogens stimulate fat deposits over the female body giving younger women an allover fairly equal distribution. But as the estrogen levels drop during menopause, fat deposits tend to become redistributed to a more pear shape with concentration over the abdomen, outer thigh (trochanteric) and upper buttocks (muffin top). The result of that redistribution is a loss of supportive fat below the skin of the face, neck, hands and arms; this allows sagging wrinkles to appear. In some women the fat deposits are reduced in the breasts, resulting in loss of fullness which causes the breasts to begin to sag and flatten.

Estrogens also effect the production of proteins, such as collagen and elastin.  Thus, during menopause, the lowered estrogen levels result in less production and repair of collagen and elastin in the dermis of the skin. This lack of repair is particularly pronounced if the skin is exposed to ultra violet (UV) rays. UV rays are very destructive to collagen, and if we lose our repair mechanism, then we lose our skin’s resiliency. This results in elastosis or very wrinkled skin.

The growth and maintenance of blood capillaries in the dermis are partially under the control of the estrogens. Thus, blood flow through the superficial skin capillaries is reduced during menopause, and less nutrients and oxygen are available to the layer of the skin producing new skin cells. This contributes to the thinning of the epidermis and a slower cell turnover rate, which is accompanied by a reduction in the barrier function of the epidermis, leading to increased trans-epidermal water loss and dry skin.  Another thing that happens is the bonds between the cells that release when the cell has aged and should shed (think of what happens inside a cast when it comes off) do not break causing a build up of dead cells on the surface of the skin leading to a duller look.

Look at what happens this way.  The walls in and on our house, pick up dinks from moving furniture, discoloration from when Junior crayoned them, and the color has faded for years of sun exposure. The floor can become uneven with wear and loss of support to the porch can make it buckle and collapse.  While we can cover up and patch up chips of paint, wash the crayon off our walls; there is nothing like a fresh coat of paint in your home. It makes a room come alive again younger and fresher looking.  Shoring up the floor boards and porch help to remove those signs of an older home.  Like the surfaces in our home our skin, neck, and face tell a story showing the effects of time and gravity. There is not just one thing, but a combination of repairs to renovate a house.

The Makeover

A makeover can take years off your face and skin and revive the youth you feel. Dr. Gartside explains and promotes enhancements based on your own personal goals and wish. Those enhancements could come in the form of surgery such as neck and/or face lifts, and blepharoplasty or non-surgical procedures such as laser resurfacing and chemical peels. 

A neck or face lift is a set of procedures which enhance the appearance of the neck and lower face by removing excess skin and tightening muscles, the use of liposuction, and fat injections in areas of volume loss help remove some of the first seen signs of aging which occur in the neck and jowls by addressing the Turkey wattle, excess fat and skin.

Blepharoplasty corrects defects and aesthetically modifies the eye region of the face from the eyebrow to the upper portion of the cheek. With the removal and reposition of tissues Dr. Gartside smooth’s the underlying eye muscles, tightening the supporting structures, and re-draping the fatty area of the eye to smooth the transition from the lower eyelid to cheek, removing wrinkles.

Non-invasive procedures such as laser resurfacing and chemical peels seek to alter the condition of the skin's surface removing blemishes, acne scars, and sun damage. Chemical peels are applied to the surface of the skin which over 1-14 days sink into the tissue causing the skin to die and peel away. Laser resurfacing uses concentrate pulsating beams of light to remove skin layer by layer with precision. Individuals with darker skin complexions or currently suffering from acne may not be good candidates as treatments may cause skin bleaching and damage to the surface lay of the skin.  There are several laser techniques and many types of chemical peels, discuss with Dr. Gartside or your plastic surgeon what type of resurfacing is correct for you during your consultation.

Do Your Homework

It is important to consult with your healthcare professional; Dr. Gartside says that “individuals with a clear idea of their areas of concern meet the highest levels of success”. Many healthcare providers are performing varying forms of cosmetic surgery but that does not mean they are all plastic surgeons. Cosmetic surgery is an important decision in life and should be considered carefully. Consult with a professional who will work with you in a trusted manner. Becoming an educated consumer is the first step towards a successful procedure.

Look for the ASPS or ASASP Member Surgeon logo with your doctor. These plastic surgeons are specialized and operate only in accredited medical facilities and adhere to a strict code of ethics. Members must fulfill continuing educational requirements including new technologies, procedures, and patient safety techniques. Make sure your surgeon has these outstanding qualities.  

By Stephen J Silverstein