Health

Nip Tuck Nation

Does cosmetic surgery make sense for you? Here's what you should ask yourself.

There is so much in my 45-year-old life that I could obsess about: money, career, kids, relationships. But you know what bugs me? My (slightly) droopy, right upper eyelid. Some nights I look in the mirror, pull back the skin there … ah, yes, just so … and think, I once looked like this all the time.

Of course, I can again. And you can, too. Those post-baby boobs, those furrows developing between your brows, those brown spots on your hands — all those can disappear — with enough money and the right doctor. And the right choices. These days, when it comes to updating your aging bod, there are so many choices to consider.

The first, and probably the most important one, is whether you really want to invest your time and money in this effort at all.

Dr. David Sarwer, a professor of psychology at the University of Pennsylvania, conducts research on the psychological aspects of cosmetic surgery. He says there are three questions you should ask yourself before committing to cosmetic enhancements:

1) Do you have a concern that’s readily visible to other people? Is it something your friends and family can see without difficulty?

2) Are you internally motivated? In other words, are you doing this procedure because you think it will make you feel better about yourself, rather than to impress someone else in your life or to make a better impression upon other people (who may or may not notice a difference)?

3) Do you have realistic expectations of the outcome? If you hope this will get you the job that’s just out of reach, or save your failing marriage, think again.

“It’s unlikely that a cosmetic procedure will lead to a Cinderella-like effect on your life,” Sarwer says.

The important time to consider these questions is before you make that first appointment for a physician consultation, he says. The good news is the average patient does mull these issues over, thinking about a procedure for one to two years before having it done, Sarwer says.

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The next question to consider is: surgery — yes, or no?

Surgery corrects “bags and sags,” says Dr. Robert Kotler, a plastic surgeon in Beverly Hills, Calif., and author of "Secrets of a Beverly Hills Cosmetic Surgeon."

“Bags under the eyes, beginning of a double chin, jowl formation — these are reflective of lack of elasticity,” he says. “The upholstery’s getting a little weak.”

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Surgeons can lift or drop, tighten and sculpt features headed in the wrong direction. So if you want to get rid of that muffin top you sprouted after pregnancy no. 2, a surgeon can do a tummy tuck. Want the fat sucked out of your thighs? See a surgeon for liposuction. Reshaping your nose, your bottom, your breasts, or any other part of your body is a surgeon’s territory. The physician’s fees for such procedures — that’s before you add in expenses like the facility costs and anesthesia — run, on average, from $2,000 to $7,000 and beyond, according to the American Society for Aesthetic Plastic Surgery (click here for ASAPS’ chart breaking it down by procedure).

Why slice and scissor, though, if you don’t have to? Of the more than 14 million Americans who underwent some kind of cosmetic enhancement last year, 13 million opted for the cheaper, faster and generally less traumatic non-invasive procedures, according to the American Society of Plastic Surgeons.

The most popular of these procedures may be Botox. That’s a toxin that physicians inject under the skin to temporarily paralyze facial muscles and reduce wrinkles. It’s most commonly used in the forehead and between the eyebrows, where those worry lines develop. But these days, that’s only the beginning.

There are also injectable fillers that plump up lips, cheeks and other areas that narrow and furrow with age; laser and radio frequency treatments to blaze away dark spots and fine lines; chemical peels to smooth out skin tone.

And this whole revolution has happened in just 11 years, since the FDA approved Botox for commercial use in 2002. Before that, “it was either plastic surgery or let nature take its course,” says Dr. Jessica Wu, a Los Angeles dermatologist and assistant clinical professor at the University of Southern California. “Now we can improve a person’s appearance without having to take time off for surgical recovery.”

Wu, whose practice is 85 percent cosmetic work, says when she first started doing this work a decade ago, “the goal was to wipe away all wrinkles and end all movement. But people today want to have a more natural look. They don’t necessarily want their friends, or even their spouses or partners, to know they’ve had anything done.”

These non-invasive procedures typically start at $400, and the effects can last anywhere from three months to several years, depending on what you are doing and how your body reacts, according to ASAPS.

And it’s so easy — particularly in major population areas — to get something done. Internists, OB/GYNs, even orthodontists offer Botox and other treatments, which patients must pay for in cash and also which generate income far beyond what insurance pays for regular medical office visits. But be careful — not all providers are equally skilled.

“Look for boutique practices,” Kotler says — in other words, someone who specializes in the exact kind of work you want to have done.

“Repetition,” Kotler says, “breeds excellence.”

   
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