Q and A with Dr. Rothaus

Can I look younger and better without surgery?

Even with the healthiest of lifestyles (a balanced diet, no smoking, limited sun exposure, plenty of rest) and the “right” set of genes, you cannot prevent the normal progression of the aging process. Fortunately, today there are many laser and surgical procedures that, in the hands of an experienced professional, are extremely safe, require minimal healing time, and can help you achieve and maintain a more youthful appearance. For the best result, you should go to a doctor who can offer a wide variety of surgical and non-surgical options so the treatment can be customized to your needs.

When do I start?

Today, many plastic surgeons believe that you should consult with a professional as soon as your face begins to show signs of aging. Patients who start sooner (early 40’s) and undergo a series of less extensive or “mini” procedures over time achieve a more “natural” looking and better result. If you wait until you are older and the changes are more extreme, the plastic surgeon has to make more extensive adjustments, making a “natural” look much more difficult to achieve.

How often do I have to do it or and how long does it last?

Since aesthetic procedures are elective and tastes and priorities vary widely, it is up to the individual to decide how often to undergo treatment. How long a procedure will last is affected by many factors, including the nature of the procedure, the rate at which the patient is aging, the age when a certain procedure (like a facelift) is performed. For example, ideally, a facelift should last at least 5 to 10 years. However, a patient who undergoes their first facelift when they are in their late 60’s or 70’s may require a “touch-up” or mini-procedure the first couple of years afterwards because of the reduced elasticity of their skin.

Do I have to look “done”?

Absolutely not. But, what defines “done” varies greatly among both patients and physicians. In fact, for some, having a facelift is a status symbol, which they see no need to hide. For them, a more “natural” look may not be enough of a change. The key is communication, which is one reason why the choice of doctor is so important. Your plastic surgeon should understand your goals and give you a realistic expectation of what to expect.

What can I do to make it last longer?

The best advice is the most obvious: Follow a healthy diet and lifestyle, including exercise, sun protection, and smoke avoidance.

Are breast implants safe?

Since the early 90’s, when the FDA first took silicone breast implants off the market there has been enormous controversy in the media regarding their safety and durability. For the last decade, silicone implants have only been available to those women who were undergoing reconstruction after cancer surgery or who were being reconstructed following complications from other related procedures. In 2005, the FDA gave approval to the Mentor Corporation to start manufacturing silicone implants for all patients and indications. This approval was given because all the extensive studies and detailed patient follow-up and review did not reveal any significant risk to the patient. As with any medical device, implants can be associated with complications such rupture, infection, and hardening. Although these risks are small, they should be discussed in consultation with the implanting surgeon.

Do I have to go into the hospital?

The majority of the commonly performed cosmetic procedures can now be done as an out-patient and do not require admission to a hospital. Patients can usually go home to their own beds the same day. The American Society of Plastic Surgeons has mandated that all of its members who perform surgery outside of a hospital do so in a surgicenter or office setting that has received accreditation from a nationally recognized accrediting agency such as the AAAHC, JACHO, or AAAA.

Do I have to have general anesthesia?

Most cosmetic procedures, including a facelift, breast augmentation, liposuction, rhinoplasty (nose job), and a tummy tuck can be done using either a combination of “twilight” anesthesia (intravenous sedation in combination with local anesthesia) or regional anesthesia (epidural and spinal blocks). General anesthesia is best saved for those patients who may have problem airways (the anatomy of the back of the throat and trachea) or are undergoing multiple procedures and those requiring turning of the patient or difficulty positioning during the procedure.

When can I go back to work/exercise/sex?

This varies by the procedure and is best discussed with your surgeon. In general, however, patients can return to work within one to two weeks following their surgery. Activities requiring physical exertion, such as exercise, usually require three to six weeks of abstinence after the surgical procedure.

Are the scars visible?

Plastic surgeons are trained to not only close surgical incisions that result in scars as imperceptibly as possible, but also to plan the location of these incisions so that they are well hidden. The current trend in aesthetic surgical procedures is to make the incisions as short as possible (minimal incision surgery).

How do I choose a surgeon?

You can contact the American Society of Plastic Surgeons or the American Society of Aesthetic Surgery. Either will recommend a board certified plastic surgeon who is a member of the society. You can also ask your own physician for a recommendation. Friends or acquaintances who have undergone the procedure and are happy with their result, however, refer most patients.

What are the complications of the surgery?

Potential complications vary depending on the surgery and should be discussed with your surgeon prior to the procedure. Certain complications are common to all surgical procedures, such as bleeding, scarring, and infection—in addition to those associated with anesthesia. It should be noted that the absolute percentage of complications for most aesthetic surgical procedures is very small.