Plastic surgery treatments should be divided into surgical and conservative treatments, i.e. those in which our patient undergoes surgery, and those in which other methods are used that have nothing to do with the surgical scalpel.
Furthermore, given the progress of plastic surgery, we should distinguish between preventive and rehabilitative treatments.
The first ones have to do with preventing a condition and mainly concern the regeneration of the skin, the enhancement of elasticity and the improvement of skin firmness and the second ones with the correction of our plastic surgeon, something that has already been installed or that has been present.
Age 16-20 years
Teenagers at this age usually have problems with acne, or acne scars or even simple acne skin roughness. In addition to treating the acne itself, the plastic surgeon can offer treatments that aim to improve, eliminate or even eliminate the scars as well as the roughness of the skin.
Such treatments are autologous mesotherapy , lasers, microdermabrasion and chemical peels. Mesotherapy and lasers are based on the stimulation of the normal collagen production process, i.e. they activate the body to intervene on its own and start the healing of the area, i.e. the production of collagen. There are also lasers that cause mechanical removal of the skin layers, as well as other technologies that have the same effect. This will result in a gradual improvement in the quality of the skin, ‘filling’ small scars, softening deeper ones and eliminating the more superficial ones. Mesotherapy has more immediate results than laser, and requires three sessions initially , one every month for three months and then repeats as needed. The result starts to be seen in one to three weeks after the first session . Improvement will be seen up to 6 months after the end of the treatments.
Microdermabrasion and chemical peels are based on removing the surface layers of the skin so that the new skin produced is free of scars and roughness. Microdermabrasion removes the layers with an electric scraper while chemical peeling uses special drugs that cause a surface burn on the skin so that the new skin is free of the problem. It definitely cannot be used for very deep scars. At very young ages we avoid these two treatments , which have their place a little later and after the acne issue itself has passed.
At this age, young men and women come to the plastic surgeon during puberty and mainly towards the end of puberty, asking for surgical repair of problems such as otoplasty (surgery for floppy ears), breast asymmetry – anisomastia (cases where the two breasts do not develop in the same size and shape), breast augmentation, breast lift and breast reduction.
With the full development of the girl’s body at the completion of puberty we are faced with the body image that because of our genes we will carry for the rest of our lives. At this moment it is possible that we are confronted with body morphology that does not satisfy us and it is here at the end of puberty that young girls come to us asking for a solution for anisomastia (different size of the two breasts and also shape many times), megalomastia (large breasts), hypoplasia of the breasts (breasts that have not developed normally).
Even in young men, male megalomania is common at these ages. This is an increase in the size of the breasts of varying degrees, from a small increase to the development of a normal female breast size.
Surgery should be performed after the body has grown. In Cyprus, the preferred age is 18 years old before a young man serves his military service.
Otoplasty can be performed at a younger age, most often the age of 5-6 years is preferred before the child starts primary school.
Also at these ages, sometimes a request for rhinoplasty due to deformity of a nose is encountered, but usually these procedures are done after the age of 18.
In the 20-30’s
In this decade it would be good to anticipate what the next decade will gradually bring. After the age of 26-27, care with conservative skin treatments that aim to boost collagen and elastin, thereby stimulating skin hydration, will help to maintain the youthfulness of the skin. Such a treatment is autologous mesotherapy, or Vampire therapy as we may encounter it, due to the taking of blood from the person himself. After the blood is taken, it is specially treated with a special separator used and centrifugation . The separated blood plasma is then injected into the face and the platelets (normal blood component) found in it stimulate skin regeneration. This treatment will be found in all ages, it is a treatment that if followed throughout one’s life will take care of one’s skin in the best way. It is done as I explained before, one session every month for three months (three consecutive sessions) and then every six months a repeat session. This repeat every six months will make a big difference to the quality of the skin. It will keep our skin in good hydrated condition, do regeneration where needed , delay wrinkles from appearing, even help the various scars that the face has as a result of the sun’s effect and will also help to a great extent the dark circles around the eyes.
The result starts to be seen in one to three weeks after the first session . Improvement will be seen up to 6 months after the end of the treatments.
Surgical treatments of this decade are rhinoplasty, breast augmentation and breast lift. After the full development of the body is now seen the size that the breasts will have and that has nothing to do with age . Therefore we can intervene and give what will help the young woman feel better about her body. Also liposuction , brachioplasty , thoroplasty and abdominoplasty are procedures that we have been seeing in recent years in this decade and in the next, especially after bariatric surgery, i.e. procedures to treat obesity. After the loss of kilos and the sagging of the skin, these surgeries come to bring the body back to its normal state.
In the 30-40s
At the beginning of this decade, it is possible to carry out some therapeutic operations to prevent the formation of wrinkles, or even to minimize them, such as the use of botulinum toxin (botox – dysport).
These treatments should be repeated every six months.
Even to continue or even start using mesotherapy, whether it is autologous (as we mentioned in the previous decade) or as mesotherapy with hyaluronic acid, vitamins and other skin hydration enhancers. In this way the quality of the skin will be improved. Also this treatment should be repeated every 6 months.
Also at the end of this decade, injectables such as hyaluronic acid can be used to restore the first signs of skin relaxation or to cover the first wrinkles.
The hyaluronic depending on their type can last from 6 months up to 2 years and there are even some with a longer duration
The use of lasers can also improve the quality and tone of the skin.
These treatments aim to delay the first signs of skin ageing.
Liposuction is a procedure for which people of this decade and the previous decade mainly come for. Many times after decisions of body renewal, weight loss, better physical condition, there remain some points that need the intervention of such a technique to obtain the desired body.
In this decade and in the decade to come, procedures are often performed that have to do with the changes in the body that pregnancy brings about. These include breast lift (after the sagging that occurs), breast augmentation (after the “loosening” that occurs), abdominoplasty (after the loosening of the abdominal walls with the changes in the body).
Age 40-50 years
This decade is characterised by a decrease in collagen production and the onset of skin ageing. The reduced production of collagen will result in a decrease in skin elasticity. What characterises the 40s is the gradual ‘sagging’ of the face, and the progressive atrophy of the facial fat cells.
The removal of wrinkling can be achieved with the use of botulinum toxin (botox-dysport-vistabel).
The relaxation of nasolabial folds can be treated with injectable hyaluronic acid preparations, as well as the filling of facial wrinkles. Often a combination of both is needed to achieve the desired result.
A new treatment that is currently available to us and comes to give us a lot of promise in relation to the treatment of sagging and wrinkles is the stem cell treatment. This is a slightly more invasive treatment but can be done in the clinic. Under local anesthesia we take some fat or a piece of tissue from an area of the body, centrifuge it in a special and again separating tool, and then reposition the fluidized fat or the serum which carries the stem cells, in the areas we want to fill and regenerate. Treatment with excellent results, both in terms of regeneration and simultaneous filling of our wrinkles from our 40’s and up. The effect is immediate as far as filling is concerned and as far as regeneration is concerned which starts in about a week to six months. The treatment is done once and can be repeated when the skin relaxes again over time, as many times as needed.
In this decade the areas around the eyes begin to loosen and the need for blepharoplasty first appears.
This is the first operation requested at this age, blepharoplasty of the upper and lower eyelid (the request for the lower eyelid usually appears a little later, except in some cases that coexist from the beginning).
In this procedure, the extra skin that is the result of relaxation is removed, as well as the fat that causes the eyelids to become “baggy”. A scarless procedure that helps to make the look more radiant because the extra skin is released.
As we said before, the main procedures performed beyond the facial area in this decade are breast augmentation, breast lift, in combination or not with reduction, abdominoplasty, liposuction.
Age 50-60 years
In this decade we usually look older than we feel and this is very much visible in the face. Deeper wrinkles have appeared on the face, the “facial sagging” is much more pronounced. The skin of the neck is loosening and now comes the sagging , as well as a lot of times the double chin.
What also happens is that volume is lost from the cheeks, the temporal regions and the areas above the eyebrows.
The conservative methods we talked about, stem cell therapy, mesotherapy, hyaluronic acid, etc. certainly help to improve all this and especially if the treatments are started in time.
All the regeneration treatments we talked about earlier should continue so that the skin can be toned and strengthened in this difficult decade.
Surgically it is the time when a woman needs a facelift so that the face can regain its youthfulness.
Also blepharoplasty is a suitable procedure to be performed during this period of time.
At even older ages
We aim to maintain the quality of the skin and therefore continue all rejuvenation and regeneration treatments with stem cells, and continue sessions with autologous mesotherapies and injectables such as botox and hyaluronic.
Surgically, it is usually possible to repeat the blepharoplasty if it has been preceded, if not done for the first time, and Facelift.
We always take into account the general condition and health problems that someone may have over time so that our treatments are the most appropriate and correct for our client.
In today’s time, people are living longer, and staying active and active for longer periods of time and therefore are concerned about their fitness and image. This is the reason why they turn to surgical and conservative treatments regardless of age.
*The interview was published in Madame Figaro Cyprus, January issue
Dr Georgia Koulermou
Plastic Surgeon
Aesthetic and reconstructive surgery, Oncoplastic surgery
Breast Centre American medical Centre
65 Prodromou Medical Centre , Strovolos Nicosia
Tel 99657810
gkoulerm@spidernet.com.cy
www.georgiakoulermou.com