Plastic Surgery: How Long Does it Last?
Will My Neck Lift Last?
With all the travel, costs of plastic surgery and other arrangements involved, one of the first questions to pop up is: “How long will my new look last?”
The well known Beverly Hills board-certified plastic surgeon Stuart Linder, M.D – who blogs as “Dr. Body” tells how long body procedures usually last. Also commenting is the equally well known Robert Kotler, M.D., a top Beverly Hills board-certified cosmetic plastic surgeon (a former Dr. 90210 star) who blogs as Dr. Face. The duo tell what you can expect with the longevity of your rejuvenation surgery.
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Dr. Body: (Dr. Linder) For breast enlargement, there are so many various factors at work, it’s very hard to tell exactly how long a breast surgery will look good.
Dr. Face: (Dr. Kotler) When you are asking about procedures of the face and head, anything that involves bone or cartilage is good for life. That includes ear pinning, or, otoplasty and rhinoplasty, although any nose will naturally change over time and with normal aging. Cheek and jaw implants should be good for life, too.
Dr. Body: There’s a popular myth about breast augmentation, that a woman will need a replacement once every ten years.
Dr. Face: A myth?
Dr. Body: It’s due to Mother Nature’s healing process. There is just no pinning down the body’s reaction to a breast implant – which your body sees as a foreign invader – so you may need a replacement in two decades, 14 years, tomorrow or never.
I always recommend that breast enlargement patients ask about a warranty for their breast implants. Some companies will even help with the cost of a breast revision surgery if the implant fails.
Dr. Face: So what can you safely forecast for your patients about breast surgery?
Dr. Body: Breast reduction, for instance, is fairly dependent on the patient, so if she does not gain a lot of weight and wears a bra with a wire bottom, her reduction should last eight to ten years. But even if she gains just a little weight elsewhere on her body, her breasts may grow to be extra large and once more painful.
Dr. Face: Facial skin and its attachments can be something like that, too. A facial plastic surgery patient may see some sagging of the skin after three to five years, but patients who take care of themselves with diet and exercise may enjoy an enhanced appearance for ten years or longer. We have seen patients who still look quite good 20 or more years later.
Dr. Body: More and more, with the Lap Band and other bariatric surgery, some patients are experiencing what we call Massive Weight Loss (MWL). After losing anywhere from 100 to 150 pounds, the patient is left with hanging sheets of skin which we plastic surgeons trim in procedures known as body shaping.
Dr. Face: I bet the results depend on keeping the weight off!
Dr. Body: Right. And when the weight stays off, a brachioplasty — the procedure that removes loose flopping skin from the upper arms – will last a lifetime. Same with body shaping on the upper thighs and the abdomen – provided no more weight is lost. But if the patient loses another 50 pounds, she will have yet more loose, hanging skin.
Dr. Face: Isn’t there a trade-off in body shaping operations?
Dr. Body: Yes, long scars. In brachioplasty, the scar runs from the armpit to the elbow. On a thighplasty, the scar is on the inside of the thigh from the knee to the crotch. And for the stomach, a panniculectomy produces a long scar across the abdomen or even all the way around the body when the belt lipectomy, or lower body lift, is performed. But those scars lighten and fade over time, like all scars.
Dr. Face: Some facial patients ask how long lip augmentation will last. In some patients, a solid or gel filled implant works. Those could last indefinitely but….
Dr. Body: But what?
Dr. Face: For lips, removal of any implant is very difficult in case anything goes wrong and is very likely to provide uneven results. Because the lips are in the center of the face, even a small uneven result is extremely noticeable and bothersome to patients. I am not in favor of solid implants; I like the absorbable injections.
Dr. Body: So what do you usually recommend?
Dr. Face: The facial fillers Juvederm or Restylane provide excellent results although the procedure has to be repeated every six months or so. Imperfections, if any, will disappear as the material dissolves over several months. With lips, you need to hedge your bets. They must look perfect or they shout out.
Dr. Body: What about the neck lift when a patient shows up with a so-called “turkey gobbler” neck? How long does that surgical repair last?
Dr. Face: Like many facial procedures, it’s not necessarily the skin, it’s what is under the skin. In this case, some fat pads and a natural, age-related sagging of the platysma, the neck muscle that runs from the collarbone to just under the chin. We shorten that muscle so it does not show through the neck skin and also liposuction some excess fat.
Dr. Body: It all lasts how long?
Dr. Face: Eight to ten years. It may need a follow-up nip or a tuck after that.
Dr. Body: Can you think of other things that last indefinitely?
Dr. Face: Sure! Taxes and political hijinks!
