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Beverly Hills board-certified cosmetic plastic surgeons Robert Kotler, M.D. and Stuart Linder, M.D. tell which plastic surgery procedures are permanent, which are durable and which are not so long lasting.
Dr. Face (Dr. Kotler): The basic rule is that, in capable, trained hands, plastic surgery procedures that involve bone or cartilage are intended to be permanent.
Dr. Body (Dr. Linder): It’s not quite that hard and fast with procedures below the collarbone. With breast augmentation, there are so many factors at work, it is hard to tell a patient exactly how long her breast enhancement is going to last.
Essentially, we are dealing with the body’s reaction to a foreign object – the breast implant – so a second corrective procedure may be needed in 16 years, one year or never.
Medical science does not know the exact cause of a condition known as capsular contracture in which scar tissue reaches out to the implant, surrounding and squeezing it to the point the breasts feel hard. That requires a second procedure.
Rough rule of thumb for breast lift patients: most who wear a wire bottom bra after their operation find their breasts may require a little attention every eight to 10 years.
The lifespan of breast reduction is highly dependent on the patient. Formerly huge breasts can grow back even in cases where the body gains only a little weight.
HINT: ask your surgeon if your implants carry a warranty. Some do, some don’t and some will even help with some of the costs of a revision surgery if the implant fails.
Dr. Face: In facial procedures let me go through the permanent ones. I include:
- Otoplasty, the ear pinning procedure
- Rhinoplasty, although the nose is still subject to aging and gravity
- Cheek and jaw implants and
- Other changes or enhancements to facial bone
But when a surgeon starts working with facial flesh, things aren’t so set in concrete. For instance, a forehead lift can be very dicey depending on:
- Where the incision is located; there are five
- How much work is done on the muscles under the skin
Probably the best that can be hoped for is three to five years. A better value, in my opinion, is losing forehead wrinkles with Botox.
Dr. Body: Body surgeons also work with a great deal of flesh. In particular, since weight loss surgery has become so popular, many of the body contouring procedures to remove loose, hanging skin are frequently done.
If done well, brachioplasty, the procedure that removes loose skin from the upper arms, should last a lifetime if the patient maintains an ideal weight. Just in passing, I should mention the scarring is sometimes a problem because:
- It is very visible, running from the armpit to the elbow
- Of difficulties in healing because the arm is always moving
A thigh lift should last a lifetime if the patient has the procedure when her weight is ideal and stable so that no more pounds are going to be lost.
If she loses another 50 pounds, she will again have more loose, hanging skin to cope with.
After massive weight loss, the loose skin of the stomach can hang down to the upper thighs like a thick apron. The usual approach in a tummy tuck is to remove loose skin from the bottom of the ribs down to the pubis region and then bring the two edges together with sutures.
Results are permanent, given ideal diet and exercise. But continued weight loss, having another baby and normal aging can undo a tummy tuck.
If the patient does not keep a stable weight, it is very difficult to do perform another tummy tuck, although a mini tummy tuck can be done.
Dr. Face: Some patients who want permanent lip augmentation often find the lips are very unforgiving to the various implants that are inserted to beef up the kissers.
A better way to go, in my opinion, is augmentation with Juvederm or Restylane.
Sure, those substances dissolve within four to six months but removing implants from the lips can be difficult and leave undesirable marks and shapes on the lips.
Many patients from their early 50s through their 60s and 70s become interested in a neck lift to tighten loose, hanging skin brought on by normal aging processes.
Actually, it’s not the skin, but what’s under the skin – the platysma muscle – causing the loose, “turkey gobbler” neck.
A neck lift shortens and tightens that muscle but the area will often needs a tune-up in about eight to 10 years.
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