Positive ageing - is cosmetic surgery right for you?

“Ageing gracefully” or “ageing like fine wine” are those annoying euphemisms we’ve all heard for looking older and making the best of the sag and bag of a once firm face and body.

Even if we’re looking older and embracing life, a mental disconnect can set in as lax faces portray emotions we don’t feel such as tiredness, sadness or even anger.

So it’s not surprising that according to a group of doctors with a special interest in cosmetic medicine, not all of us are meekly sucking up whatever nature arbitrarily dishes out, as we grow older.

The Cosmetic Physicians College of Australasia claims that when it comes to Botox anti-wrinkle injections, followed closely by dermal fillers for the face, Australians don’t stint themselves.

Australia’s per capita spend on non-invasive cosmetic treatments is among the highest globally and due in part to Australia’s harsh climate.

It’s a trend that’s showing no sign of slowing down, with fat transfers the new kid on the block joining the rejuvenation mix of dermal fillers in what is a rapidly evolving industry.

Although the terms cosmetic surgery and plastic surgery are often used interchangeably, there is a difference.

Cosmetic surgery is elective, while plastic surgery is a surgical specialty dedicated to the reconstruction of facial and body defects. A plastic surgeon can perform cosmetic and reconstructive procedures.

The road that leads to more invasive, aesthetic procedures can be a much longer and more private affair, often starting with injections to temporarily smooth over wrinkles, and dermal fillers to address fine lines and plump up once rounded cheeks and lips.

Stories that circulate like urban myths among our friends about cosmetic procedures that have left some poor soul with a face that swells in summer and shrinks in winter don’t inspire us to pay someone else to fix our ageing visages.

A year ago, Trish, (not her real name), an independent and feisty woman in her mid-60s who works globally in the entertainment industry, downed tools and reorganised her busy schedule to have the facelift she’d talked about having for 10 years.

In that long lead-up she’d tried pushing back the years with anti-wrinkle injections to ease her frown lines until the drooping skin along her lower jaw drove her to have serious discussions with a number of high-profile surgeons.

Working around celebrities in an industry absorbed with self, made those conversations that much harder.
“I’d spent enough years looking at other people with big scars at the back of their head, hair missing and keloid scars around the hairline so hair can’t regrow,” she says. “I like to pull my hair back and go, and I hated these jowls.”

She says her son was aware of her growing displeasure with her facial appearance, but she made her decision solely in consultation with her overseas connections.

By chance, a friend in the medical industry in Australia put Trish in touch with a plastic surgeon in Australia. His plain consulting rooms, lack of Hollywood slickness and assurances that the end result would be a fresher version of herself and not someone else, appealed to her.

“I listened to everything he said, and it made sense to me,” she says. “It wasn’t cheap. It probably would have been cheaper if I’d had it done in America.”

She took six weeks off work and booked in for a facelift to address the larger ageing changes of her lower face and neck in combination with an upper and lower eyelid reduction.

Fat was transferred from one area of her body and grafted into another area to correct facial asymmetry from previous skin cancer surgery scars.

Australasian Society of Aesthetic Plastic Surgeons president, Associate Professor Mark Magnusson, says Australian women tend to want natural changes and not transformations; their goal being an improved appearance that others think looks relaxed, rested and attractive.

“Common surgical procedures include eyelid surgery (blepharoplasty), brow lift, facelift and neck lift,” he says.
“The procedures are often performed in combination so that the rejuvenations are harmonious throughout the face, although the area around the eyes may be treated in isolation for both functional visual field benefits as well as to produce a more relaxed facial expression.”

Prof Magnusson says the facial surgery market is steady but there is no historical data as this is the first year that society members have been asked to supply information about the number of procedures they’re undertaking each year.

At this time there are no reliable national statistics for cosmetic procedures due partly to the fact that cosmetic surgery is both elective and not covered by Medicare.

The other contributing factor is that many different practitioners perform invasive and non-invasive cosmetic procedures.

In his 70s and retired, Bob, and wife Rose, (not their real names) were well aware of how age had hooded Bob’s eyes and encircled his neck with rolls of unsightly flesh.

He says surgery to correct both had never occurred to him until he was referred a year ago by his general practitioner to a plastic surgeon for removal of a cancerous lesion on his finger.

Bob is the first person to say he had no idea that at his age he could be a candidate for cosmetic surgery.
“One naïve side of me didn’t even realise these sorts of procedures could be done quite safely in a very safe environment,” he says.

Nor did he realise that part of his eyelid surgery, because it was to improve his visual field, was eligible for a rebate from Medicare and his private health insurance;  or that developments in drugs, equipment and techniques have made anaesthesia possible and safe for patients of all ages.

As his surgeon talked frankly about the procedures during post-surgery treatment for his finger, Rose became the gentle force that helped modest Bob do a 180-degree.

Buoyed by what his surgeon called common procedures performed across all ages and occupations, he still worried about how well his skin would heal and the cost.

Until the night before surgery, Bob says he had no idea how real this commitment would be, and he wondered whether at his age it was worth it. “Nobody really says to you you’re going to be in a lot of discomfort and pain, you’re not going to look good for a while, you’re going to be bruised and battered up to your neck and shoulders and around your eyes, and you’re thinking what have I done?” he says.

The first 24 hours after surgery as he lay in his hospital bed were, he says, “a nightmare”.

“It’s a lot of money and commitment at a time in your life when you have to watch your dollars.”

Rose had a more visionary and pragmatic approach to Bob’s surgery.

“I wanted him to look like his best self,” she says.

“I persuaded him of the difference it would make in having his appearance more normal, and it’s been fabulous. I think looking more handsome and younger, all that helps no matter how positive you are.”
Trish went into surgery feeling very nervous and second-guessing her decision. Post surgery she battled claustrophobia until dressings were removed from her eyes.

“There might have been a day or so when I said to myself, ‘I asked for this pain, so shut up’. But it’s like childbirth, you forget about it after a while.”

She hired a carer to look after her during those first weeks of her recovery and slept on a special bed she brought from the US to keep her back and neck elevated. Like Bob, she has kept her surgery quiet and says she will continue to do so.

Bob worries he might be considered vain and Trish considers Australians in general narrow-minded about cosmetic surgery.

She says the surgery has dented her savings but lengthened her working life.

“I’m not a big spender, so I suppose I would have left it for the day I retire – if I ever retire. The only thing I wish is that I had done it a lot sooner. I love it. Is it perfect? I wasn’t perfect before I started.”

That next overseas trip for Bob and Rose might have to wait a bit longer.

In the meantime, Bob says his surgery has been “worthwhile all round” and has made him more conscious of keeping fit and enjoying life to the fullest.