Cosmetic surgery and cosmetic surgery should be the subject of this guide. These terms are now in all mouth and should therefore be explained professionally, because not infrequently hide behind cosmetic surgery and cosmetic surgery rip-off and bungling.
Reasons for cosmetic surgery
Operations such as breast augmentation, liposuction and wrinkle injections with botulinum toxin (Botox(R)) or hyaluronic acid have long been established and are comparatively inexpensive to obtain. The desire to correct supposed flaws in one’s appearance, without correcting congenital deformities or surgical rehabilitation after illness or accident, most often arises from increasing age, although the age of patients undergoing cosmetic surgery has dropped considerably in recent years. Nevertheless, it mainly concerns the signs of aging of the skin. Therefore, when talking about surgical and cosmetic procedures for eyelid bags, bags under the eyes, wrinkles and folds of the face, it is necessary to touch at least marginally on the problem of aging skin. The skin is not only the life-long strained fate leather of the body and its most distinctive decoration organ, but announces also like the annual rings of a tree the age. Hands of this living chronometer are large and small wrinkles, bags under the eyes, wrinkles, eye bags, warts and age spots. However, there is a meaning to this clock. Leonardo da Vinci, the universal genius of the Renaissance, whose unfathomably smiling Mono Lisa is known to all, once spoke of the “fisiognomia fallace,” the deceptive facial features. Deceptive not least because they are not set according to any conventional standard time, but always show true local time. The true local time, however, is the biological age, which does not always correspond to the calendrical age. So it happens that one seems to have aged earlier, but the other only later.
Skin aging, wrinkles and bags under the eyes.
From this dilemma sometimes arises the desire to adjust the hands, to correct the wrinkles surgically; because not everyone is always able to remain calm when looking at his aging body and to bear the fading beauty without complaint. With the 3rd to 4th decade of life, the natural skin structure coarsens mostly on the exposed parts of the body, i.e. on the face and hands. Small wrinkles appear and here and there a particularly deep wrinkle, for which the changing, often rather monotonous play of the expressive musculature, depending on the mood of the person concerned, is partly responsible. These subtle changes in the skin, which are not least influenced by weather conditions and which make the appearance more striking and, for example, make the sailor’s face, which has been tanned by wind and weather, recognizable from afar, can hardly be influenced surgically. Ultimately, they are what give a face its personal character and its actual radiance and reflect the profile of the heart. In addition, a regular sagging of the skin and connective tissue skin develops later, favored by frequent alternation between fat accumulation and fat loss of the subcutaneous tissue, which, in contrast to the fine wrinkles and folds of the surface, can probably be corrected surgically for quite a few years. “The first wrinkle on a woman’s face is caused by the fear of guessing her age. “, the writer John Priestley once remarked. Since the critical look in the mirror with narrowed eyes plays a decisive role on this occasion, it may be that the “crow’s feet” and wrinkles near the eyes not infrequently appear as the earliest sign of age. The eyelids in particular also tend to droop. This can go so far that they double like aprons and form regular eyelid bags, which are popularly known as “bags under the eyes”, especially on the lower eyelid. If the upper eyelid also slackens, a functional disorder occurs because the eye can only be opened wide enough with difficulty. The affected person appears sleepy and tired, seems uninterested and is actually downright visually impaired. In this condition, the correction is of course no longer an intervention with exclusively cosmetic objectives. By the way, we are not dependent on clamping the overhanging eyelids in a screw clamp, as Georg Bartisch so impressively illustrated in 1583 in the famous Dresden “Augendienst”.We can shorten them surgically, thereby tightening them and eliminating both visual obstruction and disfigurement in one. Even the “crow’s feet” in the vicinity of the eyelids can sometimes be affected at the same time. Taking into account the special importance of the eye area for the appearance, one can easily imagine that such a cosmetic operation gives the previously disfigured face a completely different expression and makes the eyes shine again. The upper eyelid is shortened by cutting out an ellipse-shaped piece of skin, while the incision for the lower eyelid is either crescent-shaped below the row of eyelashes on the upper edge of the eyelid or on the lower edge of the eyelid, where the lacrimal sac overhangs, in order to be able to remove excess fatty tissue at the same time. To achieve the necessary tightening, a triangular skin gusset is often also removed at the bottom of the outer eyelid margin.
Possibilities
Such correction, like most cosmetic surgery procedures performed under local anesthesia, already takes some time. On the upper eyelid about half an hour, on the lower eyelid a good hour. The wounds usually heal faster than in any other place. Everything is done in about a week. The upper eyelid scar disappears in a natural eyelid crease. On the lower eyelid, the conditions are not quite so favorable. However, the scar will be less noticeable there as well. More of a headache are wrinkles and folds, which are caused by certain emotional facial expressions, often repeated a million times, and which can already be pronounced before the skin itself slackens. The best known of these are the vertical “anger wrinkles” on the forehead, but the nose–lip wrinkles that curve from the lower part of the nostrils like a malabar beard down to the corners of the mouth and give an otherwise still young face a sad and sullen expression are also not unfamiliar. In this case, good advice is expensive insofar as wrinkles caused by such muscle functions are either difficult to correct surgically or the incision would have to be so unfortunate that the later scars would not be inferior to the earlier wrinkles in terms of undesirable conspicuousness. Help is nevertheless possible, namely by injecting these rarely oversized wrinkles with a viscous silicone preparation. This can be done quickly, provided that suitable preparations are used. The success is immediately visible and controllable. Silicone is a collective term for various long-chain chemical compounds of oxygen and silicon atoms, some of which have strange and unexpected material properties and have been exploited accordingly only in the last fifty years. Properly placed under the skin in a suitable form, it is absorbed by the tissue only slowly, so that the effect of an injection, which, by the way, can be repeated, lasts for one to two years. According to the experience gained so far, this procedure does not have the harmful consequences that were feared earlier with kerosene injections for the same reasons. While vertical forehead wrinkles are not suitable for surgical correction, longitudinal “thinker wrinkles” can be removed by making an incision of appropriate length parallel to them just behind the forehead hairline. From there, the skin is lifted from its base, tightened and the excess strip is cut out. Similarly, the operation of the double chin caused by fat accumulation is performed. The incision, from which fat and excess skin are removed at the same time, is made below the chin. It is possible to place it, and thus the later scar, quite inconspicuously in one of the skin folds that are already present on the neck. The surgical field for the thinker wrinkles is in the hair area anyway. Thus the most important operation types of the simple wrinkle operations, which can experience naturally allleid variations depending upon situation of the things, are mentioned. Sooner or later, on average in the 4th decade of life, the elasticity of the skin begins to visibly decrease. The face gets more and more withered-slack wrinkles, which now indicate significant changes in the connective tissue layers of the skin and subcutaneous fat. This condition, if you can’t bear it any longer, can only be remedied by a major facelift. A “face lift” as this operation is commonly called.In this procedure, starting from two symmetrical incisions in the skin, which are not exactly small, but which run left and right in the lateral hair area and can be placed in the fold of the ear where they pass around the ear, the skin is separated from the carpet pad with special scissors as far as the middle of the face, i.e. almost up to the mouth, tightened in the direction of pull on the incisions, shortened by cutting out two then protruding gussets and sutured again. This procedure takes approximately two hours. The hospital stay is about 10 to 12 days. It is not always necessary to perform the major tension entirely. If the sagging of the skin is still minor, limited to the temple area or the mouth and neck area, it is possible to leave it at first with a tension of the upper or lower half of the face. In other cases, success can only be achieved if the major facial tension is combined with a simultaneous eyelid surgery, as described above. However, this is already a rich morning program for the doctor. So much, then, for cosmetic surgery and cosmetic surgery, as well as wrinkles and folds on the skin. Sometimes they appear sooner than one masters the art of being old. Sometimes one still has to fill a place in life where the environment cannot imagine one aged. In one or the other case one can be inclined to bring the biological age of one’s skin temporarily once again in line with one’s own desire or the foreign ideal and to have the hands of aging surgically adjusted. This occasionally necessary correction cannot become the rule, because the wrinkled face, as a sign of age, is at the same time part of its dignity and only rarely lacks its own kind of natural-aesthetic beauty.
