We try to look young. We exercise, diet, eat healthy foods, color our hair if need to, buy makeup and all kinds of creams, buy skin care products, and if need to lift our breasts, faces, eyelids, foreheads, upper arms, thighs, abdomen, buttocks and mons pubis. However, we forget that our very bottoms, the place where our children come from, suffer the most changes of all. First of all being so dependent, gravity causes our muscular sling as well as our skin to sag in the perineal area more than anywhere else.  We constantly run around with filling our bladder and then emptying, so constantly undergoing weight bearing and then loss.  We empty our bowels hopefully daily again causing strain and pushing.  We carry full intestines for a while before emptying. Of course if we suffer from constipating or the opposite, an irritable bowel, imagine the number of times our musculature has to contract and relax.  The pushing and tenesmus alone cause great distention and dilitation.  Then try again thinking about delivery of babies. The head coming through the vaginal canal. The amount of stretch and distention that creates, never mind the weight that the bottom muscles have to carry during the pregnancy.  Then the muscles get cut more during the episiotomy and not always put together well.  I will stop here as my own bottom is beginning to ache.  So now, with all that going on -don’t you think some enhancement may be necessary?  How about the labia that get elongated, and the vagina that gets stretched and all the tags that are hanging around.  Thing about the varicosities created in your labia majora and do not forget your saggy mons pubis.

take care of your bottom

So if you want to look younger and feel better, you better look at your bottom and consider what rejuvenation that may need before you declare yourself done.

I just read an article in Reuters 4/8/09 that there is an increase in facelifts and other cosmetic procedures because of the economy. The article states that now that the economy is bad people are flocking to plastic surgeons to look better to get a better job. That is always the case not only in bad economy.  People like to be around young looking vigorous people and so if you want to get a great job, or stay in the job or get promoted, I hate to say it, but you have to maintain your look and stay uplifted. Economy has nothing to do with it. Matter of fact economy can be bad for your uplift as the surplus money is not there. So the only bad thing that happens in a bad economy is that you get all crazed as you do not know whether to keep the money as you do not know when you will get a job or to spend it to get the job. What a dilemma. Just remember people with dilemmas who verbalize them too much usually do not get the job as they get to be too annoying to listen to. So just do it -if you do not you will say I should have done it.

As we age not only does the skin becomes less elastic and thin, but our bony skeleton also becomes thinner and smaller. The fat “baby fat” disappears and it all results in hanging empty skin with less architectural aesthetics. The atrophy of the fat is addressed with fillers.  The skin thinness and lack of elasticity is addressed with various lifts whether face lift, abdominoplasty, breast lift or mons pubis lift.  Some require arm lifts, and thigh lifts as well.  In some areas the fat disappears more than others. For example how often we hear people say-”if I loose enough weight for my thighs to be thin my face becomes too gaunt”.. Therefore often we do liposuction on the thighs which stubbornly hold on to fat while our face looses it very quickly.  So now what about the shrinking skeleton. We all know that with age we get shorter. However, we also know that even tho we look better after a facelift the area around the mouth rarely improves. ASK DR. STEPHEN COLEN who is trained as a dentist as well as a plastic surgeon. He will be the firtst one to tell you that in order for the area around the mouth to improve very often one may need to do onlay grafts to fill out the bone area under the upper lip so that the lip will not hang like a curtain with pleats.  Only grafts could also be put under the base of the nasal vestibule so that the nose will not look too long and hooked as our face shrinks.  Often we hear people say -”she is so photogenic”. This is often said about models or actresses.  They usually have in common a squere and strong bone structure which we loose as we get older.  So there are many ways to look younger besides just lifts, skin fillers and botox.  ONLAY grafts can also be very necessary.

To look like this at 43yo you must take good care of your body. Good nutrition, exercise and great skin care is of utmost importance. Of course at times Plastic Surgery must be done to achieve such a wonderful body. Not everyone is lucky to have that metabolism or that physique. However, for those who have hefty hips and thighs and would like that leaner look, liposuction is an option. Those who would like to have shapely and sexy breasts there are procedures that can accomplish that too.  Breast implants increase size, breast lift allows the breasts to look perky and if one is over endowed a breast reduction will lift and downsize to a more attractive and proportional size. Those that have children and are unable to reduce their tummy skin or tighten their tummy muscles even with vigorous physical activity, help is also available. A tummytuck can reduce skin and/or tighten muscle to create a sixpack. Liposuction alone can reduce fat from the abdominal area if the skin and muscle are in good shape. The mons pubis can be lifted through a small suprapubic incision and that may improve sex life as well. The neck and face and eyes are youthful till about 40 when depending on your skin, bone structure, weight fluctuations and genetics jowls begin to form as well as folds and bags around the eyes. Eyelidplasty and a facelift are great options for those who feel that they look older than they feel. Of course rhinoplasty enhances the shape of a nose and otoplasty makes your ears sexy and sensuous. These are just suggestions for some of the surgical procedures. However, options which are not surgical are also available and popular. Fraxel and other laser treatments tighten the skin and get rid of skin blemishes and irregularities. Dermabrasions, microdermabrasions and chemical peels are helpful. Great skin care regimen is the mainstay of great complexion. In our office I leave that to Anita our Nurse Practicioner who is a genius when it comes to skin treatments and cosmetic enhancements with the right stuff. Fillers are great in combination of various small implants like chin and cheek implants or alloderm to nasolabial folds. Do not forget botox however, the greatest thing for frown lines and other furrows created by muscle movements. Injected in right quantities in the right spots makes you younger looking and fresh. Too bad it does not last forever, but then neither do we. Even though not suggested in the picture, ladies -do not forget vaginal and labial surgery for those who feel loose and droopy. Help is simple, effective and it works. Libidos arise! So if you are interested in looking good, call us for a consultation and tell us what it is that you would like, what your budget is and we can then taylor treatment to achieving what you would like improve and what you would like to have.

Recently gastric banding has become the procedure of choice for managing extreme weight loss. Bypass surgery is still done but less frequently. The weight loss that results also leads to extreme redundancy of skin which just hangs in folds. Many must now address this condition. Skin folds besides being unattractive also lead to rashes and discomfort. One cannot fit into clothes properly and wearing a bathing suit may be embarrasing. So one needs to look for a qualified plastic surgeon to do total body skin reduction. This, if involves lots of areas,  should be done in a hospital as the procedure is long and people after extreme weight loss may be more susceptible to certain complications.  They must be monitored properly postop. If one does it region by region, it could be managed in an office setting. For example, breast reduction and or lift. facelift and eyelidplasty, panniculectomy etc. After the skin envelope is reduced the results are great and the patient can then pursue a very normal life. Clothes will fit well and exercise becomes easier. Dermatologic conditions improve as does self confidence.  So if one is interested in that procedure would love to see him/her in our office and explain the procedures and alternatives.