Decades of Face: The Sixties, the Renovation Decade

Doreen Wu (00:00):
Welcome to Park Avenue Plastic Surgery Class, a podcast where we explore controversies and breaking issues in plastic surgery. I'm your co-host Doreen Wu, a clinical assistant at Bass Plastic Surgery in New York City. I'm excited to be here with Dr. Lawrence Bass, Park Avenue plastic surgeon, educator, and technology innovator. The title of today's episode is "Decades of Face: The Sixties, the Renovation Decade." Okay, Dr. Bass. Now we're talking about the sixties. Is it finally go time? What do you mean by the renovation decade?

Dr. Lawrence Bass (00:35):
You're in your sixties, you've now had four decades of accumulated facial aging. There's at least a moderate degree of all aging changes in virtually everyone. Just like a house that hasn't been redecorated or had appliances replaced in decades, your face is ready for a renovation. This is the decade where most people need surgical procedures to restore their face. No rule says you have to do anything, especially a big project like a facelift.

Doreen Wu (01:10):
But I get the feeling that there is a "but" coming.

Dr. Lawrence Bass (01:13):
Absolutely. Of course, it's okay to decide you'll just age gracefully or maybe you're focused on other life priorities. That's totally okay, but time marches on and it's written on our faces. I always say I take a realist approach and this is an example. You will look worn out and tired if you don't include a few judicious procedures when you get to this stage of facial aging. This is the main decade for facelift surgery or even a little bit before. Lots of people at this point choose to have a facelift. The American Society of Plastic Surgeons statistics showed the 55 to 69 year old age group, and that's the group that they break it down into as the age group getting the most facelift surgery. And when you take a little bit of a deeper dive on that, it's really the second half of the fifties and the first half of the sixties where most of the facelifts are taking place. As I said, you may choose not to, but many others who think they're going to do it are dragging their feet or put another way, they're burying their heads in the sand figuratively. But since we can't do that, literally everyone sees our aging face all day every day. So it's to those foot draggers that I say think hard about going ahead with your face renovation at this stage and not later.

Doreen Wu (02:50):
Why is that? What is unique about this stage?

Dr. Lawrence Bass (02:53):
We're often at the peak of our business or work success also typically have a busy social life. At this time in 10 or 20 years, we'll still enjoy the benefits of a surgery, but we won't put it to as much public use as we will in our sixties. Also, healing ability general health to undergo a small procedure. The degree of correction we can obtain while tissues are still somewhat resilient provides an overall favorable profile for proceedings sooner, not later.

Doreen Wu (03:35):
But I'm still not sure I'm ready. Am I making a big mistake by waiting and putting it off?

Dr. Lawrence Bass (03:42):
No, not at all. One of the nice things about aesthetic plastic surgery and medicine is you don't need any of it for survival. It's not an emergency. If you're in a car crash and bleeding to death, the trauma surgeons just have to jump in and try to save you. Not a lot to think about. An immediate action is required. Aesthetic medicine and plastic surgery is at the other end of the spectrum. So you can take your time deciding. Don't go ahead unless you know it's the right decision. Now that doesn't mean a hundred percent sure. We're never a hundred percent sure on any decision we make medical or otherwise, and it's natural to have some doubts and anxieties. But if you know the feature is really bugging you and you're going to do it sooner or later, you may as well do it now and enjoy the benefits that much longer rather than walking around unhappy with your appearance. The flip side of waiting is that there are real consequences since time and aging never stop. As long as you know this and accept that flip side, you're okay to wait.

Doreen Wu (04:54):
Tell me if I get a facelift, will that be the end of my Botox fillers and laser treatments?

Dr. Lawrence Bass (05:01):
Well, nonsurgical prevention, restoration and maintenance will continue, but they're adjusted. Some items continue pretty much the way they were before. You're still going to use skin products, you're still going to get Botox, but some items are going to be scaled back. Laxity treatments certainly will go to a minimum for a number of years or be withheld altogether. And again, fillers, because often some volume restoration and some shaping take place with laxity surgery, like a facelift neck lift, fillers are likely to be scaled back as well. Some things may be added if you haven't worked very much on skin rejuvenation or skin quality. If you didn't include that in your surgical plan with something like a laser peel or laser resurfacing, then you may start adding those things in after the facelift.

Doreen Wu (06:06):
We already mentioned the facelift. What are some other typical big ticket items for people in their sixties?

Dr. Lawrence Bass (06:13):
So facelift neck lift is the principle item. Eyelid surgery, blepharoplasty, if you haven't had that done already. Depending on the degree of wrinkling, laser peels are often done either as a standalone or at the same time as facelift and general facial rejuvenation. And for some individuals brow lifting is appropriate. The other thing that we start to chase is the neck and chest skin for skin quality because we want to keep those areas matched up with all of the nice things we've done on the face.

Doreen Wu (07:00):
That brings me to my next question. Which of these should I choose?

Dr. Lawrence Bass (07:05):
So I like to choose whichever features are prominent or aging faster than the others. Anything you see that bugs you should probably put on the list because you hate to have a facelift and then come back in three or six months and do your eyelids at that time. That's kind of silly when they could have been done at the same time. So it's good to take a look over everything, look at how you're showing in pictures, decide what's really bugging you. And usually at this stage of the game, plastic surgeons will suggest the features that they see as prominent and that's a suggestion. So I tell my patients, I'll tell you what I see. If you say, "I don't care about that," then you don't chase it. But if you say, "yeah, that bugs me too," then this is a good chance to clean that up at the same time.

Doreen Wu (08:05):
Before we wrap up, what are some key takeaways for our listeners from today's episode?

Dr. Lawrence Bass (08:10):
I talked about making a reassessment in the fifties and as aging speeds up, it's perfectly reasonable to make another general reassessment in your sixties. As we were just discussing, identify the most prominent features you want to chase or correct. Let your plastic surgeon tell you the best way to do it. The plastic surgeon is the expert on how to get the result. You are the expert on what bugs you. Also let the plastic surgeon advise you on how much recovery might be involved. Don't assume you know. Figure where your beauty thermostat is set. How far are you willing to let the features go before chasing? That's a personal decision. You know, some people want to be as close to perfect as possible, and even a little bit of aging change has to be run down and other people recognize, you know, okay, they're not a 30 something any longer.

(09:16):
That's okay. They just don't want to look really worn out. And so if a feature is minimal, it's not a bother, but when it gets worse than that, then it's time to get going. Your plastic surgeon will tell you if you have enough aging change to get a meaningful benefit from having a treatment or procedure. In other words, if the procedure is medically indicated, depending where your beauty thermostat is set, you might be ready to chase it. Know that you'll chase it soon and you'll start thinking about when that might be or that the feature's not bothersome and you don't want to worry about it. Once you know these things, you'll be able to time when you can work them, the procedures, into your life and schedule. My big rule of thumb is if the feature bugs you all the time and you know you'll fix it eventually, it's worth chasing now. The sixties are the decade to put plastic surgery to use for the renovation of your facial appearance to keep an adult indeterminate sort of look. Everybody knows you're not a kid in in their twenties, but they can't really put their finger on how old you are. Most important, you don't look worn out or tired because that doesn't play well in business. It doesn't play well in your personal life. If you're not psychologically ready for surgery, you can still benefit from various treatments, but use them in proper measure rather than trying to make them do something they're not designed to do and end up looking unnatural.

Doreen Wu (10:54):
Those are great points. I think it's important to keep in mind that everyone's beauty thermostat is set to something different. Like you said, what may seem like a big deal to one person may not bug someone else. Thank you, Dr. Bass. As much as I'm not looking forward to the surgical options, I really enjoyed hearing your perspective on how to think about this.

Dr. Lawrence Bass (11:13):
Thank you, Doreen.

Doreen Wu (11:14):
Thank you for listening to the Park Avenue Plastic Surgery Class podcast. Follow us on Apple Podcasts, write a review, and share the show with your friends. Be sure to join us next time to avoid missing all the great content that's coming your way. If you want to contact us with comments or questions, we'd love to hear from you, send us an email at podcast@drbass.net or DM us on Instagram @drbassnyc.