The first signs of elapsing time
Our face is the best reflection of inevitably elapsing time as well as it shows up our real biological age. Studies and career, on the one hand, and good genes, proper lifestyle and rational nourishment, on the other hand, all made that up till now I haven’t had time or even a need to take a look into the mirror to check the way time marked significant changes in my face and body. Right now, I am already 33. I have a loving husband and two wonderful children, a good profession as well as quite a well-paid and attractive job. So, summing up, I have everything a woman can have at my age to feel fulfilled and valued. However, expectations are growing at work, and employers, taking care of the image of their companies, employ younger and younger women. Also my husband seemed to have lost his interest in me as a woman. It seemed to me that my attractiveness went pale. Consequently, I started looking into the mirror more often. Unfortunately, it was not a magic mirror that would correct all my shortcomings. On a still young face there appeared forehead frown lines as well as the vertical ones, and not big the so called crow’s feet, especially visible when I laugh genuinely and, finally, considerable furrows leading from my nose down to the corners of my mouth. Additionally, some little discoloration and remnants of acne I suffered from long time ago, all seemed to be more visible at that time than they used to be. On seeing my reflection I got scared. Moreover, giving birth to my wonderful boys, now 6 and 3 years old, and afterwards breastfeeding them, influenced destructively on the condition of my breast. Actually, I could not wear a cotton t-shirt without a bra underneath any more. My dropping breast and sadly hanging nipples, unfortunately, were not as alluring as they were a few years ago. I didn’t blame my husband that he was hankering after the beautiful shape of my body.
Thinking and looking into the mirror, I was wondering whether I could change anything. I must admit that my husband strongly encouraged me to change. Did that mean that it was much worse than that? Having a wide access to the Internet, I decided to browse a little and read something on plastic surgery. One day I came across some websites of several surgery clinics. I also broadened my knowledge on the topic by reading some foreign articles concerning face wrinkles and the corrective surgery of dropping breast. I had thought so far that the problem was not so common. For a few days I read with a great interest the comments of women, who had already corrected this and that, on a chat-line. It convinced me that I was not the only one in the word and there were lots of women in their 30s who were dealing with similar problems. Thanks to their opinions I found out how and where such surgeries could be performed. I felt a great relief. It was a chance for me.
Having collected new pieces of information, I searched for the Internet address of a famous plastic surgery clinic that had wide experience in terms of the surgeries I was interested in. On the websites, the clinic had an on-line section devoted to giving advice. I wrote an anonymous letter with some questions that bothered me. I got the answer the following day. I also interviewed my friends and relatives whether they knew a surgeon they would recommend me. I was afraid a little bit of their reaction, but it turned out quickly that lots of my friends and colleagues had been using this type of help for several years. I was recommended exactly the same clinic I had written to earlier. I phoned the clinic and found out there were some consultations available. On the appointed day I arrived there. In the waiting room there were a lot of people awaiting. I was abashed and embarrassed. While I was waiting for my turn, fear and anxiety accompanied me all the time. I was wondering what I was going to say and how the doctor was going to treat me and whether he would laugh at me or not. Being busy with the preparation of a speech in my mind, there came finally the time to take my turn to consult with the doctor. I entered the doctor’s surgery where I met a very nice surgeon. An extremely pleasant talk made my fear and uncertainty soon go away. The doctor put my mind at rest saying that all the shortcomings of my face could be improved by means of some preparations filling wrinkles and paralyzing mimic muscles. My discoloration and post-acne irregularities of the skin were easy to be removed by means of mechanical peeling, namely dermabrasion. My breast was a bigger problem. The surgeon, however, comforted me saying that it was quite common among young women who breastfed two or more kids. He offered me undergoing a surgery that would lift and, at the same time, fill the breast by means of silicon prostheses. After one-hour-long chat I left the office filled with optimism and new faith. I decided to think it over and discuss it with my husband. Full acceptance on my husband’s part and his support made me schedule an appointment to have my first surgery one week later. We started the correction program from injections aimed directly at face wrinkles. I showed up at the surgery on early Thursday afternoon. The doctor injected with gentle stabs a toxin of clostridium botulinum (dysport) in the skin of the forehead region as well as between the eyebrows and lateral regions of the eyes, whereas, in the naso-labial furrows, which are responsible for a sad look on the face, he injected hydrogel’ Aquamid. And at my insistence, he agreed to inject it also, in a small amount, into the lips in order to enlarge them slightly. The surgery was almost painless. Directly after it, I had to lie with cold compresses on my face for 45 minutes. Afterwards, I returned home relaxed and happy. On that day and two days later the places of injection were slightly swollen and exquisitely tender. However, on Monday the result of the surgery was astonishing. A smooth face with no wrinkles on it and a little prominent lips were noticed by all my colleagues at work. Oh, I wanted to live so much. I felt wonderful. And it was just the beginning of my surgical adventure.
Two weeks later I underwent a simultaneous surgery of dermabrasion of the face skin and the correction of my breast. They all were performed under a general anesthetic. I preferred to undergo both surgeries at the same time while being under one anesthetic. The doctor agreed to such a solution. Besides after the doctor had gained my absolute trust, I simply wanted the surgery to be over as quickly as possible. I woke directly after the surgery in the operating room. I had a soft dressing with a brown ointment on my face, whereas my breast were covered with plasters and white cotton bra. I was tired and felt pain. I slept a lot that day. The day after the surgery, after having had the dressing changed in the region of the breast I could return home. My husband greeted my tenderly but I guess he didn’t expect to see a mummy wrapped up in plasters. ‘Whatever’, I thought to myself. The most important for me was that everything was over and I just had to just wait for the results. I looked sometimes into the mirror impatiently and with uncertainty. My breast made an impression. I was warned that for a few days they may be painful, sensitive to any touch and quite swollen. I dared to think that something could go wrong. I had to wait patiently until one week passed because only then I could visit the doctor.
One week seemed eternity to me. During my control visit, the doctor took the dressing off from the face as well as the stitches from the grooves under the breast. My face was pink a little, but I could already use some make-up. The breast, however, looked amazing. I guess even better than before the delivery. They were big, firm and outstanding. Happily I thanked the doctor and I ran as quickly as I could to show up at home and share my happiness with my loving husband.
I had to wait a little for the final result of dermabrasion. The pink places disappeared all after six weeks. Summer was coming and I was happy mainly due to two reasons. First of all, I love this season and, secondly, that summer was supposed to be extremely wonderful. Being young and beautiful again, I could wear my light dress and show my tempting body as it was a few years ago. Here, I could just write the way men looked at me on the beach, how many intoxicating nights I spent with my husband, however, the best compliment I heard was the one said by my older son who, before going to bed, said ‘you are beautiful mummy’.
Human face is the reflection of our feelings and emotions. It helps us to express happiness and sadness. And it is also the face where the first signs of elapsing time start to appear. In the case of a 30-year-old woman those changes are slight, however, much depends on some genetic prerequisites as well as the lifestyle. The former ones can be easily predicted by a woman while observing her mother. They both usually have similar gestures, similar ways of expressing emotions and consequently similar wrinkles. Huge volumes can be written about the influence women’s lifestyle has on them. However, it is beyond the shadow of doubt that it is the woman who influences her face, which is a kind of her own ‘business card’. It is worth thinking in advance about those two basic factors influencing our beauty because their skillful prevention helps a lot in maintaining a young and attractive face. We cannot influence everything that is genetically acquired, but if there appear some wrinkles on the face of our 30-year-old woman’s mother, then the woman herself should think of avoiding sun in advance. Too intensive sunbathing results in faster aging of collagen and, consequently, excessive building of slight wrinkles. It is also extremely important to use prophylacticly brand creams of high quality. If a mother has a very expressive face with visible crow’s feet in the corners of her eyes as well as on the forehead, a daughter may also expect to have the same. So, if she notices the beginning of this type of wrinkles, then it is not worth waiting passively until their full development, but it is better to start using some preparations containing a toxin of Clostridium Botulinum of A type (Botox or Dysport). Their earlier systematic using will allow to prevent the development of wrinkles in the region of the eyes and the forehead.
The last years in plastic surgery can be called the era of Clostridium Botulinum. It has been known since 1930 when it was used as a serious poison in the production of biological weapon in army forces of a few world empires. It was not until 1980 when people noticed the possibility of its use in medicine. First, the toxin of Clostridium Botulinum was used in the case of children suffering from squint, next, in the treatment of various types of muscle spasms, disorders in face symmetry after nerve paralysis as well as the alleviation of the nerve tricks symptoms. Then, at the end of the 90s, the toxin of Clostridium Botulinum of A type was used in the treatment of face wrinkles. Poland was one of the first countries in the world to certify the use of the medication in plastic surgery*. In this case we exceeded even the USA that decided upon this issue in the year 2002. The most reliable evidence of the toxin’s of A type popularity is its leading role in non-surgical methods of face corrections. According to the American Society of Plastic Surgeons in the year 2002 as many as 1 123 510 people underwent such surgeries. There are no such statistics in Poland, however, a constant increase of the number of patients taking advantage of Clostridium Botulinum injections can be noticed. Its main advantage is a huge even spectacular efficacy with minimal pain. What is also important is that no side effects of such a therapy have been registered so far.
Forehead frown lines, glabellar rhytids and crow’s feet belong to the most often cured regions by means of the toxin Currently, the toxin’s injections are also used in the treatment of face antisymmetry, especially the position of the eyebrows, in the correction of wrinkles at the bottom of the nose, vertical frown lines around the mouth, the so called ape’s mouth, uprising the corners of the mouth and vertical neck bands. The efficacy of this slightly invasive therapy resulted in a considerable decrease of the number of performed forehead lifts, even those most modern performed by endoscope method. Skillfully performed toxin’s injections allow to change the position of the eyebrows according to the patient’s expectations and considerably improve the framework of the eyes that results in a younger look.
The only disadvantage of the therapy is its limited period of duration. Most often after six months the medicine stops working bringing back the initial mimics. However, the attractiveness of the obtained results encourages the patients to repeat injections every six months. Worth mentioning is the fact that many doctors and patients notice that after a few injections facial mimic habits do change, and consequently, make wrinkles smoother.
Not only does the toxin of Clostridium Botulinum paralyze the nerve endings in the region of facial mimic muscles, but it also reduces the production of sweat if injected in the region of armpits or palms. It is the only possible medication available for many people who suffer from excessive sweating of their armpits and hands. It makes them free from unpleasant consequences of the disease and improves their psychological condition.
Tissue fillers have been used in plastic surgery for many years. A preparation of an animal origin such as collagen was used for a long time. However, in spite of its unquestionable advantages it, unfortunately, also had its disadvantages of which the most important was the possibility of serious allergies (even though allergic tests were performed before) and transmitting animal diseases to the patient. For those reasons, it was replaced with the solution of hyaluronic acid within the last few years. In the case of this patent medication, no allergic reactions have been recorded so far. There is also no danger as far as any disease transmission is concerned because the drug is obtained in laboratories by means of bacteria engaged to work for the man (similarly in the case of insulin production). Hyaluronic acid is injected in deeper layers of the skin and is aimed at filling in little superficial wrinkles. Its main disadvantage is, however, the time it needs to undergo resorption. Most often six months after the surgery, the results of wrinkles filling disappear and the surgery must be repeated. For those reasons the search for durable and safe medicine, by means of which wrinkles could be filled, continues. In many cases one’s own adipose tissue transplant seems to be a good solution. Skillfully performed surgery allows to fill the losses on the face, correct naso-labial folds or enlarge the lips.
One’s own adipose tissue is also used in the breast augmentation surgeries (special cases) as well as in labia majora or minora plasty and in penis thickening surgeries. Apart from its unquestionable advantages, the transplant of adipose tissue is a larger surgery not always accepted by the patients.
A patent medication that allows to obtain quick and long-lasting results is AQUAMID (Contura Ltd. Switzerland). It has been used recently in various branches of medicine as well as in food industry and is considered to be extremely useful in the correction of deep face wrinkles (naso-labial folds, wrinkles of the mouth corners) and in enlargement and modeling surgeries of the mouth. The medication is 2,5% solution of polyacrylamide in water. Its high compatibility with a human tissue allows to use it in ophthalmology (contact lenses) and in plastic surgery. No harmful side effects concerning the influence on human organism have been detected so far**. In the case of Aquamid administration, the most common strategy applied is obtaining the final results gradually. It happens that the patient is satisfied with when only one ampule was administered. However, if after two or three weeks the patient claims that she expected a larger effect, then the filled region is supplemented with another injection.
The surgery is performed under a tubular anesthetic or EMLA ointment. It may result in some slight pains. Few days after the surgery a slight swelling of the operated regions is visible. However, it is not so huge to interrupt daily professional or social life.
30-year-old women are in the majority of those who undergo the surgery of breast augmentation. Terminated pregnancies, breast-feeding all influence destructively the shape and size of the breast. Meanwhile, the memory of women usually dates back to the times when two or three years before their breast was beautiful, firm and constitute the attribute of their attractiveness. Another significant factor worth mentioning here is as follows. After a few years of marriage, there comes the time of first trial of the relationship as a consequence of the change of marriage character, from a youthful carefree adventure to a mature responsible common life. The statistics are inevitable at that point providing an increased percentage of divorces in this period. A woman who usually notices a reasonable decrease in her husband’s interest in her, as a woman, she starts looking for some ways to prevent it. Then, she begins to look into the mirror more often. If she notices sunken breast, then she looks for some ways to improve it hoping that it will turn back the hands of time. The patients’ breast at the age of 30 is most often slightly dropped, and its upper part is sunken. Transplanting breast prostheses allows most often to regain a very attractive shape of the breast. It also happens that they are much more alluring than before getting pregnant. Sometimes even the sensitiveness of the nipples increases, which positively influences sexual life. The surgery of breast augmentation is always preceded by an exhaustive consultation with the doctor. The patient needs to be fully aware of all the dangers connected with the surgery. The thing that should be most frightened is infection and the development of a haematoma in the region of the prosthesis. A few days after the surgery there usually occur pains of breast. It is also extremely important to understand that a breast prosthesis is a foreign body and may bring about the development of connective tissue bag around its surface. Even though a wide spectrum of precautions are taken such as textured prostheses, suitable surgeon technique or breast massage, the risk is not totally eliminated. It is advisable that a woman should discuss with her husband the decision of taking up a surgery. His approval or its lack cannot be diminished. An extremely important issue helping to make up one’s mind is the recent scientific research that eliminates any relation between breast cancer and the surgery of transplanting breast prostheses***.
A well-motivated patent, understanding the point of the surgery and accepting the possibility of complication is the best candidate to undergo breast enlargement. The obtained results not only improve her physical appearance, but definitely improve her mental state and life comfort. They also influence beneficially the relationship with her husband many times and make the relationship enter second youth.
Jerzy Kolasiński, M.D. Ph.D.
*The doctors of Hair Clinic Poznan as one of the first in Poland started using Clostridium Botulinum in the treatment of face wrinkle. It was possible due to the participation in specialized courses organized for the first time in the world by the European Academy of Cosmetic Surgery (Dusseldorf ‘1999) and the American Academy of Cosmetic Surgery (New Orleans – 2000).
**Lise H.Christensen and all:’Long-Term Effects of Polyacrylamide Hydrogel on Human Breast Tissue’. Plastic and Reconstructive Surgery, May 2003.
***Susan J. Hoshaw and all: ‘Causation, Delayed Detection, and Survival’. Plastic and Reconstructive Surgery, May 2001.
Life begins after forty
I used to hear many times from my parents and friends that ‘life begins after 40’. I was always thinking about the meaning of this sentence. I was a teenager then, and people older than 40 seemed to be very old to me. ‘How come?’, I thought. ‘What are they talking about?’ ‘They have already experienced everything that is beautiful and young’. I could never be so wrong. Now, I am 42 and my life has just started.
So far I haven’t paid much attention to my physical appearance or the state of my complexion. I have always had a contact with cigarettes since I was very little. My parents were heavy smokers and often invited their friends and relatives for home parties. When, as a teenager, I started smoking at home, no one was surprised.
My mum never paid any attention to using good quality cosmetics or living a healthy lifestyle. So, I didn’t have any patterns to follow. I never used any diets either balanced or detoxicating. At the age of 30 I gave birth to a daughter. During my pregnancy I gained a lot of spare kilograms. I didn’t care about my appearance and I even wasn’t interested in losing some weight, although I was left with 15 kilos more after pregnancy. My husband wasn’t also the slimmest one since at home no one used any diets. Besides, we enjoyed high living standards.
My life, however, has changed a lot since then. My family situation changed dramatically, too. I lost my job two years ago. I am a pedagogist and, to be honest, who needs a pedagogist these days. I was looking for a new job for a long time but without any results. Even though I was 40 with good physical appearance, excellent qualifications and the knowledge of two foreign languages, I didn’t have any chances. During one of my job interviews, my potential employer suggested me a slight change of my image. I must admit I was surprised a bit. I didn’t exactly know what I should have thought about it. ‘Do I look old?’ ‘Or maybe am I too fat?’ That evening I came back home very nervous. I poured a glass of whisky and light up one cigarette. After a while my anger went away and I started thinking what I could really change about my appearance. I looked into the mirror very critically and I made a list of my new resolutions. First of all, I was to quit smoking and change my diet. It was very easy because my husband hasn’t been smoking for several years now, practices intensively jogging and goes to the gym. Secondly, I thought it was high time to visit a good cosmetician. I implemented my resolutions the same day. The changes started with an honest talk with my husband. He understood me and promised to support me in every activity I was to take up. That unfortunate evening cigarette was the last one in my life. In the evening I also went with my husband to the gym.
After six months of hard work and sacrifice I looked definitely better. My body had different shape and my physical condition improved significantly. Unfortunately, my happiness was not full. Some scant remnants of fatty tissue were quite visible in the region of my hips, thighs and knees. None of the exercises I did could help me to reduce adipose tissue in those regions. The results of smoking and other bad habits became also visible on my face. Grey complexion, horny skin, discolorations and considerable sacs under my eyes as well as dropping upper eyelids that were slightly visible, all bothered me much. I decided to go to the beautician. I had some face masks and massages done. After a few appointments, which did not bring any visible results, my beautician advised me to go to a surgeon who specialized at plastic surgery. A ray of hope for a better look came back immediately.
I went to a known and recommended surgeon. During my first visit I asked many questions since I wanted to know everything at once. I learnt that all my body shortcomings and slight irregularities could be easily removed by means of liposuction. As far as my face was concerned, the doctor suggested me to undergo the corrective surgery of the upper and lower eyelids as well as chemical peeling. As I knew that my husband fully supported me in my crazy ideas, I scheduled an appointment to have the first surgery without any hesitation. My correction program started from the changes in slight shortcomings of my body. With a file of laboratory examinations in my hands I came out on the exact day of the surgery. It consisted in removing an excessive amount of fatty tissue from the regions of my hips, thighs and knees. Just after the surgery I was dressed in a special pressure suit the aim of which was to adjust my skin to a new shape of my body. The results were immediate. However, few days later my measurements were exactly the same as at the beginning due to the swelling in the operated regions. I was also told that the final result would be visible after 6 or 8 weeks. So, I needed to wait impatiently. Some bruises and pains maintained for 2 weeks after the surgery. I must admit that I was worried a little, but I knew I was operated on by a specialist, so I had to put up with all the inconveniences. After two weeks time I went for a control visit. I decided to take advantage of the visit and undergo another surgery from the previously established program, i.e. the correction of the upper and lower eyelids. The surgery was performed under a local anesthetic. By means of a slight cuts in the eyelids breakings, the surgeon excised an excessive amount of droopy skin. Only very thin stitches were left which, later, were covered by little pieces of plaster. After I went out from the clinic I wore my sunglasses so that no one could notice the marks left after the surgery. Five days later I went for a control check-up to the clinic during which the surgeon removed plaster and stitches. Unfortunately, the bruises were still visible in the region of the eyes few more days. However, I was extremely happy with the results and nothing bothered me. Several weeks later I underwent, additionally, the so called mechanic peeling. The peeling of this kind is much deeper in comparison to the one made by beauticians. The surgery was performed under a short general anesthetic, and consequently, I had to stay one day in the clinic. The following day when I took a look into the mirror I laughed at myself a lot. I looked like a ‘smurf’, a character form kid’s stories, with a blue glow on my face. For the next few days, the skin on my face peeled off a lot. However, I didn’t have to wait long for the final results. A new me, with new shapes of my body and at least fifteen-year-younger face, I set off to conquer the world. I found a few job advertisements in a paper. So, I decided to try out my new power. It was not long until my first job interview with the owner of a company that I was offered a very interesting post on the position of public relations agent. Moreover, I could take up this job at once. Not only do the skills, qualification and experience count at work nowadays, but also an employee’s appearance that somehow is a business card of the company. I am very happy that I have changed so much in my life itself and my appearance. Now, I know why life begins after 40.
The turning point of the 4th and 5th decade of life may be for a woman a difficult period or, on the contrary, one of the best periods in her life. A 40-year-old woman has already survived many uneasy moments. Most often the kids are brought up, the financial situation already established and stable, personal life after first stormy moments, still full of energy and her physical appearance…… Here comes the problem. Does the appearance comes up to the expectations set by the spirit? A lot depends on a woman herself. For sure, unhealthy lifestyle will show up its first signs right at that moment. Nicotine is a toxin not only for health, but also for the beauty of a woman. Even though we are flooded with more and more special types of cigarettes, they are still one of the most disastrous addictions for the appearance of a woman. Not only will breath and teeth remind us about the disastrous effects of this addiction, but mostly skin face and hands will do. If a woman started smoking at the age of 20, then at the age of 40 some worsening in her skin will be still visible as well as additional wrinkles on the face and her tiring look. The best creams and face masks will be simply useless. The only way to protect the face and bring back its fresh look is to give up smoking. However, it happens that tiring sacs under the eyes never disappear, and often at the moments of tiredness they are becoming bigger.
Then, a surgery is extremely helpful. The correction of the lower eyelids does not consist in cutting out the excessive skin. The amount of the skin removed comparatively small in the correction surgery of eyelids. What is performed is the plasty of fatty tissue responsible for creating the sacs under the eyes. According to the prescriptions, they are either removed totally or just removed below to fill the frowns in the region of the lower orbits. The correction of the lower eyelids in performed under a local anesthetic. The cuts are located under the eyelashes and the scars remaining after the surgery are invisible. During the first few days after the surgery, the eyelids are swollen and some bruises may appear. It is strongly recommended to wear sunglasses even on cloudy days. However, one week later, make up can be put on and one may return to work. The eyelids may be swollen slightly for several weeks. Still, it is not visible, but the patients themselves may feel discomfort. The correction of the lower and upper eyelids allows for the improvement in the framework of the eyes. It helps to bring back young and attractive look. The surgery is also supplemented with the injections of a Clostridium Botulinum toxin thanks to which the eyebrows are raised and crow’s feet are eliminated. In the same way the asymmetry of the eyebrows may be improved.
The excessive amount of adipose tissue is the problem of many people. At the end of the fourth decade of women’s life, fatty tissue starts accumulating in the region of thighs, hips and knees. It appeares rarely in the region of the abdominal, although the waist may also enlarge a little. Unfortunately, repeated draconian diets do not bring any results in losing the tissue in those regions. Probably, face features will be more visible, the breast will get thinner and fall down and irresistible hips and thighs will remain well-built. A solution used in such cases is the surgery of modeling the figure by means of appropriately constructed probes, the so called cannulas connected with an aspirator. The surgery is called liposuction and it is actually the technique of sculpting human body. It was first introduced by Giorgio Fischer in the year 1986 and, soon, it became one of the most popular procedure used in plastic surgery. In most parts of the body, adipose tissue appears in two layers, namely superficial and deep one.
If one wants to reduce the size of a particular region, the doctor sucks fatty tissue from the two layers. When we want to obtain a smoother surface and, at the same time, make the skin contract, then we perform the surgery in the superficial layer. The suction of the deep layer only in some regions may result in skin dropping and its folding (for example in the region of the thighs and hips). The surgeon performing the surgery should have a wide knowledge in the field of operational techniques. It is extremely important to insert the probe into appropriate layers and know the limits as far as the amount of removed adipose tissue is concerned. The doctor should not be influenced by the patients’ suggestions the aim of which is to encourage the doctor to remove more of the hated fatty tissue. Lack of reasoning in such cases may result in deformation of skin surface, the appearance of frowns and irregularities. Their corrections bring about lots of problems in the future. Another issue to concern is the safety of such surgeries. There were some cases reported that concerned very serious complications or even death afterwards. The most often causes of death were embolism syndromes of blood type rarely fatty. The recent years brought about revolutionary changes improving the safety of performing liposuction. Right now, adipose tissue is impregnated by means of a proper liquid, namely Klein’s liquid, just before the surgery, which reduces considerably the injury of blood vessels as well as bleeding during the surgery. At the same time the patient receives, before the operation, micromolecule heparin, the medication that lowers blood coagulation. The surgery is performed by means of thin probes called microcannulas. However, the most important condition is to suck not too huge amount of adipose tissue during one operation, up to 3 liters, and to qualify only healthy people to the surgeries not those who suffer from varicocele of the lower limbs, heart defects, overcollaguation of blood or diabetes. The surgery is performed under a local anesthetic (not a huge region) or general anesthetic (greater regions). Directly after the surgery the patient is dressed up with a special pressure dressing that, on the one hand, reduces the swelling, and, on the other hand, allows to model the skin to a new shape. The dressing is usually worn 2 up to 4 weeks taking it off only during washing. After the surgery some bruises may appear and pains in the operated regions. The troubles, however, are not big enough and do not limit daily activities. The results can be evaluated after a month, however, the final effect is visible after 3 months. It is measured in centimeters and the changes of the figure not by the kilograms. A visit in a clothes shop may be very pleasant 3 months after the surgery.
A forty-year-old woman who takes care of her health and physical appearance may look at her life optimistically, feel attractive and well. It is very much so that we are those who are responsible for our own lives. The same can be applied in terms of physical appearance.
Jerzy Kolasiński, M.D. Ph.D.
It′s been already fifty years
Fifty years of my wonderful life have passed. It is even difficult to figure out how quickly it passed. I must admit that I have achieved a lot so far, and I am very happy because of that. I married a wonderful man. We have been together for 25 years, and till now, we are good partners and friends. We have two adult children, a daughter aged 24 who studies law in Great Britain and a 19-year-old son who starts his medicine studies in Cracow. My husband and I live rather busy life. We live in Poland permanently, but working in many companies forces us to go on business trips very frequently. My husband practically spends the whole weeks in Germany. We are only left with free weekends. Then, the time we have is reserved only for us, and at least three times a year, we spend together two-week-long wonderful vacation in the house in Spain. However, despite so many duties and chores, we show each other huge sensitivity, and we spent our free time together most often. Our children practically lead their own life already and visit us only on Christmas time and vacation.
For many years of conducting various companies, I had to participate in numerous business dinners and banquets. It soon resulted in putting on some weight. I have always led a very active life, however, it was not enough to maintain a perfect shape. I started looking into the mirror critically more often and valuing my shapes. Finally, I decided to help myself and lose a dozen or so kilograms. Another incentive was that from time to time I also suffered from breathlessness and heart palpitation. At night I often woke up wet of sweat. For several months I also noticed scant bleeding. I realized that I was entering the time of menopause. My relatives told me more often that I was becoming more unbearable and too sensitive. I decided to change that. I started my therapy from the visit at the endocrinologist’s. The doctor, after having talked to me, prescribed me hormone examination. After another visit I got some medications in pills prescribed and something in plaster. I took one pill a day. The pieces of plaster were to be glued once a week at my buttock. After one-month therapy I felt much better. More cheerful and with a greater enthusiasm and energy, I came back to my responsibilities. But three months later, my weight increased a little bit. I got worried. I didn’t want to gain weight. Besides, I had already had to put away some of my favorite costumes and suits into the wardrobe simply because they were too small for me. The change of my weight was also noticed by my husband. It became even the reason of various jokes about me. I had to do something with that. Thus, I asked for help an internist specialized at obesity problems. The doctor advised me to change my diet, take long walks and attend some aerobics classes once a week. According to his advice, I changed my diet immediately. During my business dinners and banquets I delighted only in a set of vegetables and fruits. I limited the use of alcohol although I loved red wine. I also bought a dog to force myself to take daily walks. We have never had a dog at home. I also took up some aerobics classes for women after 50 once a week, during which our trainer forced us to be in sweat. I didn’t wait for the effects long. After six months of restrictive routines, I weighed 23 kilos less. It was a great success for me, but my happiness didn’t last long. Although the shape of my body improved, droopy and flaccid skin was not satisfactory. I started thinking intensively what to do with it. My face was sad and the upper eyelids were dropping strongly. Sometimes it was even difficult for me to choose a proper make up that would hide all the shortcomings. The rest of my body also needed improvement. Big dropping breast had to be sustained by a massive bra, and flaccid abdominal skin was falling over the thighs as a dermal fatty fold. I looked at myself with dissatisfaction. I knew that one of my friends underwent the corrective surgery of the abdominal and face a few years ago. I called her and asked her to give me the address of the clinic as well as the name of the surgeon who performed the surgery itself.
The same day I scheduled an appointment to consult with the doctor. After one week, I was sitting in a doctor’s office talking with a nice doctor. The surgeon informed me on possible corrective surgeries I could undergo. I asked many questions. First of all, I wondered whether it was possible to undergo such surgeries without any risk being at my age. I learned that if there were no other symptoms apart from my menopause ones I could undergo such surgeries. The doctor suggested me undergoing the lift-face simultaneously with the correction of the upper eyelids, whereas, the second surgery, i.e. the surgery of raising and reducing breast was to take place afterwards, and, finally, I was to have the correction of the abdominal covering. I was extremely interested in my face. That is why we started the correction from it. The first surgery was planned in two weeks time. All the required examinations I had already done, so it enabled me to have an appointment so fast. Under a local anesthetic, the doctor incised the skin of my face and corrected the upper eyelids. After three hours of lying in the surgery room, I was taken to another room where I had to spend two hours more having cold dressings on my face. I looked rather silly with all the stitches on my face. When I came back home next day, my husband was already waiting for me. He wanted to accompany me during my convalescence very much. However, on seeing me, he worried about the size of the dressing. Nevertheless, he supported me bravely all the time. On the second day after my surgery, I could notice numerous bruises in the region of my eyes and cheeks as well as swellings. Five days later the doctor removed the majority of the stitches and took off the dressing. The swelling disappeared almost completely, however, the bruises were still visible. I had to wait two days more until all the bruises and swelling disappeared completely. Two months later, I had an appointment to undergo another surgery. This time I underwent the corrective surgery of the breast. I arrived at the clinic on the scheduled day. First, my surgeon and I discussed and valued the effects of my face correction. The improvement was significant and postoperative scars were totally invisible. There could be some slight irregularities noticed in some parts, but they all could disappear after another two months. The doctor calmed me down saying that it was typical of the skin to need so much time to regenerate and rebuild.
The surgery of raising and reducing breast was more complicated one. I underwent the surgery in a general anesthetic, so, actually, I don’t remember anything. I had the feeling of waking up on the next day feeling a soft pain in my breast. After the surgery my breast was toughly wrapped and I also wore a sport bra. Two days later I felt much better and went back home. In the subsequent period of convalescence my husband accompanied me, too. ‘He is a wonderful man’, I thought to myself. The traces of the surgery in the form of swelling, pains and bruises were visible for the next two weeks. Afterwards I went for a control check-up. My breast did not have the final shape for sure, but the doctor was satisfied with the job he had done. The scars were slightly pink, but I knew at that time that they would become almost invisible after some time.
The next meeting with my surgeon took place again in the surgery room. This time I underwent the correction of excessive dermal fatty fold. The only remaining signs of it was a huge scar in the region of the hypogastrium. Next day after the surgery, during the change of my dressing, I had a chance to see an early effect. In spite of a fresh scar I already liked the new shape of my body. For the next six weeks, I had to wear a special pressure belt.
Then, I just needed to be patient and wait for the final results of the surgery. I was to meet the doctor in two months time. These were, I guess, the most difficult and the longest days in my entire life. Every day I looked impatiently into the mirror. My face looked younger, the breast firm and prominent just like 20 years ago and my belly, ‘what belly?’, you may ask. My new shapely waist and prominent thighs just like at the age 30. Christmas was coming and my kids, who didn’t know anything about my corrective surgeries, came back home as usually. One evening during the dinner my son looked at me carefully and said ‘you know, mum, you look 20 years younger’. Yes, I felt young and beautiful. The same evening I called my surgeon and thanked him.
Elapsing time is not indifferent to the woman’s organism. Usually at the age of 50 there appear some symptoms informing her about the expiration of hormonal functioning of the ovaries. It is an extremely difficult period in women’s life. In order to survive it, sometimes a strong will and the consciousness of undergoing changes is insufficient. A strong emotional tie with the husband, i.e. his help and tenderness are extremely important is this case. Sometimes it happens that still it is not enough and there comes the need to consult with the doctor. A vicarious hormonal therapy is often used, then. Although some elements of the treatment still arise lots of controversies, there are many women for whom the therapy is the best solution ever to alleviate the symptoms of the transitional period.
With age numerous changes appear in the physical appearance and the figure itself. Some defects are usually the result of a woman’s neglected duties. An excessive influx of calories results in the overgrowth of adipose tissue in the region of thighs, abdominal and chest. While comparing the level of gland tissue to the level of adipose tissue in woman’s breast, it turns out that with age the later overweighs the former. Women whose breast was huge while being young that usually was their attribute, in the mature age it can be the cause of pains in the backbone. Moreover, huge breast unables comfortable body movements. It is extremely difficult to practise jogging or play tennis in such cases. The corrective surgery is, thus, the best solution. There are even countries where the cost of such surgeries is often reimbursed by national health funds. The breast reduction surgery* is a massive operation thanks to which it is possible to restore the attractive look of the breast and reduce their size. However, the side effects are remaining scars. They usually remain around the areolas and vertically downward. Most of the reduction can be performed thanks to the so called vertical method. If the surgery is performed on a very large breast, then it is necessary to make transverse cuts that, finally, result in a scar in the subpectorial fold. Women who are highly motivated to undergo the surgery, the matter of scars is no longer a problem for them. Moreover, after a lapse of time, the scars become pale and less visible. The breast reduction surgery is one of the most difficult surgeries in the field of plastic surgery. It is performed under a general anesthetic and it usually lasts many hours and larger number of complications is possible afterwards. The period of convalescence is also longer and one should wait a few weeks to have the breast natural look restored. However, the final result usually compensates the size of sacrifice. The patients who underwent the surgery belong to those whose the degree of satisfaction is usually very high.
An excessive amount of the skin and adipose tissue accumulated in the region of abdominal constitutes a similar problem. Usually as a result of weight loss, the dropping of those body parts occurs which, consequently, causes many life problems. Not only does the figure have an unproportional shape, but also there happen some very serious diaper rush in the region of the hypogastrium. It usually happens during summer on extremely hot days. Just as abundant breast, also a droopy abdominal reduces the capability of comfortable movements. It is almost impossible to practise sport not to mention running on the beach. The intimate life is disordered and she cannot expect huge tolerance on the part of the partner. The skin and adipose tissue reduction surgery is usually connected with the plastic surgery of the fasciae and abdominal straight muscles. This is why it is called abdominoplasty*. This surgery similarly to the breast reduction one is performed under a general anesthetic. The biggest risk is connected with embolism syndromes, so it is extremely important to prevent them . The patients before the surgery are given certain doses of micromolecule heparin. They can walk in the first 24 hours after the surgery. The vision of a belly makes the patients feel optimistic. Usually a new recreated navel can enjoy its natural shape and slender longer figure allows to make plans concerning the change of cloth size. The stay in the clinic lasts usually two days. It is recommended to wear a pressure belt for the following four weeks after the surgery. It sometimes happens that one week later a certain amount of chyle accumulates under the skin that can be easily removed by means of simple tapping of the needle. The scar remaining after the surgery is straight and lies horizontally a few centimeters below the navel. However, it can be easily hidden under the underwear or bikini. So, one can take a walk on the beach with a nice smooth uncovered belly. Similarly to the breast reduction surgery, the patients who underwent abdominoplasty belong to the patients most satisfied patients with the possibilities offered by plastic surgery.
According to many opinions, face-lift is the symbol of plastic surgery. It is mainly used to correct the changes that occur in the fascia system and in the skin while getting older. A gradual dropping of face tissues like skin, adipose tissue or muscles are the result of flaccidity of face fasciae and constant gravity. As a consequence, the face makes an impression of tiredness and seriousness. The shape of the face from an oval and harmonous one becomes droopy with enhanced downwards cheeks and double chin. There are lots of corrective surgeries of this condition. They all come down to strenghten and raise the fascia system of the face and adipose bodies of the cheeks and the zygomatic arch. Face ‘lift usually refers to the 2/3 of the lower face. The cuts run most often on the border of the cheeks and ears, in the region of the temples and behind the ears. After having a certain layer of the skin prepared, the surgeon performs the plasty of the fascia system called SMAS. There are many techniques of performing the surgery. Recently, the invasive technique of face ‘lift called MACS-lift is gaining popularity especially among European women. It is performed under a local anesthetic and is usually connected with the liposuction of adipose tissue of the chin. The patient stays in the clinic 24 hours, whereas the dressing is worn for 2 or 3 days afterwards. As after any type of surgery, the patient needs to put up with the swelling of the face that remains usually one week. What counts most for the Europeans is a short period of convalescence allowing to come back to work within 7-10 days. Of course, the scars are pink then, but they can be easily covered by a special make up and haircut. The efficacy of the surgery is estimated to last 10-15 years. After this period, further flaccidity of the face occurs. However, the period itself is so long that the patient undergoes another surgery without any fear.
In recent years due to the growth of popularity of using a toxin of Clostridium Botulinum (such as Botox or Dysport), the forehead-lift is performed rarely. That massive surgery was replaced with the injections of the toxin performed every six months. Their great advantage is little invasion and the possibility of immediate return to daily routines.
Nowadays, a fifty-year-old woman does not have to face classifying her into the group of less attractive representatives of her sex. Thanks to her vital energy lying deep in her mind as well as modern plastic surgery she can bravely fight for the best place in the ranking among other women.
Jerzy Kolasiński, M.D. Ph.D.
* Under no circumstances can the surgery be performed if one smokes. The patients who are planning breast reduction surgery, abdominoplasty or face-lift have to give up smoking unconditionally two months before the surgery.
We set up a schedule for medical examinations
When we are young, full of energy and the joy of life as well as great plans for the future, actually, we do not have time to bother ourselves thinking about pain and diseases. Such issues seem to be too remote or even unreal. However, with age we are becoming aware of the fact that such unpleasant sides of life also refer to us. Let us take a narrow window of opportunity and, in advance, think of possible ways to prevent and detect diseases which may reveal in our body while getting older.
One of the branches of contemporary medicine, the so called ‘anti-aging’, has created a list of essential minimum of medical examinations for women in specific age groups.
At the age of 30 let us devote some time to undergo some of the diagnostic examinations. Let us start with the easiest ones connected with blood testing. It is worth analyzing the blood picture, blood culture, blood-sugar on an empty stomach as well as lipidograph, i.e. total cholesterol, HDL (high density lipoprotein), LDL (low density lipoprotein) and triglyceride. It is important to remember to have those tests undergone at least once a year. The obtained results will provide us with a lot of information on possible anemia, inflammatory state not to mention tumor. Continuing the discussion, let us mention carbohydrates disorders (intolerance to glucose, diabetes) and lipoid ones, namely some premises to suffer from atheroma and another disease strictly connected with it, namely heart hypaemia. Once a year it is recommended to have general urine test done.
High blood pressure is becoming a more widespread disease, and it refers to younger and younger women. Let us control our blood pressure at least twice a year since a thirty-year-old woman with a detected hypertension is not a surprise for a doctor. Let us remember that the upper norm limit is blood pressured equaled to 140/90 mm Hg.
The next comment refers especially to women who smoke. However, each and every one of us should think of having the chest x-rayed at least once in a two-year-time.
Extremely vast amount of information can be obtained due abdominal examination by means of ultrasonography. It should be performed once in a three-year-time. We will find out a lot about the condition of our internal body organs such as liver, bile ducts and kidneys.
I do hope that none of us has any doubt that commits a huge crime resigning from annual check-up at the gynecologist who is supposed to check reproductive organs, breast as well as a sample for cytology test should be taken.
Our breast, indispensable attribute of our beauty is , unfortunately, also the source of very serious and dangerous diseases. Let us not forget them! Medicine gives us the possibility to control them by means of mammography and ultrasonography. As thirty-year-old women let us undergo ultrasonography examination every second year. Our hand is an extremely useful diagnostic tool to check our breast, too. Thanks to it, up to 80% of women detects some irregularities in their mammas. Everyone of us should undergo such a control every month in the first part of the cycle.
Let us also take care of our organs thanks to which we may perceive the surrounding world. Once in a three- or five-year-time let us check the condition of our sight and hearing.
We are becoming older and more mature, but still professionally active and often also happy wives and mothers. We cross the threshold of the age of 40. Year after year goes by. Nonetheless, we should still continue the medical examinations done during the last decade. We continue checking the same blood parameters as well as blood pressure, breast roentgen and ultrasonography examination of the abdominal. Let us add also cardiogram-the examination that will allow us to control our heart. It should be done once a year. It is the matter of concern especially for those who know that their relatives suffered from cardiovascular diseases.
Our breast should be under strict control now. Apart from monthly self check-ups and annual ultrasonography test, it is time to take advantage of mammography. It is especially advisable for women undergoing menopause and just after it. Entering the age between 40 and 50 let us do it every two or three years.
We are entering slowly the age at which we should be interested in the condition of our bones. Let us plan the examination of the femoral neck density once in a three-year time to check whether we have not become the victims of osteopeny or, even worse, osteoporosis. Let us put an end to the era when the break of one of the vertebrae was a sign of an advanced disease.
Let us also start preventing the development of tumor of the anal passage, the large intestine or other inflammation diseases of these organs. Let us decide to undergo the examination per rectum (via the anal passage) once a year and a more detailed endoscopic examination (sigmoidoscopy or colonoscopy) this time once in a five-year-time. At that point we should visit a recommended proctologist.
We are getting closer to a very unpleasant moment in our life, namely menopause, that most often occurs on the verge of the age of 50. Some unpleasant symptoms may occur even a few years before the last period. And it is not the end since just after menopause the symptoms are still present. The best solution seems to be hormonal therapy. There is, however, one problem whether to use it or not. We may be even more anxious on hearing how many controversies arise among the scientists themselves concerning the advantages and disadvantages of the therapy. Nevertheless, we are not dismissed to discontinue the planning of our examinations so that our body would be under constant control. Let us do what we have been doing during the last 20 years. We will have to intensify, however, some of the examinations. Let us devote more time to our heart and undergo cardiogram tests every year.
An extremely important issue at this point is our breast. Let us control the breast by means of mammography every year. Also the risk of osteoporosis increases with entering the period of climacteric. We need to be conscious of the condition of our bones, so let us visit the laboratory of densitometrics once in a two-year-time.
I have just presented a draft of our health duties concerning only diagnostic examinations. It is extremely important part of our health activities. Let us think it over. In the vast majority of cases, the success of early diagnosis, prophylactic and successful therapy depends only on us and our life discipline. I would like to mention that the presented above schedule concerns only healthy women who do not need to be under regular control of specialists and connected with it more intensive schedule of examinations and treatment.
Many of us may be terrified how much should be done as far as the implementation of this schedule is concerned. However, I may assure that it is a very small effort in comparison to those which should be taken while treating diseases in advanced stages simply because earlier there was not time for minor examinations.
Anna Modelska-Ziółkiewicz, M.D. Ph.D.