Senin, 29 Oktober 2007

When Breasts Start to Show More Sag Than Shape

When breasts start to show more sag than shape - courtesy of age and gravity - what's the answer? Seeing her future self in her aged mother shocked Georgia Claremont into consulting one of New York's top surgeons. The result? From "fallen angel" to fabulous.

As a writer on matters pertaining to nutrients and fitness, health is my business & maintenance is my concern. Although far from vain (defined as looking into shop windows to catch your reflection), I have always taken pleasure in hearing that I looked twenty when I was thirty and feeling thirty when I was fifty. Over the years I have played, as on a game board, with prescriptives for youth extension. I have been able to affect every visible part of my body — hair, skin, teeth, nails — by means of vitamins, nutrition, exercise and meditation. And, judging by the infrequency of visits to doctors, my body's inner workings appear to have responded equally well. The one hold-out has been my breasts. Flopping and shapeless after breastfeeding two sons for an extended period, they became like islands, floating out beyond reach of any preservative. Nevertheless, we had a truce, my bosom and I. I would wear a bra at all times, foregoing the joys of strapless gowns and bikinis, if they would stay within acceptable parameters of sag. I was heartened by a lover who assured me periodically that breasts were not his thing and that, in any case, mine had a certain fallen-angel quality that he found appealing.

This delicate truce would have continued had it not been for the sudden illness of my mother, which required of me intimate ministrations over some months. I have to confess that I had never, in conscious memory, seen my mother fully naked and the reality of an eighty-year-old body that had never known a step machine or even a vitamin, catapulted me into shock. By far the most disturbing sight, however, was her breasts, which resembled the exhausted mammaries of African women who had nursed two generations while exposed to the punishing sun. Could that be me thirty years down the line? I panicked — breast sag is genetic after all.

And so my thoughts turned to the knife, and on my mother's recovery, my first gesture of self-indulgence was not a new dress, but a visit to one of New York's top plastic surgeons. The research was a little tricky. You don't phone around, as you might for a broken wrist, to find out who's the best breast man in town. But I was fortunate enough to have access to a short-list of New York's top plastic surgeons and, after carefully reading their dossiers, selected Dr. Darrick Antell. His biography detailed a backlog of experience, but what convinced me were two quotes: "plastic surgery is really about problem solving" and "you have to pay close attention to proportions". After all, we're dealing with two breasts here and it would be preferable if they matched.

So began my first venture into body transformation, a daunting road that split before me at each turn: to the left, the mythology of striving for an ideal; to the right, the no-nonsense rebuke of a puritan upbringing (what the heck are you doing?). Unexpectedly, the most fraught experience was the initial consultation. I had showered twice, put on a new bra and allowed thirty minutes to walk five blocks. I had rehearsed my questions until memorized: how much would they lift? How much pain for how long? How invisible are the scars? How soon could I resume normal life? In retrospect, I think that what I feared most was rejection. Would my breasts be the first inoperables? Told to strip (so much for the lingerie), I remained shivering in my surgical gown for what seemed like a weekend. Then, surprisingly, two doctors walked in — the very handsome Dr. Antell and a very pretty Dr. Hamilton (afraid of lawsuits? I asked her later —"male surgeon fondles breast?" — yes, she confirmed). They took my history, then pulled my breasts up and around as though moulding silly putty, until they approximated Hedy Lamarr's. "is this how you'd like them?" Wow! Absolutely! I was then given the option of two different techniques. One, the purse-string, involves a simple drawstring around the nipple. It results in the minimum scarring but also the minimum lift. The LeJour, a much-practised technique developed by a surgeon in Belgium, gives more lift. It involves a vertical incision under each breast to stitch slack tissue into new shapes. The nipple is then excised by a cookie-cutter procedure that brought to mind years of punching out ginger snaps for school fetes, with care not to sever any nerve endings, and placed higher.

Did I have any questions? Did I ever. Although different from the ones I'd rehearsed, they poured out like a mantra, the normal concerns of a normal woman intent on remaining in the loop. How soon could I exercise, party, have sex? Ride, drive, ski, have sex? Go to work, drink wine, floss my teeth, have sex? I should have picked up on the vagueness of the initial answers "we'll have you exercising soon, you won't feel like sex for a while" — but kept pressing until I got the statistics that I was looking for: walking some distance, one week; a mild workout, passive sex, two weeks; serious stairs, three weeks; riding, skiing and responsive sex, six weeks. The big question took more courage — would I retain feeling in the nipples?" Of course, the major nerve endings are in the centre and well beneath the incision." I felt relief that such pathways to pleasure were not in the hands of even the most skilled surgeon.

So there it was, a fait accompli, as simple as a health questionnaire to fill in, paying a deposit, a pre-op check-up and a date placed on the calendar for what was listed as my surgery but became, in the intervening three weeks, my new self. I approached this watershed with my entire battery of skills. I exercised massively, storing muscle as a camel does water against post-operative deprivation. To minimize bruising, I supplemented my vitamin regime with Bioflavinoids and, four days before, with pellets of Arnica. I prepared foodstuffs as if for a siege, freezing fortified soups, cubed fruits and grains and pastas laced with vegetables in one portion jars. I set up a night table with magazines, the television guide, videos and the four remote controls that even my best efforts had never managed to combine into one. I paid all of my bills, made long chatty phone calls to my mother and sons and generally put my affairs in order as though I were going to a place from which I might never return. The night before the deed I was virtually catatonic, rigid with fear that wouldn't sleep or would eat after midnight, a habit I haven't indulged in since my youth but that worried me so much that I stuck notes on the fridge and the sinks screaming No Water No Food! And, in what seemed at the time a masterstroke, I photographed my breasts in the mirror in a ritual of farewell and a document for future comparison.

I'm not sure if I slept, nor do I know how I got to the clinic, but I remember snatching at straws of limp excuses to postpone: surely I had a cold, perhaps even a fever! There was the last minute conference with Dr. Antell about procedure — was I absolutely sure that I didn't want the pursestring (well, what do you think? He thought, no) - a reassuring, if rudimentary, felt-tip pen drawing on each breast, a kindly anaesthetist who said I'd be conscious the whole time and to signal if I felt pain. Two hours later, I looked up groggily at a nurse who kept saying it was time to go home. What?! Couldn't I please just lie here for a week? But, in true American fashion, I was prised out of bed, folded into my clothes and delivered to my aunt who saw me home and eased me into my bed, fully clad minus coat. And there I remained for the rest of the day, dehydrated and bound tightly, so it seemed, in a bodice of bandages.

Little did I know that the roughest part of the day still lay ahead. Not in the confrontation with pain or discomfort, which were minimal, but in the mustering of courage. Post-op instructions were vague and distressingly few. I mean, could I lift a kettle, pull up trousers, heave myself into bed with or without use of my arms? What about opening drawers? Would coughing or sneezing rip the stitches out? There was no advice about food intake, sleeping position, bandage removal or appropriate soap - all I was told was not to bend, which turned out not to apply in my case, and to shower on the third day. Having a shower proved to be the ultimate hurdle. I was frightened of peeling away the bandages, of seeing the wounds, of meeting my own blood. And I was frightened about how my breasts would turn out. Would they look pretty? Would they be even? When concerns about hygiene finally prevailed, I taped over my bathroom mirrors before stripping. Far from restored, I felt damaged; far from transformed, I felt mutilated. I obsessed about losing body tone. And, increasingly, worried about losing my lover. Nevertheless, I had no desire to take up my life. Parties? Forget it. Stairs? Two steps loomed like Persepolis. Exercise? I wouldn't care if I ever did it again. And sex? Well, ditto.

When both doctors called to check up on my progress, questions of ultimate survival — food, sleep and muscle rebuilding — were at the bottom of my list. Forget health, forget orgasm — my priority was preservation, how to protect my new vessels. From now on I was a curator, as sensitive to the delicacy of my charges as if I were calculating how to keep two priceless items from sliding off a slope. Happily, there is nothing less permanent than a misfounded perception, nor as rapid in healing. I remember as clearly as the markers on a marathon the first time I tickled my nipples and they tickled back; the first time I raised my arms to put on a turtleneck; walked ten city blocks; washed my hair; climbed one flight; took the tape off the mirror and reached through the sheets for my lover. If the healing was slower than the guarantees that I had forced from my doctors, it was complete. My breasts now have a lovely shape, they are soft and they are even. And, yes, I do look like someone I knew well when I was courted and, yes, I do feel sexy in strapless and comfortable when braless. Soon the scars will have faded completely and I will, in some magical way, be transformed.

www.antell-md.com/vogue09.html


Bodies Under Construction -Thinking of Cosmetic Surgery?

By Liane Beam Wansbrough

Three years ago, when a 15-year-old British girl decided to get breast implants for her sixteenth birthday, the story made headlines around the world. Since then, media reports have continued to speculate that cosmetic surgery, once the exclusive domain of wealthy older women, is a trendy new option for any teenager with an adolescent hang-up.

Dr. Darrick Antell, a top New York City plastic surgeon, says he has seen an increase in the number of teenage patients but cautions against calling it a trend. “One of the main reasons for the increase is visibility: today’s teenagers are growing up with parents who have had cosmetic surgery, so they see and hear about it more. The media has also done a good job of making people aware of the procedures available. Another reason is acceptability. In a way, plastic surgery has come out of the closet,” Dr. Antell says.

When details of cosmetic procedures are frequently discussed on talk shows and published in magazines, it’s not surprising that they filter into our consciousness. “Sometimes when I’m out to dinner with my friends, we’ll play a game called ‘What would you have done?’ where we sort of daydream and discuss what we would do if money was no object and the procedures were safe,” says 18-year-old Alison Preiss, an Ontario high school student. While Preiss doesn’t think she could actually go through with a procedure, she says it could go either way. “I could grow up to realize that there are more important things than my nose, or it could really bother me to the point where I decide to have surgery. I suppose it depends on my lifestyle and career choices,” Preiss says.

Suzanne Ma, a 19-year-old Ryerson University student, has considered a double eyelid procedure popular in Asia. “I’m Chinese, and I don’t like my eyes. I don’t have double eyelids, so I feel that my eyes look a lot smaller than they really are. My concerns are not entirely for cosmetic reasons. With my heavy eyelids, my eyelashes don’t grow out properly. Some of them get trapped under the eyelids and it’s very easy for me to get an infection,” Ma says.

As in North America, plastic surgery is booming overseas, especially in wealthier Asian countries like Taiwan and Korea, where it is seen as a way to improve career prospects and self-confidence. In China, women and some men are paying thousands of dollars to have a brutal surgical procedure performed that lengthens their legs so they can fulfill height requirements often used to narrow down the number of job applicants.

Although reasons for cosmetic surgery range from getting a better look to improving job prospects, often the common factor among patients is more than skin deep. “Teenagers who are thinking about having plastic surgery to change the way they look are often addressing issues of self-esteem,” says psychotherapist Dorothy Ratusny. “Between the ages of 13 and 19, there’s a lot of emphasis on peers and what others think of you. It’s also a time when things such as not being part of the popular crowd, changes in financial situation and divorce can negatively affect a teenager’s self esteem.”

"You should be able to do whatever you want to your body, and no one should judge you." - Susan, 16
"People should just stop caring so much about everybody else’s opinion. Yours is the only one that matters." - Carrie, 17

Cosmetic surgery may have a positive impact if your body image is consistently tied to a negative focus on a particular facial feature or body part. Dr. Antell says, “The classic case is a teenage patient of mine who had reconstructive surgery to correct a significant discrepancy between her upper and lower jaws. When she came into my office for the initial consultation she was constantly looking at the floor. After the surgery, she was looking up and smiling. Now she’s singing in her local school group.” Dr. Antell is careful to point out that there are murky areas. “Liposuction is one of those areas. So is breast augmentation because you’re not really sure that the teenager has stopped growing yet. But there are exceptions, for example, if a patient has breast asymmetry.” Dr. Mitchell Brown, a plastic surgeon at Sunnybrook and Women’s College Health Sciences Centre in Toronto says, “Correcting breast asymmetry, when women develop breasts that are different in terms of shape and size, can be appropriate for teenage girls because it causes a very significant psychological impact on them during their developmental years.”

I just have two words: Michael Jackson. - Jason, 18
"If you’re doing it because of what other people think, then it’s wrong." - Mike, 15

Doctors are very aware of the psychological drama affecting our lives and it has become a very important factor when evaluating a patient. Dr. Brown says, “The key thing from my perspective is to assess physical, emotional and psychological maturity before treating a patient. I spend a great deal of time with my patients, regardless of their age, to determine that they have thought out their concern carefully and have reasonable goals and expectations.” In other words, cosmetic surgery can improve a patient’s body but it won’t necessarily improve their self-image or guarantee happiness. Dr. Antell says, “I’ve done liposuction on a Sports Illustrated swimsuit model. This is somebody most people would think looked perfect. But she was very insecure. She didn’t see herself the way others did. I can’t give people confidence.”

So, if you’re considering cosmetic surgery you need to ask yourself what you hope to achieve because it’s not going to be the one magic solution that makes everything better. In fact, it may even change you for the worse—just surf the Web and read the thousands of horror stories from people hoping to find peace of mind or happiness by going under the knife.

Dr. Ratusny says, “[Teens] need to be really realistic with the fact that cosmetic surgery may be only one piece of many things that serve to improve aspects of themselves. There may be physical changes but the real change begins with who they are inside.”


http://www.fazeteen.com/fall2003/cosmeticsurgery.htm

What happens when one twin thinks:"It's time for the plastic surgeon....."

Plastic surgery and twins - before photoby Claudia Steinberg
Jane and Joan Kochan have spent their whole life together. Their respective marriages lasted only a short time and since then they have been each other's favorite company. Joan and Jane live only a stone's throw away from one another in Clearwater on Florida's west coast. Every day from seven in the morning until five in the afternoon they sit facing each other in the investment company Solomon Smith Barney, where they are responsible for managing their clients' capital — around 170 million dollars — profitably. The evenings are short and are often reserved for dinner with clients or a workout with their joint trainer and always entail preparations for the next morning, which the alarm clock announces at five o'clock. About three years ago, during a difficult economic phase, Joan discovered signs of tiredness in her twin-sister's face, which could not be cured by good cosmetics nor by lots of sleep at the weekends. Jane saw the same symptoms in Joan's face. "We don't smoke, we don't drink, we are not married nor do we have any kids," they both thought and attributed the lines to stress resulting from the fluctuating stock market. Moreover they were both on the other side of their mid-forties. "We haven't wasted any time thinking about growing old with dignity," as Jane puts it.

Even as teenagers Joan and Jane were interested in fashion, dressing in black in the pink and turquoise world of Florida. The tired faces simply did not go with their wonderful fighting look, made up of highly tailored suits, shiny buttons and solid gold jewelry, a look they perfected over the years. One day Jane came across an article about a plastic surgeon who had operated on more twins than any other doctor.

During his training to become a plastic surgeon, Dr. Darrick Antell had met a set of female twins, which aroused his interest in this complex form of identity: one of the young girls had been disfigured by burns. How difficult could it be for the two of them —Antell asked himself — to look at each other?

Later, after he had been in practice for many years on Park Avenue in Manhattan, Antell traveled one summer to Twinsburg in Ohio, where thousands of twins celebrate their existence as identical pairs every August and where scientists recruit volunteers for their research projects on cancer, multiple sclerosis and every other conceivable illness. To Antell's surprise no-one seemed to have seen aging as a subject for research. So he started on the systematic comparison of the skin and tissue condition of single-egg twins. Using hundreds of photos he demonstrated impressively the influence of the sun and nicotine, nutrition and worry on the physiognomy. Whilst most dermatologists regard the sun as the worst factor in wrinkle formation and as evidence point to wrinkle-free zones of the body which are protected lifelong by clothes from the sun's rays, Antell attributes to cigarettes the main role in accelerating the aging process: "Smoking is an entire body problem, reducing not only the blood supply to the skin, but also to the liver , the heart and the kidneys."

Even twins whose ways of life were very different and whose double portraits looked more like before-and-after pictures of the same people, were aware of the inequality only in the rarest of cases: they saw themselves mirrored in the face of another person — until Dr. Antell told them otherwise. Many twins decided there and then to have an operation to restore the optical balance.

Joan and Jane had in face led almost identical lives and accordingly their skins demonstrated hardly any differences worth mentioning in terms of structure, yet under no circumstances did they want to lessen the much-loved similarity of their appearances, by one suddenly looking younger than the other: "We are regarded as a unit," say Jane and Joan. The career women didn't want to change anything in their double power image. For their 48th birthdays they gave each other a facelift from Dr. Antell.

Plastic surgery and twins - after photoJoan and Jane, daughters of an Argentinean mother and a German Jewish father, are blessed with good skin with lovely coloring. Most of their friends advised them against the operation and instead recommended a trip to a health farm, to get some rest. Even Dr. Antell considers an operation in many cases to be premature and refuses about fifteen percent of all potential patients, because they suffer from a distorted self-image. He is regarded as one of the most expensive doctors in his field and does not rely on a large turnover of patients — for the New York Times he calculated that Barbie, who had just turned 40, would have to pay out about $53,000 to reconstruct her youthful perfection, if she were not made of eternal plastic. A colleague would certainly bill her for less for a facelift, tummy-tuck and hip liposuction. But at Dr. Antell's the patients lie under warmed blankets and they find chocolates on their pillows in the evening: he calls his Park Avenue practice a five-star business, with a discreet side entrance for the VIP clientele who — if they don't live just round the corner — prefer to check into the neighboring expensive hotels. He considers Joan and Jane as classic "baby-boomers" — member of the post-war population explosion who confront their cosmetic midlife-crisis with the weapons of current fashion.

With twins Dr. Antell always operated according to the time of birth for "reasons of consistency." The younger twin has to sit out the longer waiting period with an empty stomach, but she has the advantage that the doctor is working on familiar territory with her: "When I have operated on one twin, I know the second one without looking."

Dr. Antell started by suctioning small deposits of fat under both women's chins, and he removed from both so-called buccal fat, the small deposit in the cheek which prevents and elegant, firm face contour. Models particularly like this small operation which only lasts a few minutes as it enables a better distribution of light and shade. In days gone by patients used to have their molars removed for the same effect.

Joan and Jane were satisfied with a lift of the lower half of the face, which did, however, require extensive work on the tissue lying below before the skins could be gently smoothed at the the level of the eyebrows. The incisions are hidden behind the ears and the hairline. Shortly after the procedure Dr. Antell sent both sisters to a skin specialist, who reduces the swelling and bruises in the shortest possible time with herbal cremes, lymph drainage and individually selected combinations of vitamins.

Four days after their operations, Joan and Jane appeared for a check-up in Antell's office, the fading bruises hidden behind large sunglasses, and laden with shopping bags from Bergdorf Goodman on Fifth Avenue. Dr. Antell was pleased. However, even in this case he has yet again not succeeded in setting the example he dreams about: he would love to prove on a single-egg pair of twins that the benefit of a good facelift is never lost. Even twenty years after the operation, one sister will look as many years younger as straight after the operation. The chances of finding an acquiescent pair to prove his theory are very slim. Antell knows the issue with plastic surgery, not only for twins, but for everyone else, is similarity: "...similarity with the picture of oneself, which one considers as normal."

http://www.antell-md.com/vogueg.html

by Claudia Steinberg