If you’re thinking about having ‘something done’ – be it a non-surgical cosmetic treatment or a surgical procedure, there is a time factor to be considered (and we’re not just talking about downtime here). Paola Chellew does some digging into the shelf-life of your chosen treatment.
Expiry dates are part of the consumerism age: whether it’s the stale box of crackers in your pantry or the milk that is going off in your fridge, we usually know when it’s time to throw away the old and make way for the new. In fact, just about everything has an expiration date – from foods, beverages and medication – to explosives, chemicals, and plastic surgery procedures.
And yes, you read that right – even certain cosmetic procedures and surgical operations actually carry a shelf-life as well, which means that if you’re thinking about going under the knife in hope of achieving permanent results, you would probably be disappointed. We, therefore, need to consider the duration of the effects of the treatment or operation- and if it’s worth doing it all over again when the clock ticks over.
Shelf-Life of Surgical Procedures
Breast implants are a fine example in this regard, as while the thought of filling a black lacy D cup may be incredibly desirable, it must be taken into account that in a decade or so, the implants have passed their sell-by date, whereafter you’ll find that you may need a revision.
With this in mind, we ask the experts to clarify why and when certain procedures may require a
Dr Carla Norval (FCS (SA) (Plast) (2001), MB ChB Stell (1989), FRCS)
“Good gel implants, whether they are silicone or saline, come with a lifetime warranty seal. However, even though improvements have been made to increase their safety and longevity, there are a number of factors that could affect their lifespans, such as trauma to the chest area or scar tissue hardening around the implant. I usually advise patients to start a “Breast Fund” so that they can plan for surgery again in 10-15 years.
I am also strict about post-op precautions, as following the doctor’s orders can go a long way to not only ensure there is no infection but also to warrant a longer-lasting result. Screenings and self-examination are also important, as an ultrasound will be able to show if there is a rupture. Mammograms for patients with implants are best done by radiologists who are specialised in breast imaging. They will also be gentler, thus avoiding damage to the implant.
Meanwhile, breast cancer patients who’ve had reconstruction on one side might need a lift on the other side as time passes, depending on whether they are cancer-free and in good health,” Dr Norval adds.
Dr Nerina Wilkinson (FC Plastic Surgeon, MBChb)
“The longevity of breast implants is not clear, even if most companies give a lifetime guarantee on an implant.
My advice to a patient is not to wait for an implant to fail, as the surgery to remove a ruptured implant is more complex and time-consuming, as opposed to replacing an implant before it packs up.
It is quite simple: if you were to wear the same pair of shoes every day of your life, you would not expect that pair of shoes to look good after 15 years!”
Dr Gareth Tjasink (Plastic Surgeon, MBChb)
When it comes to facial rejuvenation, Dr Gareth Tjasink bases the time-lapse of procedures on the individual: “How long a procedure like a facelift would last is a difficult question to answer as so many variables come into play.
Firstly, it is not a procedure that stops the ageing process; you will still age and therefore the effects of the surgery will wane. How an individual’s skin quality, elasticity and facial volume age is very dependent on one’s lifestyle, habits (like smoking) and genetics. Some women in their late 60s still don’t need a facelift, as all these variables have been optimised in favour of decreasing the effects of time.
Secondly, a surgeon’s chosen technique can greatly affect the longevity of a procedure. A “deep” facelift, called a Sub-SMAS facelift, should, in theory, last a lot longer than a Subcutaneous (skin only) approach facelift. These differences should be discussed with the patient before surgery, as there are pros and cons to both.
In my opinion, the correct procedure for the appropriate indication can give a patient a long term result if they look after themselves,” concludes Dr Tjasink.
Dr Wilkinson agrees: “Genetics play a large role in the longevity of a facelift, as well as the technique used. Most patients today request a more natural look, where the lift is more subtle and will possibly last for a shorter period. The rejuvenating results of a facelift are enhanced if combined with the injection of fat and stem cells under the skin to improve its elasticity and texture. Maintenance after the procedure: ie. skincare, laser skin tightening procedures, muscle relaxing injections and fillers will prolong the effects of a facelift.”
Blepharoplasty (eyelid lift)
“As with facelift surgery, most patients are requesting a natural result, so the approach is not only to perform a blepharoplasty but to rejuvenate the orbital (eye) area as a whole,” says Dr Wilkinson.
“This means a combination of removing upper eyelid skin while also enhancing the volume around the orbit by injecting fat and stemcells. All in all, it gives a more natural, long-lasting result. Most patients who have a combined blepharoplasty and lipofilling will have a result for 10 -15 years, versus a traditional blepharoplasty which may last for less than 10 years”.
Dr Tjasink agrees that blepharoplasty is a great procedure to freshen the face without undergoing major surgery. He says: “A standard upper lid “show” is considered aesthetically pleasing, especially if hooded skin sits directly on the lashes as this presents a tired, sad appearance. Medically, if a lid interferes with vision, it is a good indication for surgery. A blepharoplasty should last 5-10 years, but again, with so many variables at play, it is difficult to answer that question with any real degree of accuracy”, he adds.
According to Dr Tjasink, liposuction is rather a body contouring technique than a weight-loss method: “Patients undergoing liposuction to lose weight will be dissatisfied with the outcome of the procedure, and stands to put themselves at unnecessary risk if large volumes are removed”, he says.
“Theoretically, once fat from a certain area is removed, volume in that area should be permanently reduced. But this is only if the patient doesn’t engage in lifestyle choices that result in large calorie surpluses in their diet that lead to weight gain. Moreover, when fat is removed during liposuction, some of it has to be left behind to give a pleasing, smooth skin quality – and it’s this fat that will increase in size if you feed it.”
Shelf-Life of Non-Surgical Procedures
As a different option to surgery, non-surgical aesthetic procedures give a softer result and are a great alternative if budget is an issue – however, the effects may not be as long-lasting. For example, botulinum toxin injectables last a mere 3-4 months, and so patients need to repeat treatments on average 3-4 times a year.
The durability of various non-surgical treatments:
Dr Debbie Norval MBBCh (Rand), Dip Pall, Med (UK), MPhil Pall Med, (UCT), Adv Dip Aesthetic, Med (FPD)
“Absorbable threads are a good alternative to more invasive procedures, such as a facelift, because the recovery time is faster and the cost is lower. Simple monofilament polydioxanone (PDO) threads last only 3-4 months, but other PDO threads that are barbed, coiled, spiralled or anchored can last a bit longer (with the clinical effect of 8-12 months)”.
“Hyaluronic acid fillers come in a variety of grades of viscosity or G Prime. High viscosity fillers that are used in cheeks for volumising, lifting and sculpting last 12-18 months. As for softer fillers that are used for the lip area, these may last between 8-12 months (depending on the brand and quality of course). Another factor to consider is that good quality fine line filler will last a year, while a cheaper equivalent will only last 6 months.
Then you get non-hyaluronic fillers, which work through biostimulation and collagen induction. These fillers last 8-12 months in the body, but the clinical effect can last up to 4 years, as the lasting effect is from the patient’s own collagen production.
Skin boosters on the other hand, only last for a few months and thus needs to be repeated to get longer-lasting results.”
Dr Debbie Norval does advise that permanent is not necessarily a good thing. A good aesthetic doctor will know that facial bone structure, fat pads and retaining ligaments all change as one ages. Using non-permanent treatments allows the doctor to continually adapt treatments as the patient ages to keep them looking natural and age-appropriate. What looked good at 40 will look odd at 60, so non-permanent aesthetic medicine allows for more natural-looking treatments
“Whatever your choice, make sure that your surgeon is well qualified, and remember to ask all the relevant questions at your consultation, Dr Debbie says. “And bear in mind Virgil’s sage words: “Tempus fugit”.
A2 Disclaimer: This article is published for information purposes only, nor should it be regarded as a replacement for sound medical advice.
This article was written by Paola Chellew and edited by the A2 team EXCLUSIVELY for the A2 Aesthetic & Anti-Ageing Magazine Summer 2019 Edition (Issue 32 – Dec 2019 to Mar 2020).
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