Breakfast with Dr. Frank Beninger, discussing -
"What you should know about Surgery"
Int: Dr. Beninger I would like to ask you about the "New Old" the Baby Boomers. They don't want to look old, and it seems this has created a rush to the plastic surgeon. With so many surgical and non surgical techniques , how is one supposed to know what they should get. What should the individual know about techniques to look better?
Dr. B. First, it's not just the boomers want to look younger, it's just that they feel good, they are still young, they are vivacious, they are still very active, and they want to look the way they feel. It's about trying to match their physical appearance with their internal feelings and appearance. A lot of Boomers don't mind 'looking' their age they just want to look 'good' for their age. Certainly with technology, we've come a long way, and can now offer surgical and sometimes non surgical alternatives. The techniques have become much safer to use, less downtime, smaller incisions, less scars. These techniques are now options, when in the past they were not. A lot of people are coming now for the typical facelifts and eyelid lifts that past generations have always had, as they were aging. However, many men and women are also coming for some of the lesser known procedures, like breast augmentation breast lifts, which weren't done as commonly in the past. and that's because they are trying to maintain their youthful image overall, not just in facial appearance.
Int: There's a lot of talk about injectables, particularly BOTOX, so how is someone supposed to know if they should have an injectable or surgery - how do they decide, how do you advise them?
Dr. B. Patients come with a certain problem or concern, and to find out what the treatments are. For many problems, there are two or three treatments that may work for them. Some are surgical, some are non surgical - just depends on how aggressive they want to be, what kind of outcome are they looking for, and making a choice of what would work best for them.
Int: If you've had a facelift, how long does a facelift last?
Dr. B. A facelift will last forever, in the sense that it has very long lasting visible results. It doesn't stop the face from aging, and with time some of the problems and concerns that people had and were corrected with the facelift, those problems will return. Most people find that the results will last for 10-15 years. Those that do come back for a 2nd operation, the operation is not nearly as aggressive, its more a maintenance type of surgery, if you will.
Int: if someone has never had surgery before, and they are in their seventies, is there any limit to the age of having surgery for the first time it it's a facelift?
Dr. B. I have done surgery on people in their seventies, even late seventies and with very successful outcomes. The most important thing is to look at the underlying health of that individual, whether they have or have had any heart problems, blood pressure problems, and if so, whether cosmetic surgery is a good option as far as safety goes.
There are certainly some young people in their 20's and 30's who are poor surgical candidates, because of other health issues. There are people in their 70's and 80's who are very healthy and very good candidates for surgery. One of the things you have to keep in mind is, as people age they may have underlying health problems that aren't readily apparent. Sometimes after surgery, those problems can become more apparent. We have to be very careful about drug dosing and making sure that their intravenous fluids are maintained, to keep their blood pressure at appropriate levels.
Int: The injectables for an older person in their 70's, who perhaps had a med problem, couldn't undergo surgery, could they have the option of an injectable or would that not work for someone who is older?
Dr. B. Since injectables aren't surgery, you are not going to get the same results with them as you would with surgery. But on the other hand, surgery will not always achieve the results that injectables can. Quite often the two will work together, giving an even better end result. There are some people who will only have surgery, and some who will only have injectables. It's important to realize that either of them, have some shortcomings and you have to be willing to accept those shortcomings, if you are going to appreciate the result.
Int: There has to be some risks associated with surgery. Do you discuss those risks with your patients, and explain to them what could potentially happen?
Dr. B. Absolutely! Morally and ethically you have to do that, as well as legally, you have to go through the risks and potential complications of any procedure, even if it's a minor procedure. By law we are required to talk about common risks or complications even if they are not health threatening. Bruising and swelling for example, everyone gets some and they disappear eventually, but we must alert the patient to that. I'm also required to discuss potentially disastrous risks and complications, even if they are extremely rare. This would be risks like blindness, after eyelid surgery, or even death following surgery. Those are the potential risks, and people need to be informed and made aware of them, even though they are extremely rare.
Int: What would happen if someone had a heart attack whilst you were performing surgery,?
Dr. B. The important thing is to try to prevent anything from happening, and we do this by careful screening during the consultation. We begin with the patient's history and a physical examination. There may be blood work or an ECG and if there is a history of any heart problems then we have to be prepared to treat them. No matter how minor the surgery, we monitor the patient very closely for their heart rate rhythm, the oxygen level in their blood and their blood pressure. This is all automatically recorded and continuously taken throughout the surgery. Secondly, by our own choice we all have training both doctors and nurses, in advanced cardiac life support . We have the necessary drugs and equipment to treat these problems should they occur. Finally this is not an intensive care hospital, but if anything untoward or unusual had to happen even if we did reverse the problem, all the patients would go to hospital which luckily is a half mile distance away, so we are very close to extra support services.
Int: so in other words if something had to happen you have all the facilities here to handle it, and there wouldn't be any difficulty in getting to a hospital.
Dr. B. That's correct
Read the second half of the interview
