COSMETIC SURGERY FOR AGEING SKIN: FACE-LIFTING

Attractiveness is considered a great asset in our society. As a result, there has been a surge in the demand for cosmetic surgery. This is most obvious in the United States, but the demand is also growing here in Australia. Cosmetic surgery is now sought by people from all walks of life, not just television personalities and film stars.There have been many advances in the field of cosmetic surgery, both in surgical techniques and anesthesia. Many cosmetic procedures are now performed under twilight anesthetic in day procedure centers, so that hospitalization is not necessary. This also means that cosmetic surgery can be done less expensively, and that people can resume normal activities within a short time. Improvements in the area are continuing into the 1990s, particularly with the advent of laser surgery.
Face-liftingFace-lifting is the best known of all cosmetic procedures. Here both the skin and the underlying supporting tissues are pulled up against gravity and re-attached to the upper part of the cheek bone. Face-lifting lasts about ten years and is most suitable for sagging facial and neck skin. It is less effective for fine wrinkles and does not improve the textural changes that occur due to sun damage, that is, photoageing. Many people are disappointed with the results of face-lifting, because they have unrealistic expectations of what it can achieve.Major advances have occurred in this field, especially over the last decade. In the past, many facelifts looked rather unnatural and often produced unsightly scars as well as swelling and bruising. People often needed to take two weeks off work and hide from curious friends and neighbors. The older method of face-lifting relied on pulling the skin very tight under excessive tension. This distorted the facial features and did not last very long.A breakthrough occurred in the 1970s when surgeons took into account the fact that the facial skin is supported by an underlying structure called the SMAS. This membrane surrounds and supports the delicate facial muscles. By pulling up the SMAS against gravity, and attaching it to the top of the cheeks, facelifts became more natural looking and longer-lasting. Lasers, for example KTP lasers, are now used in face-lifting, causing almost no bruising or bleeding.Another major improvement in facelift surgery occurred in the field of anesthesia. Facelifts are now routinely performed under twilight anesthetic as a day patient procedure. This lighter anesthetic has minimal health risks, so that facelifts can be done more safely with much quicker recovery. In the United States, people can now return to work within four or five days with no obvious signs of recent surgery.Complications can occur with face-lifting, although major problems are rare. It is common to see swelling and bruising, and scars are often visible behind the ears at the hairline. Scars in front of the ears are usually virtually imperceptible.Anyone contemplating a facelift must remember that the procedure only lifts the skin up against gravity. It will not improve the skin’s texture and will certainly not remove wrinkles around the mouth. To do this, a chemical peel or dermabrasion is necessary.
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HELPING YOUR CHILD COPE WITH EPILEPSY: WHAT DO YOU TELL THE SCHOOL AND HIS CLASSMATES?

Teachers are an important part of your child’s environment and can be enormously helpful to the child with epilepsy. If they are informed and properly educated, the teacher will know what to do and what to say to classmates should a seizure occur in school. They need to be prepared should a tonic-clonic seizure occur. They can be very helpful in alerting the parent and physician to changes in performance or personality that might be related to drug toxicity.One of the prevailing myths is that children with epilepsy are stupid or have learning problems. According to many studies, children wi th epilepsy do tend to have more difficulties in school, but this may be a consequence of fear or anxiety, his own and others’. Nor does this mean that all children with epilepsy have learning problems. Most children with epilepsy do not. Some teachers may see learning problems that aren’t there. They may be responding to the myths. But often, the teacher is sensitive to your child’s needs. If she points out problems, your physician can evaluate whether they are related to medication. The school may be able to devise an individual educational program to meet your child’s needs, if one is required.Learning problems may not be the result of epilepsy at all. Many children who never had epilepsy don’t learn easily. Or, as noted, problems may be a side effect of medication. A change in your child’s personality or in his abilities when medication is started may signal such a cause. Early identification of this possibility may allow the physician either to reduce the dose of the drug or to change the medication.To be sure that teachers, school nurses, and principals have accurate information, you may provide some of the excellent pamphlets available either directly from the Epilepsy Foundation of America or from a local affiliate. Many pamphlets are written so that a young child can understand them and are available either free or for only a nominal charge. Pamphlets such as Because You Are My Friend explain epilepsy in simple terms to a young child’s siblings and friends and, when appropriate, can be used in the child’s classroom. Your local epilepsy association can probably provide speakers or perhaps the wonderful puppet show “Kids on the Block,” and will try to help educate the school. A brief classroom session may help your child’s classmates be more understanding, helpful, and friendly should they see your child have a seizure.*181\208\8*