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  • By Sherrell Aston, M.D., F.A.C.S.

    Rachel A. Miller, PA-C

    The holiday season is quickly approaching, and we are all eager to celebrate with family, friends, and colleagues. But some of us are, at the same time, wishing we could have a little more time to get “holiday ready.” That is, we know that our holiday décor is not the most important thing on display this year—we are! If you are a member of the some of us crowd, then read on:

    You have decided that this year is your year, and you are going to look and feel your best! Plastic surgeons have a few special tricks to get you there, but time is of the essence. Since time is our limiting factor, let’s begin there:

    Sherrell Aston, Plastic Surgery

    Your schedule is tight, and so is your plastic surgeon’s. If you plan to spruce up before the holidays, you are running short on time. But, don’t despair; modern techniques offer less invasive procedures and faster recoveries. For example, you could have a facelift and be “party ready” in just 2-3 weeks. If you are even shorter on time to spare before the holiday season, Botox injections can leave you looking more refreshed in just days. Of course, you should not forget that plastic surgery is really surgery, and the recovery time depends upon your chosen procedure. Certainly there is variability among patients in bruising, swelling, and final healing, but it is possible to make some generalizations for the most common procedures.

    Modern facelift techniques can provide dramatic improvements to your face and neck and require a recovery time of just ten days to two weeks before you could attend a social function. In just twenty-one days you could be back in the gym, engaged in full activities. Short-incision facelifts look very good in seven to ten days for many patients. Today’s facelift procedures are technically sophisticated and highly individualized for the particular patient. No two people are just alike, and accordingly, nor are any two facelifts. Repositioning of the underlying facial foundation (muscles, muscle coverings, and fat) rather than just pulling the skin tightly across the face is the key to a refreshed and youthful, but not “operated-on” appearance.

    Unless they desire a look very different from their original face, most men and women in their 40′s and 50′s do not need volume addition or replacement. Some individuals do lose facial fat volume as they age, and they may benefit from fat grafts (fat taken from one area of your body and injected into your face) or filler substances very judiciously placed. Injectable filler solutions fall into two main categories: (1) man-made or natural hyaluronic acid substances (Restylane, Perlane, Juvederm, Sculptra) and (2) fat. Recovery from injectable fillers is extremely variable and dependent upon the amount of substance injected and individual healing. Very limited amounts of injectables can offer short recovery times—days to weeks; but do not be fooled, extensive additions of injectable solutions can cause significant swelling and bruising, and therefore, they require extended recovery times—three to six weeks. Most importantly, you should seek out an experienced plastic surgeon and openly discuss your cosmetic desires. Injectable solutions, if used too liberally, can significantly alter your facial shape, which is not usually a patient’s goal.

    The fine lines surrounding your eyes and upper lip will not be best improved with injectable solutions. Do not lose hope, because plastic surgeons have tools for these pesky grooves. Advances in laser technology allow plastic surgeons to target the fine lines in the surface of the skin to reveal refreshed, smoother, younger-looking skin. Do not be fooled—Any skin resurfacing procedure that provides a significant result will require some down time. You should expect significant redness that will regress over four to six weeks, but this redness can be easily concealed with makeup within about seven days. Laser resurfacing of the skin around your eyes or lips is a procedure to consider if you desire a smoother skin surface and you have at least one week of flexibility before your event. You will be so pleased with how smoothly your makeup will glide across your newly-smoothed skin.

    Speaking of makeup, have you realized that you are wearing eyeshadow that no one else can see? This may be because your eyelid skin is getting droopy with age, or it may be due to an increasing heaviness and drop in your brow position. Regardless of the cause, the problem can be fully remedied in time for your holiday festivities, if you have around two weeks to go. Modern browlift techniques avoid the old-fashioned scar across your hairline and can lift the brow into a more youthful position with just a couple of very small incisions that are fully hidden in your hair. A blepharoplasty “eyelift” procedure can not only provide a smooth surface for your eye makeup, but it also removes excess skin and bulges from your eyes to give a refreshed, awake, younger appearance. As with any surgery, individual healing times will vary. In most cases, significant regression of bruising and swelling occurs within ten days, and you can begin wearing makeup even sooner. In fact, a skilled makeup artist could conceal any bruises resulting from a browlift within one day of surgery.

    Perhaps you have been too busy with holiday planning this year and you do not have even one week to spare! Do not despair; with just a few days to go before your big event, there is still time for Botox. Skillfully placed Botox injections can leave you looking refreshed and rested with zero downtime. Just spend ten minutes with your plastic surgeon and then you can hit the mall again or continue your holiday preparations. Of all cosmetic procedures, Botox is one of the least-invasive options, and with skilled delivery, you will not look “over done.” Botox decreases the contraction of facial muscles, which subsequently decreases the amount of skin that can wrinkle up in certain regions of the face. Particularly good areas to target are the forehead, the crowsfeet, and the area between the brows. Perhaps you were considering a browlift but you worry about having enough time to recover before your upcoming events. Botox offers a temporary solution that can lift the outer edges of the brow just a bit. For most people, Botox begins to take effect within a couple of days, but its full action is not realized until around day ten. Though Botox is popular and widely available, it is not risk-free. You should still seek out an experienced physician who can skillfully inject the Botox without causing distortions in your facial expression.

    If you are wondering about what the possibilities are for the rest of your body, you are in luck! The options for targeting troublesome body zones are much more flexible, as your healing parts will be concealed under your party clothes. For instance, breast augmentations and moderate liposuction procedures do not significantly impose upon your holiday schedule. Take a day or two off from shopping and holiday prepping just after surgery, and then, if you feel like it, you can put on your finest frock and head out the door (but please refrain from vigorous activity or exercise). Just don’t forget to communicate with your surgeon, follow his instructions, and return to the office for your post-operative appointments. Larger volume liposuction procedures, breast reductions, breast lifts, and abdominoplasties (“tummy tucks”) require a bit more recovery time, and so should be considered if you have at least two weeks of flexibility.

    If you have decided that this is your year to outshine your Christmas tree or Menorah, then it’s time to get started! You are the most important person on your gift list, and if you are like most of us, you really hadn’t thought about that. Give yourself a gift this year that will keep on giving and spread some holiday cheer!

    About the Author

    Dr. Sherrell Aston, Plastic SurgeonDr. Sherrell Aston is the Surgeon Director and Chairman of the Department of Plastic Surgery at Manhattan Eye, Ear and Throat Hospital (MEETH) in New York; more cosmetic surgery procedures are performed each year at MEETH than any other institution in the World. He also serves as a Professor of Plastic Surgery at the New York University School of Medicine and Institute of Reconstructive Plastic Surgery.

    His major research interests are facial anatomy in aesthetic surgery and techniques for improving surgical results. Dr. Aston is renowned for his development of the FAME (finger-assisted malar elevation) technique for facelifts, which repositions not only the skin, but also the soft tissue of the face to give a youthful but non operated appearance.

    Dr. Aston received his Medical Degree from the University of Virginia, in Charlottesville, Virginia. His post-doctoral training included a surgical internship and residency at the University California, Los Angles (UCLA) Medical Center. Prior to being Chief Resident at UCLA, he was a Halsted Fellow in Surgery at John Hopkins Hospital. Dr. Aston continued his training as a Plastic Surgery Resident and Chief Resident at the Institute of Reconstructive Plastic Surgery, New York University Medical Center. Dr. Aston is certified by the American Board of Surgery and the American Board of Plastic Surgery. Learn more about Dr. Sherrell Aston.

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