Dr. Robert Grant’s Life-Stage Approach to Cosmetic Surgery

Since its introduction into the field of medicine, cosmetic surgery has been a controversial and often misunderstood practice. Many believe it is reserved for the elderly, the wealthy, or the vain, while others simply view cosmetic surgery as a series of complex and expensive procedures. But the truth is that cosmetic surgery has a wide range of applications. Adults from all walks of life, of any age, can benefit from its responsible use.

In fact, these days a patient can start to take small, inexpensive steps to look her best from a young age, thereby avoiding the need for complex and costly operations later in life.

Dr. Robert Grant, Chief of the Joint Division of Plastic Surgery at New York-Presbyterian/Columbia University Medical Center, is one such surgeon who believes in this practice. He calls it “life-stage personal enhancement,” and he believes it is the driving force behind modern-day cosmetic surgery.

We sat down with Dr. Grant to learn more about life-stage personal enhancement.

Dr. Grant, how would you describe your life-stage personal enhancement approach to cosmetic surgery? How does it differ from the traditional “anti-aging” approach?

I believe that modern-day plastic surgery is no longer about simply going in for a nip/tuck procedure. After all, no one wants to be a walking plastic surgery advertisement. The life-stage personal enhancement philosophy, which I have practiced for over 20 years, is a gradual program of age maintenance procedures that enable my patients to look and feel their best at any age.

These procedures not only utilize less invasive and more cost-effective techniques, but they also deliver results that look far more natural than other more radical surgical options.

How early would you recommend people begin to consider age maintenance procedures?

Age maintenance means that you are beginning to care for your appearance at a younger age, rather than trying to play catch-up and have more extensive procedures done all at once, later in life. Of course, many women prefer to wait as long as possible before undergoing a plastic surgery procedure. This may be the right decision in any given case, but it’s a decision that should be made in the context of the biological reality that significantly affects not only the aging process, but how plastic surgery can best work in the context of that process.

Skin care is a perfect example of this. When a woman waits until later in life to have plastic surgical procedures, the skin isn’t as resilient, elastic and smooth as it once was when her hormone levels were higher. Because of this, the aesthetic results of surgery may not be as appealing and may last for a shorter period of time.

How do your recommendations for cosmetic surgery differ depending on a woman’s age?

A life-stage personal enhancement approach to beauty can help a woman maintain her personal best at any age. However, in order to achieve this, I always recommend my patients undergo age appropriate procedures. These recommendations, which are much different for a woman in her twenties than a woman in her fifties, may include:

  • For women 20 and older – Liposuction, but only if a realistic trial of diet and exercise has not allowed her to achieve the goal of improved body contour.
  • For women 30 and older – Botox and filler treatments.
  • For women 40 and older – Central facelifts and eyelid rejuvenation procedures.

Women 50 and older typically experience changes in their bodies and hormone levels that need to be taken into account when considering cosmetic enhancements. Recommendations for women in this age group can vary depending on their overall health, height for weight index, amount of sun exposure, and underlying health conditions.

Age maintenance procedures are not only for women. How can men benefit from this approach?

In recent years plastic surgery has become increasingly popular with men, and a man’s cosmetic plan to maintain a life-stage balance of his facial and body appearance remains pretty consistent throughout his adult life. The most common cosmetic procedures performed on men generally include:

  • The use of Botox and fillers – For men in their 40’s and 50’s who are beginning to deal with the loss of skin elasticity in the face.
  • Eyelid surgery – Also known as blepharoplasty.
  • Specialized facelifts – For men aged 50 and older, facelifts can help remove excess skin along the neck and jaw line. Special geometric patterns are used in order to hide the scar between the chin and Adam’s apple.

Liposuction is an important part of cosmetic surgery. When is it appropriate?

Liposuction is a cosmetic procedure that is used to trim and reshape trouble areas of the body that diet and exercise can’t seem to target. Liposuction removes excess fat deposits, resulting in a more ideal body contour that not only improves one’s figure, but boosts self-esteem as well. Liposuction is an ideal solution for people of normal weight who just can’t seem to shed those last few pounds or have resilient deposits of fat in certain areas of the body.

While liposuction is a surgical procedure, it is actually considered minimally invasive. Many patients are on their way home in as little as 30-60 minutes after the procedure and are able to get back to light activities within a few days. Swelling is normal in liposuction patients but, in most cases, the swelling is gone within 4-8 weeks and the full results of the liposuction can be seen.

You discuss skincare a lot on your website and blog. Why do you believe skincare is so vital to proper age maintenance?

One of the best ways to combat the signs of aging is by being good to your skin. Your skin is often the first place to give away your age. While there are many great cosmetic treatments and plastic surgery procedures that can help restore a youthful glow to your skin in your later years, proper skincare should be a lifelong pursuit. Much like my life-stage personal enhancement approach to plastic surgery, skin care should start early to ensure you look your best throughout your life.

When might injectable skincare procedures or surgery be appropriate?

According to the Wall Street Journal, there were over 10 million surgical and non-surgical procedures in the U.S. in 2013. Given this staggering number, it stands to reason that patients undergoing these cosmetic procedures are getting younger and younger. And, contrary to popular belief, this isn’t always a negative thing. Yes, I have seen young patients come in wanting radical procedures that they don’t need in order to emulate the hottest new movie star – whom I’ve obviously turned away.

But some patients in their late 20’s or early 30’s come in with a real face or body image issue, and they may just need an injectable to combat those fine facial lines that are beginning to form. And, in truth, this is the best time to start. In my experience, women in their late 20’s and early 30’s who already have an excellent skincare regimen and begin Botox or other injectable treatments are less likely to get pronounced wrinkles in need of major facial cosmetic surgery procedures when they get older.

For more information on plastic and reconstructive surgery at New York-Presbyterian/Columbia University Medical Center, visit our website at: columbiaplastics.org.