An article in this week’s New York Times* focused on men and women in their late 60’s, 70’s, 80’s, and 90’s who decided to have face, neck, (and for women) breast surgery to appear younger. As one woman, 83 years of age says, “Physically, I’m in good health, and I just feel like, why not take advantage of it?”
According to the article, Cleveland Clinic researchers reported no significant differences in the numbers of major or minor complications in well-screened, 216 patients, averaging 70 years of age that had undergone face-lifts, as compared to individuals averaging 57.6 years, despite an increase in such surgeries.
However, Dr. Michael Niccole, a plastic surgeon in Newport Beach, CA. has found in his practice, “older patients may take longer to heal, and the results of plastic surgery may not last as long as in younger patients”.
As with any type of injury to the body, including surgery, the body has to heal itself when damaged. Inflammation is the first phase of wound healing, but in some older individuals wound healing is delayed because of an impaired inflammatory response.
Healing is an immune inflammatory process requiring a balanced, immune inflammatory response to help clean up an area and rebuild damaged tissues. Pain (the result of an immune response), swelling and bruising, especially during the first few days after injury or surgery, are also involved in the healing process.
Certain specialized cells, are then drawn into the area to lay down “biological fibers” such as collagen. These proteins are used by the body as scaffolding onto which to lay cells, which will replace damaged and dead cells to regenerate healthy tissue. When the normal structure of the skin cannot be rebuilt, and instead the collagen fibers are more closely packed and disorganized, then scarring may follow.
Just as production of collagen is essential for healing, it is equally important for collagen production to be controlled so as to prevent excessive scarring. Cells accumulate in the area, collagen production is slowed, and less scar tissue is formed. Interestingly, despite a decreased ability to heal, older individuals have less scarring than many younger individuals.
Optimal, rapid, healing — with minimal scarification– requires a balance of the appropriate inflammatory responses. A body in immune homeostasis is body that heals well.