Lora began low carbing nearly 5 years ago, and has shed over 150 pounds, learning a great deal in the process. With an education in nursing and nutrition, Lora debuted Low Carb Luxury in 1999, and now writes for multiple publications as well as speaking in public arenas.

As we told you in our last issue, this past October (on the 16th), I underwent cosmetic surgery. I had two procedures done. A Rhytidectomy – a facelift, and a Blepharoplasty – eyelids.

I made the decision to have these procedures done because after losing a great deal of weight, I found my face looked older at the end of this journey than I'd expected. It's quite common, actually. Like any other part of the body, the face had held an excessive amount of weight. And while small to moderate weight loss rarely causes problems with skin, a big weight loss usually does.

In our last issue, we took you through the basics of these procedures, explaining how and why each are performed. If you missed Part One, click here to read it.

In this issue, we bring you an in-depth interview with Dr. Jon Mendelsohn, who performed my surgery at the Advanced Cosmetic Surgery & Laser Center in Hyde Park, Ohio. Board Certified by the American Board of Facial Plastic & Reconstructive Surgery and Fellowship trained by the American Academy of Facial Plastic & Reconstructive Surgery, Dr. Mendelsohn is a renowned specialist in facial plastic surgery.

Because Dr. Mendelsohn just "does faces," he was the ideal choice for my procedures. Your face is your calling card to the world... So before we begin the interview, I want to reiterate that this is a time to find the best surgeon for the job. Use someone known for their work on facial procedures. Don't cut corners and don't "price shop." There are better times in life to "look for a bargain." And for heaven's sake, know their qualifications.

Question: What special qualifications are needed for a surgeon to perform facial surgery?

Answer: The American Board of Facial Plastic and Reconstructive Surgery (ABFPRS) certifies a facial plastic surgeon. In order to be certified by the ABFPRS, the physician must already be board certified by either the American Board of Plastic Surgery or the American Board of Otolaryngology, the specialty addressing surgery of the head and neck. The facial plastic surgeon has spent five to seven years in post-graduate surgical training. This includes one to two years training in general surgery and at least four years of specialty training in head and neck and facial plastic surgery.

Their education should focus on both surgical and nonsurgical techniques. A general plastic surgeon (having 8-12 months education in facial surgery) routinely does fewer than 5 rhinoplastys in 8 years. And perhaps 1 or 2 facelifts. A specialist does as many as 4 to 5 each day.

Complications that may arise are also better handled by your surgeon if he is a specialist in his field.

Question: Who is a good candidate for plastic surgery?

Answer: Someone with realistic expectations and goals. Someone who (if weight loss is an issue) has lost their weight before turning to surgery. Someone who is NOT having the surgery for the furtherance of a relationship. Someone who does not carry medical risks — diabetes, smokers, poor healers, has little or no sun damage to skin.

Question: What areas can't be helped?

Answer: Primarily skin issues. Lip lines, spots and sun damaged skin. Tightening skin will improve wrinkles, but skin resurfacing is a common follow up.

Question: What pre-op considerations should be planned for?

Answer: Know what medications not to take... primarily those with platelet issues. The face is very vascular, so ceasing smoking, looking to proper nutrition and sufficent water intake, and good skin care are musts. It's also important to manage any complications that might slow healing.

Question: How do you recommend patients deal with the mental preparation and fear?

Answer: Speak with other patients that have had it done. Your doctor should have no problem supplying you a list. Use your initial consultation and more visits to the doctor's office if need be until you have no other questions. Bring in your list of questions and make sure they're answered before you leave the office.

Question: What are the average ages of people interested in facial surgery, and are most patients women?

Answer: 82% are women; 18% men. Most are between 40 and 60 years of age.

Question: What's the difference between a facelift and a mid-facelift?

Answer: A typical facelift includes the lower fold, jowl, jawline and neck. A mid-facelift also includes the area btween the lower eyelids and the cheek pad. Check-neck is also added with mid-facelift.

Question: How long can one expect the results of a facelift and/or eyelid surgery to last?

Answer: Eyelid surgery is for the most part permanent. Over time, the upper 1/3 of the face will of course begin to age again until the aging process catches up... generally 7 to 10 years. However, without the surgery, the patient would have aged that much anyway — but of course, on top of their "older" look. So in effect, you keep a several-year advantage. Ten years later, one may want to have a procedure done again, or look at other options.

Just remember that the excess skin that is removed during a facelift does not return, so you will look younger than you would have without surgery. The skin does continue to age and aging changes will continue to occur.

Question: Can you tell us about the Autologous Platelet Gel that you use in your practice?

Answer: A simple, effective, and safe preparation of Autologous Platelet Gel aids in the healing of patients undergoing plastic surgery procedures. The newest and most exciting process used in cosmetic surgery involves the use of an autologous platelet gel.

Autologous Platelet gel is made from a natural component of the patient's own blood that is used to aid in the quicker recovery following certain cosmetic procedures.

It is derived from your own blood, and the preparation adds no extra time to the procedure. Prior to starting the surgery, approximately 45 cc of blood (1.5 oz) are taken from the patient. This small blood volume is then placed into a tube and spun in a centrifuge (a small device that spins very quickly). This process automatically separates the blood into several different components, one of which we refer to as the "buffy coat" or platelet rich plasma. It takes 12 minutes.

The main components of this solution are platelets. Platelets are tiny cells that are partially responsible for blood clotting (stops bleeding), and are critical to healing. The normal concentration of platelets is from 140,000 to 400,000 per cubic mm. During this process, each cubic mm of solution contains 1.5 to 2 million platelets (very concentrated).

It's used at the end of a procedure like a facelift by mixing it with another component and spraying it under the skin. Because it's so concentrated, it acts as a wound sealant (or tissue glue.) This eliminates the need for dressings and drains, and also reduces the incidence of hematomas. And it also reduces bruising and swelling. In addition, it promotes more rapid healing by secreting healing and growth factors which enhance recovery.

Question: What types of anesthesia are used and what are the side effects?

Answer: Usually local anesthesia will be administered to numb a specific area to be treated, along with a light sedative to make you feel drowsy and relaxed.

Any pain experienced is usually controlled with a medication prescribed by your surgeon.

There may be some side effects with anesthesia. Some people have a slight feeling of nausea during the postoperative period. Some people may vomit, but this is uncommon. Some patients may feel slightly tired for the first few hours after surgery, which typically wears off quickly.

Side effects of anesthesia vary from person to person dependent on the reaction of their body. Some people may have side effects even with slight amounts of sedation. Most important to remember is that anesthesia is an integral part of your surgical experience. You should know as much about it as possible. You should thoroughly discuss your anesthesia needs with your surgeon.

In our next issue, we'll continue our interview
with Dr. Mendelsohn...

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