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Personal Health : Nonsurgical Alternative to Face Lifts

Why get a face lift to look younger, reasoned Nana Weinberg, when simple implants to plump up the cheeks might do the job for now. So the 48-year-old Los Angeles architect opted for a new and controversial anti-aging procedure called submalar augmentation.

Offered by a growing number of physicians, cheek implants are quicker and cheaper than traditional face lifts. The small, teardrop-shaped silastic implants are inserted through the mouth during a simple 45-minute office procedure, and the bandages are removed within three days. A face lift operation, on the other hand, can take hours, and swelling can persist for a week or more afterwards. Fees for California face lifts that can cost as much as $4,200 are three times the implant fees.

The implants work by restoring the facial fullness that wanes with age as underlying fat in the cheekbone area shrinks, says Dr. William A. Binder, a Los Angeles facial, plastic and reconstructive surgeon who just published a report of the new procedure in the Archives of Otolaryngology--Head and Neck Surgery. The fat loss usually becomes evident after age 35. “That’s the time,” says the plastic surgeon, “when patients begin complaining, ‘I look old, depressed and sad.’ ”

Binder sees the implant procedure as an alternative to face lifts for younger patients between the ages of 35 and 50 and as an adjunct for older patients. Weinberg, for instance, followed up the implant with a face lift a few years later.

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But some of Binder’s colleagues strongly disagree that the implants can ever take the place of traditional face lifts. “I don’t believe it’s an alternative at all to a face lift because they only fill out the middle of the face,” says Dr. Edward O. Terino, an Agoura Hills plastic surgeon who has inserted implants similar to those used by Binder for more than a decade. “But it can be a valuable adjunct to face lift.”

Whether implants are adjuncts or alternatives, there can be problems. In Binder’s study, 5 of his 78 patients ended up with asymmetrical implants that required adjustment. Two patients got abscesses that were resolved by drainage and antibiotics; three had reduced lip movement that returned to normal within a month; and some had numbness of the upper lip, but sensation returned within three months.

Even when the implants are inserted without a hitch, they can’t always solve the “great expectation” problem. Explains Binder with a sigh: “Everyone wants to look like Kim Basinger.”

Drinking to Excess

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Downing a couple of alcoholic drinks a day might help prevent heart disease, several studies suggest. But if you exceed two drinks, you may risk a double whammy disadvantage. The excess alcohol is likely to increase blood pressure and decrease your absorption of dietary calcium that may help lower pressure. That’s the conclusion of a study released today and published in this month’s Circulation, an American Heart Assn. journal.

“For the average person, bad things start happening physiologically at more than two drinks a day,” says Dr. Michael H. Criqui, professor of medicine and professor of community and family medicine at the University of California San Diego School of Medicine. He studied the effects of alcohol in more than 7,000 men, discovering that higher calcium consumption is associated with lower blood pressures among nondrinkers and light drinkers. But those who drank two or more drinks per day did not seem to enjoy the blood pressure-lowering effects of calcium.

Another expert, Dr. Arthur Klatsky, chief of cardiology at Kaiser Permanente, Oakland, sees the new study as an extension of some of his own cardiac research. “We’ve done two different studies showing that those who drink three or more drinks a day are more likely to have high blood pressure.” And several studies suggest that 1000 milligrams of calcium a day--about that found in three glasses of milk--can help lower blood pressure.

Criqui’s advice: Don’t exceed two drinks of beer, wine or mixed liquor daily. And don’t consider two drinks a requirement. The study isn’t meant to encourage drinking, he says, nor to persuade those drinking less than two per day to hike intake.

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Advice to Parents

For most parents, the situation is familiar. You’re worried about your child’s vocabulary, attention span or some other developmental milestones, but you wonder if it’s important enough to mention to the pediatrician.

Speak up, suggest Vanderbilt University researchers who found parents anxious about their child’s development usually have valid concerns, even if they lack medical knowledge.

The researchers asked 100 families seeking pediatric care to describe concerns about their children’s development while their offspring took a developmental screening test. Eighty percent of the children who failed the screening tests had parents who expressed concerns about their development in the same areas. In comparison, 94% of the kids who passed the screening had parents without developmental concerns.

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This study proves parents don’t need to rely on formal knowledge to assess development, explains William MacLean, a pediatric psychologist and one of the authors of the study just published in the American Journal of Diseases of Children. What was their most frequently used measuring stick? Comparisons with other children.

“Parents should not be afraid to bring up their concerns with pediatricians,” says MacLean, noting that several studies have found parents reluctant to discuss “nonmedical” issues with their children’s doctors, fearing they are not correct or that they will take too much of the busy doctor’s time.

“Most parents are good observers, even if they are not medically sophisticated,” adds Dr. Diane Henderson, a pediatrician and developmental specialist at Childrens Hospital, Los Angeles. “I’ve been trying to teach residents the importance of listening to parental concerns for years. Now I have a study to back me up.”

Trauma Folklore

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It’s well-known folklore among emergency room doctors: when the moon is full, the waiting room will overflow with victims of trauma and violence. Not so, find three Pittsburgh doctors who reviewed the records of nearly 1,500 trauma victims admitted to Allegheny General Hospital during a calendar year. They discovered, in fact, admissions were slightly higher on waning moon days (a mean of 3.98 patients a day) than on full moon days (3.58 patients per day). Fewer helicopter transfers of trauma patients occurred on full moon days, too, found the researchers, who published their report recently in the Annals of Emergency Medicine.

The full moon may even have a protective effect against violence, suggest the researchers. A brighter night sky, for instance, might deter crime by better illumination of roadways. “That’s speculation of course,” says co-author Dr. Wendy Coates.


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