Nowadays, when a woman considers plastic surgery to enhance or improve her body, she’s likely to get a “you-go-girl” response from her peers. But it wasn’t that long ago that even the mention of plastic surgery was taboo, reserved for conversations about celebrities who had taken it too far. Discussing surgical enhancements to the body was generally considered uncouth. But now, thanks in part to the media and reality TV, plastic surgery has become common, leading procedures like Botox® and liposuction to become normal topics of conversation.

The mainstreaming of plastic surgery is a mixed blessing, says Gary Tuma, M.D., a Capital Health specialist in plastic and reconstructive surgery. “The positive is that more people are open to discussing it and considering it,” he says. “Ultimately, it’s better for the practice and growth of plastic surgery that people are more comfortable with it.”

But Dr. Tuma cautions that some procedures are misrepresented as being more or less effective than they actually are, which makes it that much more important for patients to be fully aware of their options and educated about the procedures they choose. “You just have to understand what the risks and benefits are. If you’re comfortable with them, then you should move forward,” he says. “And once you’ve elected to have a procedure, the most important thing is to go to a board certified plastic surgeon who understands and has been trained on the full range of aesthetic and cosmetic procedures.”

To help you along, Dr. Tuma offers a decade-by-decade breakdown of what procedures you can consider and when to get them for the best results.


In Your 20s
Women in their 20s should be concentrating on eating well, exercising, staying hydrated, using sunscreen, limiting sun exposure, and refraining from tanning beds, says Dr. Tuma. “It’s essential to start a good skincare regime using products that are directed by physicians, often with the assistance of an aesthetician. You can use retinol products to remove dead tissue and promote healthy tissue with the help of an aesthetician that will help keep skin looking youthful.”

Most procedures have optimal results when patients are in their 20s because the quality of the tissue is healthier and more youthful. “When you’re younger, your dermis is thicker, more elastic, and responds better to surgery,” Dr. Tuma says. “It’s a fine line between doing it too early vs. doing it too late.”

Common procedureMicrodermabrasion: Tiny crystals are sprayed onto the skin to remove the outer layer of skin to rejuvenate and exfoliate.


In Your 30s

In many cases, women’s bodies dramatically change in their 30s as a result of hormones and child bearing, which often shifts the focus from the face to the body.

It’s preferable if you are finished having babies when you have these procedures, Dr. Tuma says. “Having more children doesn’t preclude you from having them, but you don’t want to do abdominal or breast procedures if you’re having more children because the results will be affected. Particularly with tummy tucks, it’s important not to stretch the abdominal wall after you’ve just tightened it.”

Common procedure | Tummy tuck: A procedure designed to remove skin and fat in the subcutaneous plane. “By tightening the facia and pulling skin tightly, you can improve the contour of the abdominal wall.” {important note} Tummy tucks have a lengthy recovery because it’s your core. On average, recovery time is 3-4 weeks of limited activity. Increased activity can begin around the fourth week, Dr. Tuma says.


In Your 40s

When women are sure they are finished bearing children, they often look to have a “mommy makeover,” which allows women to address multiple sites at the same time, typically the breasts and stomach, the areas that often lose their shape and tone during pregnancy.

Women often opt for breast surgeries, including lifts, reductions, or augmentations in their 40s. While the procedures have largely remained the same over the last few decades, Dr. Tuma says newer silicone implants are much improved, and the gel is more cohesive. “There is also a procedure in the early stages of study that transfers fat from the belly or thighs to the breasts to add volume.”

Common procedure | Liposuction: This procedure slims and reshapes areas of the body by removing excess fat deposits, improving body contours. Dr. Tuma cautions that it’s not weight-loss surgery. “Many people believe they can get liposuction and lose weight—it’s not true. The best candidates for liposuction are people who stay healthy and fit, and no matter how much they work out, there are areas that they just can’t change,” he says.
{important note} Liposuction does not address cellulite. 


In Your 50s

Many women in their 50s have worked through their body image concerns and tend to focus more on the face, Dr. Tuma says. The most common procedures for women in their 50s include fillers and injectables, laser therapies, radio frequency tightening, and ultrasound in an effort to stimulate collagen growth and tighten skin. Surgical procedures like face-lifts, upper and lower eyelid surgery, brow lifting, and chin augmentation can also address tightening of the skin.

Common procedure | Injectables: Doctors inject medicine into the skin to add volume and smooth wrinkles. The most common is Botox, a neurotoxin that “basically paralyzes the underlying muscles to limit the ability for movement that causes animation lines,” Dr. Tuma says. “It’s relatively safe and is probably one of the most prescribed drugs in the country.
{important note} Botox fillers are temporary treatments, but there are more long-term alternatives. “We have a newer product called Valuma, which adds volume to the face as a more permanent fix.”


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