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  • Writer's pictureDr. Megan Dreveskracht

Menopause and Plastic Surgery: Am I Too Late?



person standing on a cliff to illustrate the inevitable fate of women in menopause

Menopause has traditionally been taught to women as this proverbial cliff – you can spend years teetering along its edge, knowing its there and feeling its pull– and then one day you just fall off. Once you’re off, you’re off– that’s it, forever. There is no prevention, just acceptance of your inevitable fate. The symptoms of menopause and the perimenopausal period are hugely life-altering for most women and sadly, have only recently gained the attention and legitimacy they deserve. As women’s hormones begin to shift towards the eventual cessation of estrogen and progesterone production, a whole slew of symptoms begin occurring that can drag on for years before a woman is even technically considered to be in actual menopause. 


SYMPTOMS OF MENOPAUSE: 

Now, let me just state the obvious– I am not a menopause or hormone expert but merely just a 40-year-old female Plastic Surgeon who happens to see a ton of perimenopausal and postmenopausal women for plastic surgery procedures. Now that we have that disclaimer out of the way, let’s move on to the appalling number of consequences women face during this dreaded time. According to online sources, symptoms of menopause include: hot flashes, night sweats, low libido, dry skin, vaginal dryness, low libido, brain fog, memory loss, thinning hair, weight gain, decreased metabolism, insomnia, joint and muscle pain, decreased or increased breast volume, and mood swings to name a few. 


women measuring her abdomen to show hormone related weight gain associated with menopause

HORMONE RELATED METABOLIC CHANGES

Underscoring most all patient complaints I see in my peri/post menopausal women is weight gain. And not just regular old weight gain, but hormonal weight gain– a term which, to any woman, should strike an all-to-well-known cord. Hormonal weight gain is different. It feels “puffy” and “bloated.” And worse yet, it happens regardless of how much effort we are putting toward caring for our bodies. Hormones don’t seem to care about exercise or eating healthy, and they certainly don’t care if you have managed to maintain your body at a certain level for years doing the same thing. In fact, I hear this phrase over and over again from frustrated patients– “I do the same thing I’ve always done. I eat healthy. I exercise. I am doing all the things and yet I cannot seem to get this weight off.” Dramatic hormone changes with menopause completely alter our metabolism, and affect not only how and when we burn calories but also where we store fat.  The most common areas of weight gain I see in my plastic surgery patients include the trunk, upper arms, and breasts (especially on the sides of the breasts). It is important to distinguish that liposuction cannot eliminate visceral fat, which accumulates with weight gain on the inside of the abdomen around your internal organs and can only be eliminated with diet and exercise.


HORMONE-RELATED SKIN CHANGES

Another dramatic effect of a decrease in endogenous estrogen levels during peri and post-menopause is on skin integrity. Estrogen plays a vital role in the health of cells that provide the building blocks for healthy, youthful skin. It has also been shown to improve new blood vessel formation, cellular immune response and wound healing. Studies comparing menopausal women to their hormone-replacement counterparts show that a lack of estrogen causes skin to 

skin becomes thinner with decreased collagen content, decreased elasticity, increased wrinkling and increased dryness. For every year after menopause, women’s skin collagen content reduces by 2%. Global skin changes with aging are a common occurrence in my Seattle Plastic Surgery practice. These skin changes can be accelerated with menopause, and often women don’t realize exactly why. Skin gets more lax despite a healthy diet and exercise, clothes and bras begin to fit differently, and patients begin to get frustrated. 



Packet of hormone replacement to illustrate menopause

BREAKING THE CYCLE

No, it's not just you, your lack of “willpower” and your poor choices at work. It's biology working in contrast to you and all the hard work and good decisions you are making for your health. It’s biology we’ve never been educated on or collectively talked about, resulting in symptoms that have historically been dismissed by modern medicine. With menopause symptoms viewed simply as a ‘fact of life’, there has never been any real push to develop solutions to the problems women face. I don’t want to get too off track as this is a blog post about Plastic Surgery, but it is important to let women know they are seen, they are heard, their complaints are valid, and they don’t have to spend the rest of their lives hiding their bodies. 


HOW PLASTIC SURGERY CAN HELP

Menopause symptoms are wide-ranging and affect most organ systems from the brain to our bones. Plastic surgery simply cannot address the majority of symptoms that women face during menopause, but a few of them such as hormone related skin and weight changes are a perfect target for those who have maxed out other, non-surgical options and are ready to take the next step. Liposuction, for example, is a great surgical tool to help address areas of stubborn fat deposits in an otherwise motivated and healthy patient. Common areas of liposuction I see in peri/postmenopausal women include the upper arms, abdomen, lateral breasts, upper backs and posterior trunk (aka muffin top). These tend to be the anatomic areas that my plastic surgery patients notice the most changes in and find the most distressing and uncomfortable. Areas with both fatty tissue and loose skin may also require some type of skin tightening procedure in addition to liposuction. 


Other common procedures I see a dramatic increase in with postmenopausal patients are tummy tucks and breast procedures. Tummy tucks often go hand in hand with liposuction of the abdomen to help improve the overall appearance of the abdomen– tightening the skin, flattening the tummy and tightening the waist. Breast procedures can include breast lifts, fat grafting to the breasts to replace lost volume at the top of the breasts or, surprisingly, breast reductions. All of these procedures aim to reshape the breasts to some degree and restore the breasts to where they once were. 


Patient being marked for a plastic surgery tummy tuck and liposuction


CONCLUSIONS

The landscape for menopausal changes is changing, albeit slowly. There is a rise in hormone-replacement therapy being offered to women and an ever-expanding industry of supplements, diets and exercise routines geared toward combating the negative consequences. I am not saying that Plastic Surgery is the answer to menopause, not even close. I see Plastic Surgery as one tool in our toolbox to consider. I want women to know that plastic surgery can be life changing at any age or stage in life. The goal is to look and feel better, period. And for some, Plastic Surgery may be that missing tool they need to help them reach their goals and feel their best self.


 

Dr. Megan Dreveskracht is a Female Plastic Surgeon in Seattle, Washington who specializes in Aesthetic Surgeries of the Breast, Body & Face. To schedule your consultation, call 206.860.5582 or fill out a contact form here.


Dr. Megan Dreveskracht is a Seattle Female Board Certified Plastic Surgeon who specializes in cosmetic surgery of the breast and body such as breast lifts and tummy tucks.






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