AGING OF THE SKIN - IMPLICATIONS FOR CUTANEOUS SURGERY

There are precious few benefits, save perhaps experience and wisdom, t hat those of advanced age may claim over those who continue to dwell i n their youth. One somewhat paradoxical advantage, however, is the abi lity of older patients to apparently heal better than younger patients after cutaneous surgery. In older patients, the incision lines are le ss red, the scarring is less hypertrophic, and ''normalization'' of ap pearance occurs more rapidly. And yet, the ''wrapping'' does not neces sarily reflect the contents of the ''box.'' Unfavorable age-dependent alterations in the physical properties of the skin and the wound-heali ng cascade may affect the viability and structural integrity of the po stoperative result. Surgery on the aged population must therefore coup le the optimism for a pleasing aesthetic result with the caution refle cting a cutaneous substrate altered by the perturbations of time. This somewhat shaky balance, although not altogether understood, is worthy of study by the physician approaching the patient of advanced age.