April 22, 2004 -- The latest luxury for aging baby boomers looking for the fountain of youth is the so-called "voice-lift," designed to make patients' voices sound more youthful.
In the past, doctors have mostly performed vocal chord surgery on people with voice-robbing diseases or injury. Now cosmetic surgery for the voice — the voice lift — is becoming more widely known among an aging population, dismayed to notice hoarseness that makes them sound older creeping into their voices.
Professionals who use their voices — including performers, lawyers and telephone operators — are seeking out the procedure, hoping to shave years off the sound of their voice.
But doctors are warning against doing cosmetic surgery on normal, but aging, vocal cords.
There are two general kinds of voice lifts: In some cases, implants inserted through an incision in the neck bring the vocal cords closer together. Doctors also use injections of fat, collagen or other substances to plump up the cords and make them more limber, so that the voice sounds younger.
There are risks to the procedures, experts say.
"It is not that uncommon in an attempt to actually bring the vocal folds together that they become over-closed," said Dr. Steven Zeitels, an associate professor at Harvard Medical School and a laryngologist at the Massachusetts Eye and Ear Infirmary in Boston. "You can make the voice worse, and we've all seen cases in which that can occur."
A Raspy, Hoarse Voice
By the time Bob Anzidei reached 66, he found himself struggling to speak. Now 75, the retired construction superintendent underwent voice lift surgery several years ago.
"When I spoke, many times the person I was speaking to would not hear me as clear as they should," Anzidei said. "I had to repeat myself because it was very raspy and hoarse."
To produce sound, the vocal cords must meet each other at a rate of between 120 and 220 times a minute, and that high level of usage takes its toll. Unlike skin, the surface of vocal cords don't sag as we age — they get stiffer. "Over time, from the use of the voice, they actually decrease in pliability," Zeitels said. "They become stiffer, which makes it more difficult for them to vibrate."
Singing, smoking and just day-to-day speaking can make vocal cords less limber and speech less recognizable.
Vocal Changes a Red Flag
Even so, a changing voice shouldn't be ignored or written off as just "old age." Vocal changes can be the first signs of polyps, a paralyzed voice chord, or even cancerous tissue in the voice box. Physicians can use everything from traditional surgery to lasers to treat these kinds of disorders.
In Anzidei's case, one of his vocal cords was paralyzed, and the second one was becoming partially paralyzed. Injections of fat have allowed him to speak normally, so that his voice can be heard.
Dr. Robert Thayer Sataloff, chairman of the otolaryngology department at Philadelphia's Graduate Hospital, performed the surgery.
"I'm happy," Sataloff told Anzidei. "You don't sound like a 75-year-old man with a completely paralyzed vocal cord at all."
Though he does not know if he sounds any younger, Anzidei does say that he sounds clearer.
"Friends and family who knew that I was having this problem heard me speak for the first time. They spoke with me after the surgery and were very impressed," Anzidei said. "They said, 'Wow, you sound great! '"
There may be some safer ways to treat aging voices on the horizon. Researchers are looking at new chemicals and new materials which can be injected safely into aging vocal chords.