Some 30 years ago, a 50-something acquaintance of mine made a killing in the software field and decided to spend it all on her face — a complete surgical lift, neck, chin, cheeks, eyelids, brow. The full Monty, so to speak.
I couldn’t wait to see the result — she was the first person I actually knew to have major work done. When a month or so later she invited me to a small party I showed up eagerly, dying to see what she looked like.
She looked like an egg.
Her face was pulled tight as a drum; you could bounce a dime off it. No lines whatsoever. There was something almost a bit reptilian, even ET-like about it, an impression her tightly coiffed hairdo did nothing to dispel. She had never been the most emotional person in the world; now she seemed to have no expression whatsoever.
Only her eyes were unchanged, and they looked…well, they looked her age. They peered out of her new face somewhat anxiously, as if wondering what they were doing there.
I managed to keep my own expression under control, congratulating her. But privately I was pretty horrified. Though relieved on at least one level — I knew I’d probably never have enough money for a complete facelift myself. Given that, it was comforting to know the results were far from desirable.
How times change. Needless to say, over the years I eventually got to witness far more appealing facelift results, some amazing enough that they caused me to seriously consider going that route myself. Two things held me back: a strong aversion both to general anesthesia and to cleaning out my bank account.
But the change has gone far deeper. Back in the day, facelifts were not only expensive and often no more than rather crude attempts to pull the skin back as tight as it would go, they were also considered somewhat shameful. Certainly nothing anyone talked about. Women invented excuses to stay home for the first few weeks; asking someone whether they’d undergone a facelift was considered the height of bad form.
Today the entire industry has come roaring out of the closet. I know no one over 50 who has not at least given plastic surgery some thought. And facelifts are only the beginning; there is barely a body part that isn’t considered a possible target to be shaped, tightened, pared down or buffed up. Butts, boobs, bellies, you name it. And not just for women. Man boob reduction is a common operation. Furthermore, in the last 15 years a young sister industry has risen up like a phoenix.
Injectables! Botox, Restylane, a slew of other substances. Hard as it is to believe, Botox was only approved for cosmetic use in the U.S. late in the 90s, Restylane not till 2005. Today these and a variety of other relaxers and fillers are all over the place. Not only are dermatologists and plastic surgeons using them, many beauty salons have gotten into the act.
The advantages over major surgery are obvious: Far less expense. No anesthesia. Hardly any pain. A series of injections takes under 10 minutes. You need almost no recuperation time. The main disadvantage, of course, is the Chinese dinner curse — four months later you have to do it all over again. Nonetheless millions have jumped on the bandwagon.
In a recent interview, plastic surgeon Dr. Michelle Shermak, who trained at Johns Hopkins, listed the most popular procedures currently being done in Baltimore.
“Four things are really big right now,” she said. “Minimally invasive procedures like injectables, fat crafting, Mommy makeovers and massive weight loss body surgeries. Those are the things consumers are most interested in right now.”
With injectables, Botox and Restylane were the originals, but “now the market has really taken off,” with similar products, she said. The two work differently. “Restylane is a filler, Botox works by weakening muscles which cause wrinkles.” Relaxers are generally used on the brow, fillers lower down, on sunken cheeks, or the wrinkles surrounding the mouth.
There are still many problems that can only be solved by surgery, of course, breast augmentation and rhinoplasty (nose jobs) being the most popular. Fat grafting is “the new innovation we’re all talking about,” Dr. Shermak said. It involves taking fat from places you don’t want it, and using it where you do, like in the face, as a filler (strange as it seems, face wrinkles are often caused by diminishing fat). A true win-win situation.
Mommy makeovers are just what they sound like. “Women come in for a tune-up after having a baby.” This can involve breast, butt, stomach lifts and tucks, and vaginal repair. Then there are the weight loss surgeries.
“A very big area. Some 200,000 a year are being done,” said Dr. Shermak. With all the publicity about the obesity epidemic, with popular shows like “The Biggest Loser,” people are trying harder than ever to lose weight these days. If you lose enough, you’re going to have a lot of loose skin to deal with. Surgery can help.
“The entire field has exploded,” agreed Dr. Eva Simmons O’Brien, a local dermatologist who trained at Yale Medical School and Johns Hopkins. “It’s been able to piggy-back on the interest in being youthful, on the fitness bandwagon.
“People like pretty people. They like to see them. Those in sales, in high profile positions need to look good..it’s a harsh reality.”
Daily, it seems, there are more options for those in the market for a fix-up. Other popular non-surgical treatments involve ultrasound and lasers.
“Lasers help get rid of sunspots, and can be very effective for sun damage.” said Dr. Simmons O’Brien. She often employs more than one method. “I tell people it takes a village approach.”
The field is “ever changing,” she said. “It’s really 180 degrees different from 20 years ago.”
Speaking of evolution, last week in The New York Times, Maria Russo’s The Mirror essay — optimistically titled “Older Women Are the New Faces of Beauty” — promised that the world is making room for various (imperfect) versions of middle-aged beauty. True: “average-looking” Ellen DeGeneres and Diane Keaton are currently the faces of major makeup campaigns. And that’s all well and good. But it’s extremely difficult to believe that, despite a few steps in the direction of self-acceptance — or older-Diane-Keaton-acceptance — human nature won’t keep us forever fixed on plastic-surgical fixes. From the looks of it, the next 20 years could offer even more striking changes and developments in the industry.
“There’s interest in figuring out how our bodies can fix themselves,” explained Dr. Simmons O’Brien.
For the face, one new method involves taking blood from the patient, isolating platelets and injecting them back in the face, to stimulate collagen (stimulating collagen growth is the sin qua non of the injectable trade). Another, still in planning stages, involves having your own cells removed via mini-biopsy, grown in a lab, treated, suspended in a gel and sent back to the doctor for injection.
Then there’s the rest of the body. “Women are obsessed with cellulite,” she said. Ultrasound machines are now being used “to break up the fat by sonic shock waves.” But new methods are coming. “The latest machine on the block freezes the fat, then the body basically breaks it down over a period of weeks and excretes it.” Not the most appealing idea, perhaps…but one never knows where the next hot thing in the field will emerge.
As it is, we’ve never had more choices, more ability to change our physical characteristics. It doesn’t stop with our own bodies, either. In 1995, a former ad man from Kansas City, Missouri, invented something called neuticles — basically false testicles for dogs. He claims close to a half million dogs have since undergone the procedure, at various veterinary clinics throughout the country. A number of vets in Baltimore perform this operation. Men, especially, feel a need to shore up a neutered dog’s manliness, apparently. Testicle implants come in all sizes, of course, since no Great Dane is going to look right with dachshund-size balls (and vice versa).
Dogs themselves, of course, could not care less. As for their owners, and everyone else, there seems to be no limit to our urge to stay, as Bob Dylan sings, forever young. Or at least to look as if we have. And our options for pulling that off continue to expand daily.
Judy Oppenheimer is the author of a literary bio, Private Demons: The Life of Shirley Jackson, and Dreams of Glory, an in-depth look at a high school football season.