Four plastic surgeons tell me what's wrong with my face.
Since I've turned 47, I've noticed that when I move my head, my skin is increasingly reluctant to follow. As a strictly journalistic inquiry, I consulted four plastic surgeons to see what I could do about this. I now know that my problem lies either in the upper, middle, or lower third of my face. I was told variously that I needed a face-lift, upper and lower eyelid resculpting, jaw-line liposuction, laser resurfacing, a chemical peel, facial implants, a brow-lift, and Botox injections. Either that, or wear a burka.
In the past decade, the number of cosmetic surgery procedures performed on Americans has tripled, with more than 1.2 million done in 2001. Even subtracting those surgeries done on Michael Jackson, the statistics show aging scalpel-free is going to be increasingly lonely. So I decided that "Human Guinea Pig"—a column in which I go out and experience odd corners of life—should start at the plastic surgeon's office.
I found doctors by looking them up in Washingtonian magazine's top doctors issue. A few of my surgeons were actually listed; the others merely advertised. My sole criterion: a free consultation. I tried to get a woman's perspective, but all the female doctors I called charge between $100 to $250 just to tell you how awful you look. I did not tell the doctors I was working on an article—no one asked my line of work—so I am not revealing their names.
Dr. Gravity's waiting room is drab—a bad sign, I think, for a practice that is selling its aesthetic skills, although the two receptionists are young and flawless. Dr. Gravity, who looks like he just graduated from medical school, calls me into his consulting room, puts me in a sort of paper-covered dental chair, and sits opposite me on a stool. We enter into a game of cat-and-saggy-mouse.
"What can I do for you?" he asks.
"I look old and lousy," I say. He begins to press me on what specifically I want done, and I tell him I don't know, I want his advice. He says it's unethical to tell someone she needs a procedure, unless it's obvious she has skin cancer.
"My jaw line is cracking up," I say.
He nods, "Anything else?"
I realize from his tone there is a right answer.
"My eyes?" I reply. Bingo!—he nods his head again.
He says I don't look that bad but that as I have aged, gravity has caused the fatty pads that cover my cheeks to start sliding. I suddenly have an image of my cheeks as breakaway glaciers heading toward Miami. Then there are my baggy eyes, or "fat herniation of the lower eyelids." I've had a set of Samsonites under my eyes since my 20s. I used to think it gave me the look of the young Jeanne Moreau or the young Bob Dole. Sitting in Dr. Gravity's chair, I realized this look is no longer working, especially since the old Jeanne Moreau and the old Bob Dole have had their eye bags hacked off.
Dr. Gravity suggests several fixes: 1) liposuction on my jaw to tighten it up; 2) a lower-lid eye-bag removal; 3) a midface face-lift. To do this last surgery, he would make a half-inch cut alongside each eye. He would tunnel down, locate my wandering cheek pads, suture them back where they started, and take away some extraneous skin. This would also take some pressure off my nasal-labial fold, the line that runs from the corner of the nose to the mouth. "People are obsessed with their nasal-labial fold," he explains.
I was surprised to hear that the doctor would leave my upper lids alone. He explained that when he was getting his training in the '90s, someone with eyes like mine would have been told to do the upper lids. The prevailing philosophy was to cut and suck away as much as possible. Now the style is to leave the uppers alone unless someone looks like a Shar-Pei. The problem turned out to be that while the cut-and-suck looks good initially, as the aging process continues, the eyeball begins to sink into its socket. I wonder if all the people who paid to get the living-corpse look will get refunds.
Cost for all the procedures: $6,500.
Dr. Centerfold and his partners work in a temple to plastic surgery—all blond wood and frosted glass. A sculpture of nymphlike figures emerging from a fluid stands in one corner. In the luxurious waiting room, I fill out forms, one of which certifies that I understand any electronic imaging of my improved face will not necessarily bear any resemblance to the face I end up with once the scalpels start flying. There are a large number of bustling, unwrinkled female employees, all of whom have shrink-wrapped jaws and Vulcan-like brows.
A pretty young woman, my patient consultant, brings me into an office. She tells me that Dr. Centerfold is wonderful. He did her jaw liposuction and her brow-lift. She takes a digital photograph of me and downloads it. I tell her I'm dissatisfied with how I'm aging, and she runs the mouse over my photograph erasing all my lines and sags. The retouched me looks fantastic, and I think it would be cheaper and safer if I just glued a printout of it on my face. Alas, the doctor's insurance company forbids them to give patients a copy.
Dr. Centerfold, who is 44, comes in. He is tall and thin with a bulbous nose and deep nasal-labials. The realness of his face makes him the most attractive person in his office. He warns: "You only get three face-lifts in a lifetime. If you have more than that, you start to look very weird." But if I had my first one now, he says, I'll get better results than if I wait till I'm 60 when there's so much more to cut away. He rolls up to me on a stool and gently pushes and prods my face.
He rolls back. He agrees with Dr. Gravity—I need a midface face-lift. He adds, "We have to address your lower lids." He touches the area right under my lower lashes: "There's supposed to be a ridge right here." He moves his finger down almost an inch: "Yours is here." And like Dr. Gravity, he would leave my upper lids alone. "I like them. They're bedroomy." Actually, he starts thinking aloud, he would plump them up with a little fat. I have plenty to donate to that cause.
I ask Dr. Centerfold how many face-lifts he's done. He tells me more than a thousand and almost all are satisfied customers; one is a recent Playboy Playmate of the Month. He continues to look at me and starts musing, like someone who is remodeling the kitchen and realizes the dining room also needs work. "Because your face is narrow and your chin is slightly recessive, I thought of doing a chin implant," he says. Wait a minute! In all the time I have spent in front of the mirror, how is it that I missed that I'm chinless? But, he goes on, he would have to "burr the bone a little bit," so I probably don't want that. No, probably not.
I ask him about scars. He says I should talk to some of the women in the office who've had face-lifts, that they'll show me what the scars look like. Dr. Centerfold leaves, and while my consultant works up a fee, I talk to another consultant. When she walked in, I assumed she was about 50. Not because she looks it—there isn't a line on her face—but because there isn't a line on her face yet it's still apparent she's not young.
It turns out this consultant is 46, but she's already had an eye-lift, a full face-lift, brow-lift, nose job, and a second jaw-tightening. The first face-lift resulted in her lips looking too thin, so she's had a procedure to turn some of the inside of her lip out—four tiny white scars bracket her mouth. She lets me in close to inspect her scars: a small one under her chin, virtually invisible ones in front of her ears, ugly red welts behind her ears. Looking at her I wonder: If you can tell someone has had plastic surgery, is that by definition bad plastic surgery?
My consultant hands me a proposed invoice: $12,400. No wonder there are brochures in the waiting room on financing your cosmetic improvement.
Dr. Neckband's small office is done in the usual wood and glass-brick motif, with a sculpture of a female figure who is emerging from what seems to be a frozen lake. Maybe they hand these out when you get your board certification.
I am taken to the examining room, decorated with a large poster showing different sizes and styles of breast implants. Dr. Neckband is a handsome man of about 50 with salt-and-pepper hair. I give him my saggy jaw spiel, and like Dr. Gravity, he asks, pointedly, if there's anything else. I surrender. "My eyes," I say. He does a visual and tactile inspection of my face, and I expect to hear that I need to have my cheek pads hauled up, but Dr. Neckband has a different conclusion.
"I think you would really benefit from an S-lift. It's a minimal face-lift that would nicely take care of your softness and looseness and jowls. It would also address the bands just starting to form on your neck." I obviously need my eyes checked: I have missed both my missing chin and my banded neck.
The S-lift, which just pulls up the lower part of my face, will make me look refreshed but not surgically so, he says, and while I'm under, I should have my eyes done. "You don't want to take care of your jaw and draw more attention to your eyes."
By this time I realize unless I do something about my eyes, I'm in danger of frightening small children. He wants to do both upper and lower lids. He leans in: "Your upper lid is almost touching your eyelashes." Well, one man's "bedroomy" is another man's "exhausted."
Dr. Neckband gets his photo album of befores and afters. I have to admit I'm impressed with the S-lift; his patients have lost their wattles but still look natural. He shows me photographs of his receptionist, who is about my age and had an S-lift last year, and suggests I talk to her. Although her eyes—which have been done—are a little too bright, her neck and jaw look great; the scars are almost undetectable. As we talk, another employee gives me the proposed fee for the work: $10,790. I wonder if I can convince Slate it needs to pay for this.
Dr. Implant takes a cubist approach to how to fix my face. I need a mini-lift to tighten my jaw line. A brow-lift would take pressure off my upper eyelids, which he would reshape. The bags below also have to go. He recommends Botox and a laser resurfacing for my crow's feet. His consultant explains, "When you make up the bed, you want the sheets to be ironed."
Dr. Implant notes my recessive chin (a consensus is forming!) and would do a chin implant, which would take up some of the slack in my jaw. He turns to my digital image on his computer screen and performs these procedures. The chin implant is the most startling of all. Suddenly I have my mother's chin! No wonder she's aged so well. I realize I've been genetically robbed and that Dr. Implant can rectify this.
I express concern about putting a silicone object in my face. The consultant lifts her head and shows me the scar below her enhanced chin. From the way she describes the surgery, it feels at first like having a Dr. Scholl's heel cup sewn on your chin, but after a few weeks, she says, you don't even notice it. The doctor then splits the screen, and my new high-browed, strong-chinned image mocks my real face.
I ask about the other procedures that have been recommended—the midface-lift and the S-lift. Dr. Implant furrows his brow, inadvertently revealing how communicative an un-Botoxed face can be. I don't need the midface-lift, my nasal-labial is not that bad, and a midface-lift is fairly risky and requires a long recovery. He has been to lectures on the S-lift, but he doesn't perform them because all the ones he's seen leave pleats in the face. This is alarming, especially since I wouldn't even wear a pleated skirt because of its effect on my hips.
Dr. Implant leaves, and as his consultant writes up the proposed fee, she says: "If you're going to do anything, do your eyes. When you came in, that's what I noticed. I didn't notice your jaw." Maybe Zorro has a spare mask I can borrow until I take care of this.
Oddly, my consultations left me more content about my baggy, banded, weak-chinned face. I kept imagining myself bagless, unbanded, with a jaw like a proscenium arch, yet looking sadly artificial. It also helps that I have discovered the secret to happy aging—a 25-watt bulb over the bathroom mirror.
In Human Guinea Pig, I'm going to take strange jobs, sample peculiar therapies, pick up odd hobbies, and generally try the activities that my colleagues have always wondered about but don't have the guts to do themselves. (Can you really get rich from Internet get-rich-quick schemes? What happens when you take one of those free-vacation-if-you-look-at-this-Florida-condo vacations?)
If you have an idea for something I ought to do, please e-mail me at firstname.lastname@example.org.
Emily Yoffe is a regular Slate contributor. She writes the Dear Prudence and Human Guinea Pig columns. You can send Dear Prudence questions for publication to email@example.com. (Questions may be edited.) Subscribe to Emily Yoffe's Facebook page.
Photograph of Emily Yoffe by David Plotz. Illustration by Robert Neubecker.