Linda–not her real name–decided to have cosmetic surgery eight years ago. Then sixty, the U-M prof took a group of her students to Europe during winter break. “Some of the pictures, when we got back–I looked at them and I could not believe it!” Linda says. Seeing herself alongside students one-third her age, she didn’t like the way she looked: “Great big bags on my face–in my chin, on my neck. It was all kind of hanging there. And I thought, ‘Oh, this is pathetic.'”
Her doctor referred her to the Center for Plastic and Reconstructive Surgery (CPRS). Five years ago, during summer vacation, plastic surgeon David Hing gave her a full facelift, eyelid lift, and neck lift. It was a seven-hour operation, done in the practice’s own surgical suite on the fifth floor of the Reichert building at St. Joe’s. Linda paid the entire cost, $10,000, out of pocket.
Afterward, her husband was supportive, but she says her grown daughter “was my best nurse. She was really good about emptying out the drains. My cat even bit a hole through one. Dr. Hing thought that was pretty funny.”
She didn’t tell her mother. In her mother’s day, plastic surgery was for repairing cleft palates and lips or for fixing bodies damaged during the war. Not to make women (or men, for that matter) prettier, younger, or sexier. Her mother grew up during the Depression, when “you got things because you needed them, not because you wanted them,” Linda says. If she’d asked her mother, “I think the first thing out of her mouth would be, ‘You don’t need a facelift.'”
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If she’d have asked her U-M colleagues, they might have agreed. Linda says she knows plenty of women who let their hair go gray and wear hand-knitted socks and long, loose-fitting dresses. “We call that Ann Arbor chic,” she says.
“Ann Arbor is a more natural city, a green city,’ agrees “Joanie,” who, like Linda, had a facelift at CPRS. The attitude here, she says, is “‘Why change what you have?’ If this were Chicago or West Bloomfield, it wouldn’t be a big deal.”
And even here, it’s not uncommon: the five doctors at CPRS typically perform a total of 500-600 cosmetic surgeries a year. Last year, U-M plastic surgeons did 220. According to William Kuzon Jr., head of plastic surgery at the U-M, things were even busier before the recession. “The number of people who want breast augmentation doesn’t change,” he explains, only the number who feel they can afford it: “They just don’t do it now, because they’re worried that they might lose their job.”
At a local country club, “Tom” looks around and tells me that virtually every woman over fifty in the dining room has had some kind of cosmetic surgery–and some of the men as well. Among women he knows, he says, “75 percent, at least,” have had “something done … anything from breast augmentations to eyelids to full facelift, mini-facelift.” His wife tells him that “they occasionally will talk about it–not to a male, but among themselves.”
They definitely won’t talk about it with a reporter, though. When I contact some of the women later, even the most gentle queries are met with promises to see if someone else might be willing to speak about cosmetic surgery, then silence. So how can Tom be sure it’s so widespread? “Someone arrives at the club you haven’t seen for a while, and all of a sudden she’s sporting a new chest,” he says. “If you’re paying attention to someone’s features at all, it’s not too hard to figure out [that they’ve had a facelift], either. This stuff works. All of a sudden, someone’s looking younger.”
Tom’s had work done himself. Fit, handsome, and wealthy, he’s nonetheless unhappy with the wear and tear of his sixty-plus years. He gets his age spots burned off and has gotten part of his beard (and other unwanted hair) removed permanently with electrolysis. And this year he made an appointment to get his nose done too.
He says the surgeon at CPRS asked him, “What is it you don’t like about your nose?”
Tom says he replied, “I want a straight nose.”
That’s the kind of answer a cosmetic surgeon wants to hear. “A good candidate for plastic surgery is someone who says, ‘I just don’t like the way the wrinkles around my eyes look. I just want them to look a little better. I want to understand what might be possible,'” says the U-M’s Kuzon. “A poor candidate for cosmetic surgery is someone who says, ‘These wrinkles around my eyes make me look really old, and that’s why my husband is divorcing me and my children have a bad relationship with me and I’m getting fired from my job.'”
Tom went in for his rhinoplasty one morning early this spring. Since he’s separated from his wife, he paid the extra money to spend the night at McCauley Inn in the St. Joe’s complex. (For patients who don’t want to do that, CRPS surgeon Paul Izenberg often makes house calls–“I love seeing where my patients live,” he says.)
His surgeon visited Tom the next morning to see how he was doing and gave him the OK to leave. Tom drove himself home almost exactly twenty-four hours after the surgery and went back to the office a week later to get the stitches taken out.
Not one of his friends has noticed the change, but he says he’s happy he did it. “The swelling won’t be completely down for a year,” he says, and “my nose runs all the time, but I’m assuming that will go away.”
He told no one but one relative and a friend and paid $6,000 for the surgery. When asked if he would get more work done, he responds, “You bet. If I need it, I’m going to get it done. I don’t like the aging process–at all. And I’m going to do my best to deny it.”
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“A lot of times [patients will] come in and say, ‘I was looking in the mirror, and for the first time ever, I see my mother!” says U-M surgeon Paul Cederna. “‘I’m not ready to be that old yet.'”
“I was a pretty little person in high school,” Joanie says. But over the years, she gained and lost a lot of weight and her skin loosened. She was closing in on sixty. So she went to CPRS for an eyelift, facelift, and neck lift (but no rhinoplasty–“same old nose”).
She was in surgery for eight hours and paid $17,000. After some time in the recovery room, she recuperated overnight at McCauley Inn, with drainage tubes and collection bags to catch the excess blood and fluid from her cheeks and ears. When Dr. Hing came in at seven the next morning, he took off the drains, made sure she could move all her face muscles, and gave her a “face bra” to wear for support.
She says the pain was “ever present” for days, and “Vicodin is the drug of choice.” She adds, “He gives it liberally.” She describes the pain as “throbbing.”
She says she looks very different since the surgery, yet no one has said so. Instead, they ask, “Did you lose weight?” “Did you go on vacation?” “Is your hair different?”
Was it worth it? “You need a supportive caregiver,” she says. The bandages came off six days after surgery, and two weeks afterward, she got thick makeup to cover the black and blue. She wore big sunglasses, a big hat, and moisturizer with sunscreen.
“It was quite painful,” she says. “Six months ago I’d say I wouldn’t do it again; now, I’d do it again.”
CPRS founder Robert O’Neal, now retired, recalls that patients used to tell him, “‘I went for twenty years and never did anything for myself. I took care of my husband, my kids.’ Finally they have some time to do things for themselves and [cosmetic surgery] seemed like a reasonable thing to do … they want to sort of spruce up a little bit. They have a lot of life to live.”
Women also want to look younger, O’Neal says, because they’re staying longer in the workplace, and competing with younger and younger people. That’s the case with “Annette,” who works in sales. After her children were born, when she was still in her thirties, she went to Southfield surgeon Michael Gray for liposuction. Later she went back for an eyelid lift.
“I didn’t look very good when I was younger,” she says, describing herself then as “chubby” with “frizzy, curly hair … the kind of person everyone made fun of.” She married her high school sweetheart, but “I swore I wasn’t going to look bad later.”
Now in her fifties, she goes to the gym every day–“I work my ass off,” she says. Her stomach is flat, her nails are polished, her clothes are impeccable, her tan is sprayed on. She wears a size four and can proudly still wear two-piece bathing suits.
Most of her clients are men, she says, and since the surgery “they are responding to me better.” While people may suspect that she’s had work done, she does not talk about it openly with anyone. “Guessing is different than knowing,” she says. “I’ve never told my own family.” She says women in particular can be “catty” on the subject of cosmetic surgery.
For many people, cosmetic surgery is a way to attract positive notice. For Trish Smith, now forty-two, it was a way to avoid attention she didn’t want.
“I’ve always been very chesty,” says Smith. “Uncomfortably so.” As a professional person, “you don’t want people looking at you and saying, ‘Well, she’s just got big tits.’ It’s just that whole mentality.”
Four years ago, Smith had a consultation about surgery but decided not to go ahead. The doctor, she says, was “very clinical. He wasn’t that concerned about my concerns. Aesthetically I was very concerned. I was still very young, and I wanted to make sure [my breasts] looked good.”
This year, when she started thinking about it again, she turned to her hair stylist. “I knew she had [breast] implants,” Smith explains. “One day I just asked her, ‘Did you have it done locally?’ She said, ‘Yeah, let me tell you about Dr. Izenberg.'”
Smith went to see him, and he answered all of her questions–“and I had a lot.” She was concerned not only about the size of her breasts but that one was larger than the other (such asymmetry is common).
Post surgery, her breasts are smaller and “almost identical,” she says. “I just went on an eight-day vacation in Mexico. It’s the first time in my life that I’ve ever been able to wear a tank top! It was amazing. I bought a whole bunch of new summer clothes … I feel like more of a girl.”
And she can exercise more. She’s a golfer. “I can tell you right now, my swing’s gonna be much improved!”
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Linda meets me at Sweetwaters on Plymouth. Her hair is frosted blond, and she wears it as she always has, casual and windswept. Soon after her first surgery, she went back to Hing to have her eyes done–“he cut right below the eyelash line and took out those fat pads.” She motions to the light, smooth area under her eyes now. After the surgery, one eye drooped a little, so Hing had her wear a tiny butterfly bandage at the outside of her eye and then put makeup over it. “Nobody ever knew I had it on.”
Two years ago, she was diagnosed with breast cancer. That was surgery “that I didn’t want to have to have,” she says. And it changed her, perhaps more than the cosmetic surgery did. “It makes you really aware of your mortality,” she says. “I want to do everything now. I want to squeeze as much in as I can.”
She’d been on a low dose of estrogen since menopause but had to drop it after the cancer was found. “When you can’t be on estrogen, your lips really go,” she says. So Hing is plumping them back up again with injections of a filler called Juvederm.
She is happily married to her one and only husband, and she’s still enjoying her work–“I just signed a new five-year contract” with the university. But she believes there is ageism at the university, as there is everywhere, so she doesn’t tell her students her age.
In fact, she says, “I’ve been known to put [19]’53 instead of ’43” as her year of birth.
“Why not?” she asks. “It’s the cheapest facelift–just get a new birth date!”
