Facing the ‘80s With New Eyes--a New Nose. . .

Face it. The look has changed.

From the taut, wide-eyed visage of the ‘60s--the one that graced magazine covers, the one with the upturned nose and the just-slightly startled expression--the face of the ‘80s has evolved into a more individualized countenance: a face that is less artificial, less preordained or prestructured and certainly more personalized, more distinctive and more assertive.

Meeting here recently to consider the changes in their specialty, a panel of the 2,400-member American Academy of Facial Plastic and Reconstructive Surgery outlined a surgically renovated face of the ‘80s that may well feature:

--A stronger nose with broader tip.

--Narrower eyelids, probably including a “more athletic” upper eyelid.

--A strong, possibly clefted chin, compliments of improved, new artificial implant materials and techniques.

--More firmly defined cheekbones, also a new development in implants.

--Hair lines that appear fuller and far more natural, unlike the row-of-corn tufting that often resulted from transplants of the past.

--Foreheads without the fret lines, mouths without the deep-set laugh lines and between-the-eye zones without those nasty frown lines.

--Smaller earlobes.

--Better harmony and balance between the features and regions of the face: heightened interaction and a renewed focus on angles, curves, contours and proportions.

“Today’s emphasis is on a more natural look,” said Dr. Gaylon McCullough of Birmingham, Ala., “enhancing a patient’s own features rather than placing a kind of mask over them.” More and more, McCullough said, “the trend is to individualize the procedures to the patient rather than creating the same look over and over.”

And for the ‘80s, said this specialist in otolaryngology (surgeons who work exclusively in the areas of the ear, nose, throat and face), “fuller, richer lips, high cheekbones and stronger chins are the look of the day.”

While a taped recording of, for some reason, “Bolero,” wafted through the meeting room, blessedly ungruesome slides of before-and-after surgical success stories flashed on a huge screen. In the context of the looser, less rigid fashion of the ‘80s, Vogue magazine cover girls of the ‘60s looked suddenly starchy and plastic, “like Kewpie dolls,” said Dr. Robert Simons of Miami, “like mannequins.”

But in fact, said Dr. Toby Mayer of Beverly Hills, the typical plastic surgery candidate of the ‘80s is probably neither model nor starlet, and certainly is not striving to look like either. On the contrary, “the majority are very happy, well-adjusted, normal people who just want to look a little better.” When they walk into his office, Mayer said, what these potential patients are likely to say is something like “I don’t want to look younger, I just want to look better.”

More and more, Mayer said, his patients are likely to be single mothers, working women for whom “how they look is important to their jobs.” All too often in the business world, Mayer has found, the sad truth is that employers “simply don’t want to promote someone who looks haggard and tired.”

For these plastic surgery patients, Mayer said, their reconstructive surgery does not seem to them a luxury. In some ways, rather, “it’s an economic reality.”

And New York surgeon Dr. Norman Pastorek agreed. Modern advances in blepharoplasty, better known as an eye job, are producing not only a fuller brow, Pastorek said, but also a “healthy, intelligent, assertive, athletic eyelid.” The change from the old oh-my round-eyed look is in large part related to what Pastorek dubbed a “sociological, attitudinal change among women.” Flashing slides of this less-hooded eye line, Pastorek added, “This is the look of someone who is on the floor of the Stock Exchange. It’s a normal look, the look of someone who works in the world.”

Similarly, said Dr. Jack Anderson of New Orleans, today’s nose, “definitely the most prominent feature of the face,” is tending toward “a stronger, more aggressive nose with less tilt, less of an upturn at the end.” This reconsidered proboscis, Anderson said, is “more in keeping with our life style today.”

Rating an existing nose on a scale of 1-to-100, Anderson said that “normally, we can expect to bring a nose up 20% to 30%.” One additional axiom, however, is that “you get the biggest improvement when the deformity is great.”

In either case, Anderson said he and his colleagues sketch a patient’s new nose on a view box, “much like the game plan a football coach has before he goes into a game.” These days, he went on, surgeons try particularly to “make the nose fit the face,” rather than, as in earlier eras, “turning the noses out by rote--six every morning, done exactly the same way.”

And again, Anderson stressed, nose make-overs are hardly the province of “the big city or the jet set.” Mostly, he said, his patients are working people, not the sorts who frequent the covers of fancy magazines at all.

Lasts One Hour

In an office procedure that lasts just one hour, Dr. G. Jan Beekhuis of Birmingham, Mich., said an entire forehead can now be lifted, “improving the temple area lateral to the eye, where you get those crows’ feet.” With the incision hidden in the hair, Beekhuis said, this procedure boasts “dramatic, long-lasting results,” and, unlike certain other procedures of plastic surgery, “seldom needs repeating.”

And, Beekhuis continued, “by the way, this is not a problem of old age. There are a lot of young people who are realizing this is a problem of heredity and are correcting it. Lots of people in their teens and 20s are having it done.”

“I love forehead lifts,” Mayer concurred, sounding as if he were endorsing a new kind of health food. “They smooth the face out. More importantly, you put the brows where they belong.”

Among an increasingly health-and-beauty-conscious population at large, said San Francisco’s Dr. Samuel Stegman, a general move toward “less smoking, better skin care, less exposure to the sun and more exercise” has meant “we are getting a very different population of patients.” Specifically, the natural lines and creasing of aging may be less than welcome among “people who are 40 and who are feeling great, but are beginning to get some of the first signs of aging.”

In Stegman’s practice, an increasingly popular antidote to those creepy, crepey souvenirs of the years is an injection of collagen, a natural component of the thick portion of the skin harvested from cows and inserted into tiny, annoying wrinkles at repeated intervals averaging six months.

Men as well as women flock for this increasingly popular form of treatment, said Stegman, noting that “Men don’t have to be completely smooth. They just don’t want to look beat up or haggard.”

And while 3% of the population seems to be allergic to this method of attacking wrinkles, “the general evidence is so good that the FDA has reduced the restrictions covering the use of collagen.”

In the case of Mayer, a steadily growing segment of his patient population is comprised of men seeking that most elusive of tickets to eternal youth: hair. As Mayer pointed out, “it is often said that baldness should not bother men--but the person making that statement is usually a man with a full head of hair.”

Alas, he said, nature has dictated that “two-thirds of the male population will eventually experience some degree of baldness.” Fashion conspires against this reality, for “hair, and plenty of it, continues to be the style.”

Indeed, Mayer said, a family may be open about its most intimate financial problems or its history of mental illness, “but we know we never discuss Harry’s little bald spot in public.”

Frustrated, however, by the crochet-hook results of the hair transplants that became popular in the ‘60s and ‘70s, Mayer said he and his partner have opted increasingly for the relatively new “flap method” of hair replacement. Under this procedure, an entire strip of hair from one side of the head or the other is removed and relocated to the balding area, the incision stretched and closed almost imperceptibly and “the patient goes home the same day,” with hair.

Hairy, or surgically rehabilitated though he or she may be, the plastic surgery patient is also likely to head home with a giant-sized dent in his or her wallet. New noses vary anywhere from $2,000 to $3,500, Mayer said, a face lift can cost between $2,500 and $4,000, or more, and eyelid surgery averages between $2,000 and $3,000.

As for recovery time, the new techniques have also slashed periods of post-operative hibernation. Mayer pointed out that “I had my lower lids done on a Friday, and was back at work on Monday.”

Out of the Closet

On the same subject, Mayer, for one, agreed that plastic surgery seemed to be coming out of the closet: Patients, he said, are less embarrassed about having undergone these procedures, and are definitely less reticent about discussing them. Still, Mayer said, “You know those actresses, you look at them, and you say, ‘That woman is incredible. She just doesn’t age.’ ” Having resculpted the facial features of many such celebrities, Mayer said he knows entirely too well that “what happens is that a few weeks after their surgery, I’ll be reading a magazine article and I’ll see them attribute their wonderful young look to wheat germ and exercise.”

On the other hand, at least one prominent American female has been almost excessively confessional about her surgical uplift. As a finale to his own presentation, Dr. H. George Brennan flashed a slide of the Statue of Liberty, currently under major renovation.

“This lady,” the doctor said playfully, “is also having a facial make-over.”