Tales From Under the Knife

“You know,” said the man who was just about to cut into my face, “the older I get, the more I value writers.”

I took courage from his words, and I felt something similar toward him--because the older I get, the more I value cosmetic surgeons.

For many Angelenos, the first trip to the plastic surgeon’s office is simply a rite of passage, like that first martini at the Sky Bar or the first time contesting a prenup. For a woman who has had exactly one manicure in her lifetime, who has never had her legs waxed, who has a hard time remembering to put on lipstick, it was an excursion into a whole other world.

Just getting to the first appointment was fraught with misadventure. The doctor who was recommended to me has an office on Spaulding, and here’s how Eastside-located I am: I thought it was Spaulding Avenue near Midway Hospital, which made sense to me (doctor=medical procedure=hospital). I spent 20 minutes searching for an address that did not exist before realizing that it was Spaulding Place, which lies just a bit west of Barneys in Beverly Hills, which apparently makes sense to the rest of the world (doctor=improved appearance =high-end shopping).

Driving down Wilshire Boulevard I realized I had no business going to a cosmetic surgeon. Yes, I have had a facial scar that has plagued me with low-grade infections for 12 years now, but I’m Irish Catholic--we’re supposed to grit our teeth and offer our suffering up to the poor souls in Purgatory, not high-tail it to some medical Sodom and Gomorrah where faces are peeled, breasts inflated and botulism is considered a panacea. But by the time I had decided to turn around, I was there already, and when I found out the doctor validated parking, well, I took it as a sign from God.

The examining room was small and dull, although a sheaf of pamphlets promised many wonderful things regarding my breasts, hips and tummy in such matter-of-fact language that I could see how easy it would be, if you had the money, to try to tuck and clip your way to physical perfection. Me, I just wanted this darn scar to stop getting infected and the doctor said it would be simple enough--outpatient, local anesthesia only, take about an hour.

According to the American Board of Plastic Surgeons, more than 220,000 Americans had scar revisions last year, making it an even more popular procedure than breast augmentation (212,500), but nowhere near as prevalent as liposuction (354,015), eyelid surgery (327,514) and nose jobs (389,155). There are no local statistics, but I think we can assume that many of these occur in Beverly Hills.

When the big day came, I was nervous on several levels. Signing the arbitration agreement, I became convinced that there would be an earthquake just as the doctor was making his first incision and all the nerves in my face would accidentally be cut and I would go blind. Then I worried that I would not be satisfied with this procedure, that soon I would be back requesting fewer wrinkles, a tighter neck, and a body like Halle Berry’s. I’d become one of those women you see in restaurants who can move about only after dark because their skin is stretched so tight and thin that any contact with sunlight might cause it to burst into flame.

What really happened was much less dramatic and much more interesting. Getting a scar excised is a bit like going to the dentist, only you have to take all your clothes off and wear a paper dress. There’s the same little prick of the needle to numb the area, the same blinding bright lights, the same rustle of baby-blue paper that medical facilities seem to drape over everything. But unlike at the dentist’s, I could talk during the proceedings, a distraction I was grateful for: Although I couldn’t feel any pain, I could feel that things were being done, things that did not bear thinking about.

So in lieu of contemplation, I chose conversation and learned many interesting things about the cosmetic surgery industry.

It is, according to my doctor, an economic bellwether--the first thing to go when times get tough, the last to rebound when things improve. Last fall, things were very slow, despite the fact that October and November are usually big months for facial work as folks prepare for holiday parties and family reunions. The other boom time is early spring when a young man’s, and woman’s, thoughts turn to liposuction. About 35% of patients are men, a number that undoubtedly would be larger should pec implants ever really catch on.

Although things are a bit sluggish in general, he said, breasts are back and in a big way--where before most women wanted a B cup, now they’re asking for Cs. Mini-face-lifts, procedures that are less extensive and have a shorter recovery period, are also gaining popularity among an increasingly younger clientele, and eyelid tightening is still very hot. But not as hot as Botox, the botulism-based wrinkle-tightener that was injected into hundreds of thousands of Americans last year. Botox injections require regular visits, which creates a doctor/patient relationship one usually associates with a general practitioner or an ob/gyn. In fact, during the recent anthrax scare, my doctor said he received many calls from patients looking for Cipro prescriptions.

Why on Earth would someone call a cosmetic surgeon for such a thing? I asked.

“I’m the only doctor they see on a regular basis,” he answered.

For a moment I simply lay there, loving Los Angeles.

Seeing one’s cosmetic surgeon on a social basis is something else again. At a party or social gathering should this doctor see a patient, even a patient who has become a friend, he never greets them until they have been introduced as if for the first time. As he stitched me up, he recounted one instance of a woman who waved him over from across the room, and introduced him around, only to have her boyfriend ask, “And how do you know Dr. X?” The woman stuttered until the doctor stepped in. “Mutual friends,” he said smoothly. Ah, yes, mutual friends.

And then it was over. I left the office much as I had entered it, with a small, almost unnoticeable bandage on my forehead. When the numbness wore off, it hurt quite a bit more than they had indicated, but having been through childbirth I am accustomed to the Hippocratic tendency to use “discomfort” as a synonym for “excruciating pain.” Still, I wouldn’t rush back just to look a few years younger or a few pounds thinner.

Although, when you think about it, that might solve a couple of problems. When the surgeon general called on every citizen to shed 10 pounds, I don’t think he ruled out lipo. And forking over another stack of bills would surely help prove that economic recovery is on its way. Why, it might just be my duty. Not just as an Angeleno, but as an American.