Years ago, on a subway in Paris, Dr. Bruce Connell conducted an informal experiment. He discreetly examined each passenger's face, mentally measuring from the edge of the eye to the hairline. Then he tried guessing each person's age from that one bit of skin.
Each temple (pink or brown, taut or wrinkled, narrow or--most tellingly--broad) was a trove of data, each centimeter a clue to the mystery that has driven Connell for almost 50 years: What makes one face look young and another look aged? Where, specifically, do the years mark us?
And how much would one man--say, one curious plastic surgeon--have to alter so that a youthful heart might acquire a countenance to match it, or so that beauty might always greet the eye of the beholder? And then what would it take to erase the hand of the doctor as well? In a career spent troubling over these questions, Bruce Connell quietly has become one of the preeminent gurus of an American obsession: the face-lift.
For decades, colleagues have flocked to his sold-out seminars and stalked him at medical conferences. Other surgeons have pestered him to work on their own faces. Textbooks and scholarly papers have detailed his techniques for elective surgeries in every imaginable niche of the burgeoning market, from women whose necks sag to bald men who want brow-lifts. His former apprentices, known as Connell Fellows, gather regularly from around the globe as the collective Connell Society to learn from one another and their mentor.
"I met him 30 years ago at one of those little alumni receptions," says Dr. P.G. Arnold, a professor and former chief of plastic and reconstructive surgery at the Mayo Clinic, "and I knew who he was before he walked in the door."
Critics rail at what they view as the Orange County surgeon's outsized place in the profession even as the invitations continue to pour in. His spring calendar has him addressing societies of plastic surgeons in Mexico, El Salvador, Argentina, New York, Idaho, Berlin and Las Vegas. In reporting this article, I heard his peers, otherwise serious people, babble like groupies, comparing him to Einstein, Hawking, Balenciaga, Baryshnikov and a Swiss watchmaker, not counting the references to assorted Renaissance masters. (A detractor stuck with the metaphor, too, referring to Connell as "an attitude artist.")
"What Michelangelo was to the Sistine ceiling," Dr. Richard D'Amico, president-elect of the American Society of Plastic Surgeons, says in a typical homage, "Bruce Connell is to facial aesthetic surgery."
It's a level of reverence that would verge on eccentric (face-lifts are up there with God and Man touching fingers?) if cosmetic surgery weren't such a big business--if Americans hadn't spent more than $9.4 billion on it in 2005.
But stick around long enough and anything can happen, Connell jokes. He, for example, is almost 80. Tens of thousands of years have been removed by his hand from thousands of faces, and still there remains this matter of time.
"You have to admit, she's a good lookin' woman."
Connell has walked into the room carrying a copy of Cosmo. It is midweek, and thanks to a canceled European speaking engagement, the doctor is in.
I've come to talk about aging, given Connell's expertise. Only 30 of the more than 6,000 members of the American Society of Plastic Surgeons are over 75 and still practicing, which means that very, very few have been fending off sags and wrinkles for as long as he has. I tell myself that's all there is to it: Cosmetic surgery is for actors; the way to go is to grow old gracefully, etc., etc., but whatever. Something in me--possibly something that's starting to sag and wrinkle--is very interested in meeting this Michelangelo of plastic surgery.
But the Michelangelo doesn't want to talk about age. He wants to talk about beauty.
"Look," he says, gesturing at the dark-haired model on the cover. She is indeed lovely. She is also, as it turns out, unbelievably out of whack.
"See, this side of her face is longer. It has a different contour, a different bone structure. And if you look closely, this side of her mouth is wider--if you need a ruler I can bring you one."
He rummages around for a ruler, still talking. "And this eye is not on the same level. And this ear is much lower than the other. Yet put it all together, you have a beautiful woman."
But her beauty is--
We're in one of the rooms where he consults with patients, and he stands at a big wooden desk, a triumphant smile on his own--and now that he mentions it, asymmetrical--face. Tall, with a slight stoop to his walk, he is wearing a white lab coat and a wide German tie he got as a gift from an old friend. His voice is soft and Southern, inflected with the warmth of his childhood home in Alabama. Periodically, he tosses off a biblical reference, a habit that would also feel out of whack had his friends not explained that, among other hobbies, he's a student of religion. "'Study to show thyself approved unto God, rightly dividing the word of truth,'" he recites, twice, to punctuate stories about his distrust of conventional wisdom.
"You say what's truth? Is what you've been taught the truth? Or is there a better way?"
Take this office. A lot of plastic surgeons go for that "Nip/Tuck," Beverly Hills aesthetic--the receptionists with cleavage and collagen-plumped lips, the big potted palms, the flat-screen monitors featuring the doctor's latest appearance on "Today." Connell's suite is almost absurdly modest, tucked into a tan stucco medical complex in Santa Ana, kitty-corner from a hospital and next door to an acupuncture weight-loss clinic and a dentist with a "se habla espanol" sign. The waiting room is decorated with parlor furniture in the style of, say, late 20th century Sears, Roebuck, and there are coffee-table books on gardening, another of Connell's passions. The women working behind his appointment desk appear unretouched and mostly middle-aged. Most of his staff has been with Connell for decades. ("He keeps things," says one longtime friend, a designer who fondly observes that the doctor's decor could use an update.) When I glance up at some missing ceiling tiles and ask why he doesn't have more glamorous digs, Connell laughs and waves a hand as if appearances weren't the whole point of his profession. "Because if I did, I'd just attract patients who are only interested in superficialities!"
Superficially, Connell has bright blue eyes, which are at the moment behind wire-rimmed glasses. His teeth appear to have been straightened and whitened, and his gray hair has been colored light brown. But he is also surprisingly frumpy--the brows ever so slightly bushy, the nose ever so slightly lumpy--like Martin Landau, maybe. But less well-preserved. But in a good way. He admits to a face-lift and a brow-lift and, he says with a wink, "work done when I was a baby, but I didn't have any control of that." His last procedure, he says, was eight years ago, performed by one of his fellows.
"You can push my hair back and see the incision." He leans forward and pulls back his hair. The forehead is ruddy, the hairline gray but apparently scarless.
"See? Right where the hair joins the forehead, all the way across."
I can't see it, I tell him.
He chuckles delightedly.
"That's the whole point."
Connell's claim to fame isn't celebrity faces. Yes, there have been famous patients. "I would walk into the operating room some days and go, 'Oh God!'" remembers Dr. Francine Vagotis, a Michigan surgeon and former fellow. "'Is that who I think it is?'"
But his is more a "plastic surgeon's plastic surgeon" sort of stardom. A clinical professor of surgery at UC Irvine, he has schooled scores of doctors, from international luminaries such as Dr. Thomas Bell of Toronto to locals such as Dr. Garth Fisher of "Extreme Makeover." And he has refined dozens of surgical procedures, finding elegant ways to fix double chins or to ensure that a man who has a brow-lift won't emerge with eyes that look vaguely female. Or, as in that subway experiment, figuring out how to precisely match a target age to the width of a temple. More than 4 centimeters between the outside corner of the eye and the hairline, he found, makes a face look older.
His published research is all about the difference between a face-lift that's as fine as couture and one that's slapdash, like a cheap sport coat. A surgeon can quickly tighten the sides of the face, for example, with a slice along the front of the ear and into the hair, a yank of the loose skin and stitches to give a patient a hairline that sits back on the head like a Chinese Mandarin's. That same quickie on a man might result in earlobes with whiskers. Some of the best-known surgeons will neglect to preserve the look of the tragus, that little flipper of cartilage at the front of the ear where face-lifts are often sutured. Or they will pull the earlobes forward and down and tack them onto the cheek--"pixie ear," surgeons call it, a rush-job staple that will be later camouflaged with long hair or those big button earrings that adorn so many matrons.
Or they will make incisions along the front of the ear that stand out like chalk lines on people with ruddy complexions. Or scalp incisions that create telltale bald spots. Or they will lift just the delicate top layer of skin, rather than the more resilient muscle tissue beneath it, flattening the cheeks like a G-force simulator on a trainee at NASA. Or they will lift both layers but carelessly reattach them.
"Just make a cut in front of the ears, undermine the skin, grab the deep sheet, pull to the ear, pull to the ear and you've got that wind tunnel look," says Connell with annoyance. "They still do it today. I see them today, from big centers where they have big PR."
Connell, by contrast, is famously fastidious. "He really refined the face-lift a lot several decades ago, and brought a level of attention to detail in aspects that had been overlooked," says Dr. Steven Teitelbaum, a Santa Monica plastic surgeon. But, he added, Connell's contributions "are very specialized within the profession." So specialized, in fact, that a Connell-style face-lift can take twice as long--up to 6 1/2 hours--as the average procedure, and less-exacting surgeons often view the longer operation as not worth the fuss.
Other critics admire his skill but say he simply points out the obvious in his ubiquitous lectures. "Have you ever heard anybody speak, and you're inspired, and then you walk away and it's a big bite of cotton candy?" says one plastic surgeon. "He's like that."
When I ask Connell about his critics, his smile freezes and his eyes look more than a little wounded. "I can only be responsible for myself," he says.
Then, quickly, it's back to his passion.
"You see," he says, eagerly reaching over his desk to retrieve a thick binder filled with his published research, "if you want a person to not look like they had a face-lift, the earlobe has to come back 15 degrees behind the long axis of the ear. . . ."
His fans say that, as arcane as his observations may seem, they have been revolutionary within the profession.
"Basically, I had to relearn everything when I met Bruce," says Dr. Timothy J. Marten, a San Francisco plastic surgeon who was a Connell Fellow in 1990 and who remembers Connell's constant admonitions against what he called "cookbook surgery."
Whereas most surgery is "like changing a carburetor--important but not stimulating," Marten says, performing a face-lift "is like pruning a bonsai or growing an orchid." Connell, he explains, "used the 'good results' shown in the textbooks I had studied from as examples of what not to do, and he showed me how they could be done better.
"Bruce would say, 'What do you need to do to make this beautiful? What's the underlying problem?'" And even those questions turned out to be more art than science.
"I used to look at people and think of the things that they might have fixed. Bruce said, 'Don't waste your time dwelling on what isn't beautiful. The real mystery is in what is.'"
Connell says that cosmetic surgery patients don't necessarily want to look like anyone else.
They don't want Sophia Loren's eyes or Brad Pitt's chin or some other lovely extreme of nature. They just want a younger-and-pleasanter version of their own face, with no sign that they resorted to surgery to achieve it. "It's no difference if you're a child born with a deformity, or a teenager with an ugly neck, or an ugly nose," says Connell. "Most people just want to fit in."
Fitting in is a subject about which he knows a little something. Long before it was commonplace, especially in Gordo, Ala., Connell grew up poor as the only child of a divorced mother. His parents, a schoolteacher and a baker-turned-cattle rancher, split when he was 5 during the Great Depression.
Harold Davis, the mayor of Gordo, a town of 2,000 about 15 minutes west of Tuscaloosa, remembers Connell as an "outstanding student" and a dutiful son: "When his mother would yell for him, she'd call, 'Koo-koo Brucie-boy!'" Davis chuckles. "We used to be pretty hard on Bruce."
Despite the community's small size (even now, locals say, its biggest event is the local poultry plant's annual celebration of chickens), it managed to produce some stellar students, Davis says. The street he and Connell grew up on yielded a pharmacist (Davis), a veterinarian, two ministers and three physicians.
Connell graduated at the top of his class and worked his way through a year at the University of Alabama before winning a scholarship to a pharmacy school in a smaller Birmingham college. There was a stint in the military--in Italy as World War II was ending--then a medical degree from the University of Buffalo, one of only two schools that was still accepting applications when he got out of the Army.
His plan, he explains, was to become a general surgeon, but he found himself drawn to the challenge of maimed hands and cleft lips. After an internship at what was then Los Angeles County General Hospital--now County-USC Medical Center--and a residency at the University of Buffalo in general surgery, he ended up as a resident in plastic surgery at the Mayo Clinic. When he graduated, he returned to Southern California to start his practice, largely because, he says, the climate reminded him of Italy.
By now, plastic surgery--a field that Americans had generally viewed as fascinating but vaguely immoral--had begun to gain respectability. The work of military specialists on the disfigured casualties of plane crashes and bombings during World War II had received enthusiastic coverage from wartime reporters. Postwar audiences had jammed the theaters to see the 1947 movie "Dark Passage," in which Humphrey Bogart plays an escaped convict who snares Lauren Bacall and a new face. Japanese burn victims were brought to the U.S. for reconstructive surgery after Hiroshima.
The war's end had flooded the market with plastic surgeons, but their skills and credentials were better than surgeons before them, and so was their timing. Peacetime and social progress had created a generation of Americans who, for the first time in the nation's history, were facing middle age with both the health and the wealth to enjoy it.
It was the beginning of what would be a decades-long rise in the acceptability of surgery as a means to that suddenly all-American mantra: self-improvement. And with the baby boom and youth at the cultural forefront, it would now include something as previously questionable as an operation to shave a few years off your face.
But in Connell's early career, elective cosmetic surgery was the least of his practice. Because he had chosen the wide-open market of Orange County rather than Los Angeles ("the smog was so bad in L.A. even then that it made me cry"), Connell says he was, for many years, one of only two plastic surgeons for miles in any direction.
"Most all the general surgeons sent their parotid [salivary gland] tumors to me, and most all the dermatologists sent me their skin cancers," he remembers. There were the emergency calls from all over the county: "The freeways were not so good, and on Friday and Saturday nights the Marines and the sailors would cross the midline and have everything smashed in."
Then there were, and still are, the special cases. Marten says that one of the most inspiring moments in his career occurred when a young Latina housekeeper and her child wandered into Connell's office; the little girl had a cleft lip and the mother had seen the sign advertising plastic surgery.
When Connell found out, the doctor, who had a year-long waiting list and a waiting room full of patients, came out to the apprehensive duo. Connell greeted them warmly in Spanish, Marten says, and invited them into his office to schedule the procedure. Then he repaired the child's face for free a few days later. When the uninsured mother asked about cost, Marten says, Connell told her that a "special insurance fund" would cover the operation. Of course, Marten notes, "there was no such thing."
For many years, Connell recalls, his waiting lists were as eclectic as they were lengthy: "One day for children, one day for tumors, one day for others, one day for elective surgery."
But as the county grew, he gradually ceded what he viewed as "the easier things" to younger surgeons, focusing instead on "perhaps the most challenging work, utilizing all your surgical knowledge, anatomical knowledge, color matching, balance and proportion."
In other words, the aging and imperfect face.
Here is what happens:
Years pass. New cells are slower to replace old ones. Collagen and elastin break down. Lines that once came and went like a smile--at the mouth, at the brow--linger. The fat in the cheeks disappears. The jaw softens. The lips thin. The neck goes. The forehead falls.
Half a century as an expert on what age does to faces has left Connell with one inviolable rule: Never take a patient who can't take a joke. "If they can't smile at all during an hour interview," he says, "or if they look completely annoyed with life and themselves, I don't think they can handle recovering from the surgical procedure." Not to mention their reaction should anything go wrong.
Connell says he had his first facial surgery in his mid-50s. "I looked tired. Pull of the frontal muscles. Came with time. Did not represent the inner feeling. I see lots of patients that way. This pulls--" He points toward the space between his brows, at the vertical lines plastic surgeons call "the elevens." "They look angry. It just comes with some people--the face begins to look like a basenji dog's."
Five or six years later, he says, he had a second procedure. "I looked too much like a hound dog. Sagging of the deep tissues and the skin too."
It wasn't for romance--though he never married and has no children, he has been in a relationship for decades. Nor was it concern about losing clients; when he's not lecturing or away from California, he still does two or three surgeries a week without the benefit of advertising, publicists or a website.
Rather, he says, it was a matter of pride, and not just professionally: "I felt in good faith I should have something done as an expression of confidence in what can be done," he says. "But I still would have felt like looking my best."
Still, I ask, what about expressing confidence in the attractiveness of experience and wisdom? And isn't it a little deceiving to greet the world with a face that's underage?
Connell bursts out laughing.
"It's kind of deceiving to wear a brassiere too!"
Then he makes me turn off my tape recorder. I brace myself for a lecture about ageism or maybe my own increasingly basenji-like wrinkles.
Instead, Connell tells me a joke about three young women who answer a help-wanted ad for a secretary. The first is a former A student. The second types a thousand words a minute. The third is a whiz at handling people. Who gets hired?
Connell hoots: "The one with the big t--s!"
I suppose I should have known better than to sling conventional wisdom about aging at a man who has spent the last 50 years as a professional subverter of time. Certainly I was warned.
"We don't get old. We get old-ER," says Dr. Max A. Schneider, an Orange County physician who is one of Connell's best friends. "We don't talk about it." Schneider notes that, like Tony Bennett, Sumner Redstone and other octogenarians, he, too, is still working. And he's about to turn 85.
Ron Silverman, a 71-year-old Honolulu real estate broker who has known Connell for decades, tells me that Connell was ruthless three years ago when Silverman casually asked him for advice on his neck, which was "hanging lower and lower, kinda like Ronald Reagan's was there at the end."
Silverman ended up paying "around $20,000," he says, for face, neck and brow work so good that Connell still uses his before-and-after shots in some of his lectures, but not before an exceptionally blunt assessment. "He said, 'Your face is a mess,'" Silverman recalls. "I gotta confess, it bothered me for a few days."
Finally, if a little impatiently, Connell addresses his own age question.
"If I didn't enjoy the work, I'd slow down. But I enjoy it and the results are still holding up." He had a knee replacement not long ago, he says, and has been testing his mental acuity with an advanced class in German literature. (He's fluent in four languages.)
"Everything seems to be going well," he says. "And my hands have always been steady. Except when I play the piano."
He laughs and holds out his hands, which are clean, tanned, only a little age-spotted and, as advertised, not shaking.
"I've been fortunate and blessed as a surgeon. I consider it a gift--nothing to get puffed up about." Then he gives a merry glance and goes biblical on me.
"For how dyeth the rich man? How dyeth the wise man? Ashes to ashes. Dust to dust."
Years ago, Connell says, he was asked what he would do if he knew he was dying.
"I said I would plant a tree."
We are driving down Pacific Coast Highway from Connell's oceanfront house in Laguna Beach to another of his properties, a ramshackle rancher where he keeps his garden.
Connell's Fellows have regaled me with stories about him--how he once tried to drag a bunch of uptight doctors out to a Mexican cockfight, how he once absentmindedly showed up at a big medical gala with a sock stuffed into his handkerchief pocket, how he once struck up a conversation at a Venice cafe and wound up dressed as Henry VIII at a Carnival masquerade ball.
But their greatest amazement is reserved for his quirky orchard, a backyard acre and a half filled with trees on which he apparently has performed surgery.
"This is for you. It's a Fuyu persimmon," he says, snipping a piece of bright fruit from a thicket of low branches. "This is a Satsuma. It has no seeds. Every week it stays on the tree, it gets sweeter." He snips again.
The place is a jungle--bougainvillea, blood oranges, tangerines, strawberry guavas. A rooster crows. Chickens race. Some, Connell says, are exotic hens that lay green pastel eggs.
There's a yellow peach tree on which one set of limbs bears fruit in the spring and another set bears in the summer, and a citrus tree whose assorted branches hold tangelos and two kinds of oranges.
He shows me where he has grafted them, a skill he taught himself 15 years ago while recuperating from a skiing accident. Time has diminished the scars to little more than bumps on the branches, all but erasing the hand of the doctor. The work is as invisible as it is exquisite.
"Physical appearance isn't the most important thing," he muses in the car later. "I think it's the attitude."
On one side, the blue Pacific rolls off to the horizon. On the other, green hills bask in the sunshine. He nods toward the passing scenery, reveling in the shades and textures of the foliage
"Eucalyptus, Ficus benjamina, queen palm," he calls out. "Cup of Gold, bougainvillea, sunflowers, anise. . . . " I've driven this stretch of road a thousand times and never noticed.
What makes one face look young and another look aged? Where, specifically, do the years mark us?
"Look!" he cries in delight. "A loquat in bloom."