New you? New us

THE windows of the Beverly Hills plastic surgeon’s office face west, which means that an afternoon consultation shines a particularly bright light on any imperfections, real or imagined.

When Cheryl Palmer, a 62-year-old real estate agent, came for a consultation, she sat before a triptych mirror and showed plastic surgeon Toby Mayer what was bothering her: a jaw line that had gone south, sagging upper eyelids, thinning lips and pucker lines. Her husband, Cliff Palmer, 61, a school psychologist, leafed through a big album of befores-and-afters. He was just here for emotional support.

But after Mayer explained what he could do for Cheryl, who had been contemplating surgery for several years, the subject turned to Cliff, a lean, muscular man who was accustomed to jogging five miles a day on the couple’s horse ranch in Montana. Mayer took what he calls his “fancy Armani pointer” (a Q-Tip) and traced the deep nose-to-mouth lines on Cliff’s face. “We can remove these, which would be a great improvement,” Mayer said.

And sooner than you could say “consent form,” Cliff had signed on for excision of those lines and, while the doctor was at it, a forehead lift and a hair transplant.

In consultation rooms across the country, husbands who just come along for the ride are finding themselves on the business end of a scalpel.

Many see it as the newest way to bond with their wives, with some likening it to just another activity they do together, such as renovating a house.

Others are trying to keep up with their partners, whose zeal for cosmetic improvement is making the men look old by comparison. Being mistakenly referred to as your wife’s father is apparently quite the motivation.

“They’re having eye jobs and forehead lifts so they don’t get traded in for a new model,” said Richard Fleming, a Beverly Hills plastic surgeon.

And as the cultural taboo against plastic surgery has lifted, a man is more likely to say “yes” when a woman suggests it. After all, wives often do all the advance work -- shopping around and interviewing surgeons -- so it’s relatively easy for husbands to sign the papers when all the research is set before them.

“Men are figuring out what women figured out decades ago, which is that like it or not, our appearance really matters. We see it not only in men’s pursuit of cosmetic surgery but also in the growing number of health magazines and skin-care lines directed at men,” said psychologist David Sarwer, lead editor of the new book “Psychological Aspects of Reconstructive and Cosmetic Plastic Surgery.”

For men, such surgical togetherness is part of a larger trend. The number of cosmetic procedures performed on men increased 16% from 2000 to 2005, according to the American Society of Plastic Surgeons. (The number of cosmetic procedures performed on women is up 42% since 2000.)

Though the organization doesn’t keep statistics on which patients share the same household, its members performed 10.2 million cosmetic procedures in 2005, up 11% from 2004, with men having 1,196,392 of those procedures. Many of those patients were husbands and wives, or boyfriends and girlfriends, said Dr. Darrick Antell, a spokesman for the organization. He cites a 15% increase in couples in the last two years at his New York practice, and other doctors report a similar uptick.

“Perhaps it’s due to all the makeover shows on TV, but men are paying a lot more attention to their bodies and realizing that having plastic surgery doesn’t mean they’re wimps,” said Diane Gerber, a Chicago-based plastic surgeon.

Most of the couples surgeries she performs at her practice are instigated by the wife. “The usual pattern is, I’ll do face or body work on her, and then subsequently she’ll mention something like, ‘My husband’s eyelids are drooping,’ and I’ll say, ‘Well, bring him in.’ Often the man doesn’t even know something can be done about the lids, and that it’s not that big a recovery.”

Among couples in their 30s and 40s, the women frequently seek a “mom’s body tuneup” (a post-childbirth breast lift, tummy tuck and lower-body liposuction), said Barry E. DiBernardo, a plastic surgeon in Montclair, N.J.

“And the husbands, who suddenly wonder how they’re going to stand next to their wives on the beach, get lipo of the chest, neck, belly and love handles, plus a hair transplant.” Couples in their 50s each order “the blue plate special,” as Mayer of Beverly Hills calls it (an eyelid-, brow- and face-lift).

Although partners can bring different motivations to the surgical suite, men and women alike feel the need to stay competitive in an increasingly youth-oriented workforce, plastic surgeons say. Some, however, have moved beyond the workplace and are now facing the prospect of a comfortable and active retirement, with lots of travel -- and a desire to look as good as they feel.

Regardless of the motivations, mental health experts say, cosmetic procedures have the potential to backfire. Surgery can change appearance so dramatically -- whether done individually or as a couple -- that it throws off the dynamic of a romantic relationship.

“We intuitively think that if one partner loses weight or undergoes plastic surgery, that person will feel better about him- or herself, and as a result the partner will feel better about the relationship,” said Sarwer, an associate professor at the University of Pennsylvania School of Medicine. “But, in fact, things like appearance and weight actually play a much more central role in the dynamic of a relationship, which means that some partners may feel very threatened and fear that their current partner will leave them for someone else.”

Couples must talk beforehand, experts say, about what each partner is personally looking to get from these procedures -- and whether the expectations are realistic.

“If the woman wants a face-lift because her husband is fooling around, and he wants a face-lift because his business is failing, well, they’re not going to be happy afterward because their motivations are all wrong,” said Beverly Hills surgeon Fleming. “God bless me, I hope I’d pick up on that before the surgery -- because it’s not going to work.”

Adds Sarwer: “There is pretty conclusive evidence that cosmetic surgery does lead to an improvement in body image.... But there is not much evidence that surgery improves self-esteem and quality of life, both of which derive from so much more than just the way we look.”

Mutual benefits

Many couples who undergo surgery together say they already eat right and exercise -- and that the procedures are just another way to do something good for themselves.

Sarwer refers to it as a “positive self-care strategy,” one that “if done together allows them to lend support during the healing process -- so that it’s a shared experience instead of an isolating one.”

New Jersey residents Esther and Alan Wilson didn’t tell many friends, or even family, that they were considering surgery at the ripe old age of 35.

“I figured, I’m done with having kids, and if I’m interested in having procedures, why wait until I’m 40?” said Esther.

So she had a breast lift and tummy tuck from surgeon DiBernardo.

Encouraged by Esther’s results, Alan, a financial advisor, signed on with DiBernardo for a neck lift and lipo.

“It’s given me a defined chin line, something I haven’t had since I was a kid,” Alan said. “It feels really good to improve a portion of your body that you can’t exercise or diet away.”

Though he admits to having been nervous about the surgery, and that the first couple of days post-op “were brutal, because I had to wear this chin strap wrapped around my head,” he’s glad he did it. “The reality is, we all get older, and if there’s something you don’t like about your appearance and you’ve got a couple bucks to spend on it, then why not?”

Carla Lundblade, 40, a property manager and full-time student in Medford, Ore., wanted a smaller chin, higher cheekbones and a breast lift. She’s training to become a clinical psychologist and will be “coming into that professional setting in my late 40s, and I don’t want to be at a disadvantage with the folks just starting off in their early 30s. I want to look good and fresh!”

So several months ago she and her lawyer husband, Rick, 43, drove down to Beverly Hills to see Fleming, the same doctor who just a year ago had given her a forehead lift, nose job and lower eyelid lift. (It had been a family vacation: On one of Carla’s recovery days, Rick took their two kids, 4 and 15, to Disneyland.) But on this second visit, as Rick sat in the consultation room, he lifted his shirt. “OK, doc, what about this?” he asked, revealing love handles on an otherwise toned 6-foot-5 physique.

A few days later, Rick had liposuction and was tended to by Carla before she had her procedures; both shared a room at a recovery center hotel not far from Fleming’s office. (While mom and dad recuperated, their children stayed a few floors above in the hotel proper.)

Said Carla: “I can’t tell you what a difference it’s made to Rick and me, intimately. We feel like teenagers in love again. When we take a bath together, he’s feeling good about his stomach and I’m feeling good about my chest. I mean, I loved his love handles but he feels more beautiful to me now.”

Other people’s opinions matter very little, she adds. “It’s more about feeling young and sexy and confident when we’re nude with each other.”

Said Rick: “I’m glad I had the lipo, because that hereditary fat around my midriff always bothered me, but I have no desire for more work. I mean, I’ve got a pretty big nose, but I just figure it’s something I’ll hang onto forever.”

Even husbands and wives of markedly different ages are no exception to the couples-surgery trend. “I always thought I would not have a problem growing old. And then I hit 40!” said Melinda Powers, now 45 and 22 years younger than her husband. On their recent visit to William Silver, a plastic surgeon in Atlanta, she had a CO2 laser resurfacing, while her husband, Marvin, 67, had a face- and eyelid lift.

He acknowledged that had he not gotten a divorce from his first wife, who is closer to his age, the idea of surgery wouldn’t have come up. “But with Melinda, it was a whole new consideration, things were a little out of balance. And when I saw how well she recovered from her earlier procedures with Dr. Silver, I was encouraged,” said Marvin.

What sealed the deal was a round of golf with the doctor a week before the surgery. “I said, ‘Does what I’m about to do make sense to you, other than the fact that you’re gonna make money off it?’ And Dr. Silver just had one comment: ‘Your wife’ll like it.’ ”

After spending 10 days recovering together at an Embassy Suites hotel in Atlanta, where their bandaged selves shopped and went to movies until the staples were removed from Marvin’s face, the couple is back on their southeast Georgia farm.

Melinda is thrilled with the results. “I look so much brighter, wide-eyed and glowing. I’d recommend plastic surgery to anybody because it’s such an ego boost!”

Marvin’s enthusiasm is a little more measured. “I’m probably about three months away from being 100% sold on it, because all the feeling in my face hasn’t come back yet from where the nerves were cut. But it’s gradually returning.”

But Laurie Mintz, a psychologist at the University of Missouri-Columbia who has studied body image and couples issues, said that couples who are trying to have a better retirement or better life satisfaction were setting themselves up for disappointment down the road.

“Studies have shown that the strongest correlate of happiness in old age is not beauty, but health,” she said. “Taking care of one’s health -- eating right, exercising -- is a much better predictor of happiness.”

A bonding experience

Many couples who undergo surgery together say they’re already happy -- and that the procedures bring them closer.

It’s the healing process that can come as the biggest surprise.

“No one ever talks about the recovery,” said Cliff Palmer of the post-anesthesia vomiting and bruising. His wife Cheryl added: “At the time I thought, Gosh, he’s complaining a lot! I had much more work done!” (She had a face-lift, chin implant, forehead lift, lip implant and laser resurfacing of the lower eyelids and mouth lines -- more than she originally sought but hard to resist when you learn during the consultation that, so to speak, procedures are cheaper by the dozen.)

When pressed she’ll admit that her weeklong recovery was painful and that she was so black and blue she made Cliff bring the hotel’s continental breakfast up to her on a tray from the lobby. They spent the first night at an after-care facility, with round-the-clock nurses and a price tag that reflects it, about $600 a day, and then moved into a high-rise hotel for the next six days.

“Next time I’d go to a Motel 6,” said Cliff, who was too groggy to appreciate the plush surroundings of either retreat. But now that it’s over, both say they’re pleased with the results.

“It’s taken 10 years off my age,” said Cheryl. “It’s great to have my turkey neck gone, but the most rejuvenating thing is the eyebrow lift -- it just pulls your face back up.”

And while Cliff is glad to have the deep lines erased from his face, he said, “I don’t think I’d do it again. And I’d never tell anyone to have plastic surgery, because appearance is so subjective. We all know people who physically maybe aren’t attractive, but they project such a vitality that you don’t even think about their looks. If you can accept yourself however you are, that’s what’s going to make you feel good.”

Still, one senses that if Cheryl’s happy, Cliff’s happy.

“We got married at 20 and 21, and at that age you don’t see beyond the bed sheets really, so I was very lucky that my husband turned out to have so many wonderful qualities,” Cheryl said. “We’re still crazy about each other. In fact some young kids have even asked us if we’re going steady because we hold hands all the time! We’re having the best time, because our sons are grown and we have grandchildren and they’re a joy to be around.”

And now neither Cheryl nor Cliff looks like what she calls “a retirement-age person.”