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Looking Good: Better or Worse? Much, much better
By Diane York
“I can take 10 years off your appearance!” These words, from Dr. James Carraway of Virginia Beach, reputed to be one of the top cosmetic surgeons in the country, warmed my heart.
I spoke with his nurse, who gave me the price of the full face lift, throat lift, forehead lift and eye lift – just under $18,000. I gulped and prayed my ‘95 Toyota will last another 150,000 miles.
Dr. Carraway explained that during surgery, he will take a small amount of fat from my thigh (I have plenty to spare) and freeze it to use as a “filler” for places in my face that need filling out. He wants his patients to stay on a healthy, green-vegetable-rich, lean-protein diet, with no smoking and no alcohol, starting three months before the surgery.
The day of the surgery, the doctor goes over everything with me. Then comes the anesthetic. Sleepy time. I remember nothing later, but the doctor assures me I was awake and responsive but felt no discomfort.
After the surgery, the biggest surprise is there is no pain. A pulling sensation, yes, but no pain. Looking in the mirror is pretty scary – bruises, stitches, black eyes – but I can see a different face emerging.
I must stay down – no bending, no lifting, not even a heavy purse on my shoulder – and I must sleep on my back with my head elevated for a week. This is the hardest part.
By Day Four, I can see that I have a new face. It looks much improved over the old saggy one! 
Weeks later, without the bruises, I see my brother in Boston. I do not tell him I have had surgery.
He squints at me and says, “You look different.”
I ask, “Better or worse?”
He replies, “Better … much, much better!”
Looking into plastic surgery yourself?
Dr. Alan Burke of Richmond advises: “I try to emphasize that this type of surgery has to be done for yourself, not for a life change. It should be because you feel better when you look better, not to impress other people.”
Risks
The risks for surgery are potentially twofold, Burke says. Intrinsic risks include diabetes and other health problems that would complicate surgery, as well as smokingand the taking of any medication or supplement that might increase bleeding. “As far as extrinsic factors – that is, from the surgery itself – aesthetic surgery is extremely low-risk,” Burke says. “We just don’t see complications often from this type of surgery.”
Tips
• To show how cosmetic surgery can improve your looks, a computer program can morph you on the screen.
• After surgery: No stretching the neck; use a neck brace for several days. Driving can be done with caution.
• Plan to take at least one week off from work and strenuous activity. There should be no lifting for 10 days.
• There will be seven to 10 days of bruising. Expect some degree of settling after surgery.
Alternatives to cosmetic surgery
Numerous new procedures are available as a substitute or to help prevent the need for surgery entirely. Carol Maddock, owner of Ageless Remedies in Richmond’s West End, explains: “You lose 1 percent of your collagen every year after [age] 30. Collagen loss contributes to the sagging that later requires cosmetic surgery. Exposure to sun and toxins in the environment increases that rate but can be slowed by care.”
Skin tightening with laser. This is an alternative to a face lift. The laser heats the dermis and makes it contract. Thermage is similar but uses radio waves, not light. Thermage is a one-time-only treatment. (Maddock adds, “The success rate for Thermage is less than 60 percent. It is painful. We don’t do that here.”) With both procedures, the anesthetic is topical and it takes six months to see the results.
Fillers and injectables can be used in lieu of surgery or as a complement. Fillers such as Restylane, Juvederm, collagen and fat injections use your own fat. You might try a dermal filler to see how a more permanent surgical procedure would look. These fillers last from six months to five years. Some physicians favor real fat injections, as they have found that your own fat (taken from your thighs) can actually grow, merging with your tissue.
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Diane York is a Richmond, Virginia freelance writer.
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 The Four Stages of Cosmetic Surgery
Stage One: Denial
1) As Nora Ephron says: “I feel bad about my neck.”
2) Why do my trip pictures look so much worse than last year?
3) “You qualify for the senior discount, right?”
4) Your husband says, “Of course, you don’t need plastic surgery.”
Stage Two: Fear
1) I could wind up looking like Meg Ryan or Priscilla Presley or much worse.
2) It could be painful.
3) The grandchildren won’t recognize me.
4) I might not wake up.
Stage Three: Acceptance
1) Your husband says, “Of course, you don’t need it. You know you don’t need it. … But if you did … we could afford it.”
2) Your closest friend is two years younger and she’s had it done. The waiter asks if you are mother and daughter.
3) You seek out others with experience, who all say it was not painful, they all woke up after surgery, and you are a wuss.
Stage Four: Bargaining
God, if you let me do this and I don’t look like a monster later and I do wake up … I will be good. Very, very good.
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