So You Don’t Like The Way You Look?
Well, would you change your face if all it took was the price of a good stereo, a few days’ living in bandages, and some tiny scars even if your closest friends wouldn’t notice—that is, if that was all it took?
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“I want to look good,” fumbled Auntie, seemingly taken aback by his solicitation of her amateur opinion. Then, recovering, she began talking about the ponderous sagging of skin just beneath her eyebrows. “Why don’t you take off your glasses so that we can see?” suggested Jim politely. She removed the glasses—enormous structures of black and gold—and her eyes appeared as two slits amid bulging blue-purple expanses of eye-shadowed flesh. Her face began to twitch like some ultrasensitive night-dwelling organism that had suddenly been exposed to daylight. Gilmore reached forward and started drawing his fingers across the skin at the corner of her eyes as carefully as if he were placing decorations on top of an elaborately frosted cake. He moved down to the cheeks and neck and pulled at the jowls and folds with the same delicacy. His fingers confirmed what he already knew to be the case: there was too much fat under the skin for her to have successful surgery. Not only would the surplus fat prove a poor sculptural material for the “contouring of the face” but the fatty tissue would promote bleeding, prolong the operation to untenable lengths, and cause the skin to sag back into its original position rapidly.
Auntie provided Gilmore with his opening. “Is it foolish to have this done at eighty?” she asked rather hopefully.
“It would be foolish if you can’t get your weight down,” replied Gilmore.
That soured things immediately. “I can’t lose weight,” mumbled Auntie stubbornly.
“She loses inches, not weight,” offered her niece. And with that, the battle was joined.
Gilmore began to suggest formulas for weight loss. Walking. Reduced caloric intake under medical supervision. Weight Watchers. He hammered away at the theme like a diet doctor promoting his latest book on a talk show. Gradually he drew the women into his discussion of weight loss, and gradually the niece began to offer evidence that Auntie perhaps could reduce her intake of food and beer. But the real turning point was when Jim suggested a physician to supervise her weight loss program. “Yes, he’s the one who does the stapling-off of the stomach,” said the niece happily. “My daughter-in-law had that done.” The ladies agreed to set up an appointment with this physician, perhaps hopeful that some internal surgical magic could pave the way for the external transformation. It was agreed that Auntie could return for her eyelid lift when she had lost ten pounds, and that her face could be done when she had lost another ten.
“You’re not mad at me?” asked Gilmore, with what seemed to be genuine contrition.
“I’m not mad at you,” said the lady from Minnesota.
Looking, Then Leaping
There is something deeply rooted, almost primal, that is aroused in someone when he goes into a doctor’s office and decides to change whatever God, nature, or personal fate gave him in the way of looks. Yet most cosmetic surgery patients are not obsessively introspective or guilt-ridden individuals. They tend to be positive, success-oriented people who are comfortable with material reward, and they have a determined faith in their ability to shape their world. But when they come into the realm of the magic knife that can alter even the person who looks back at them in the mirror every morning, all sorts of strange things start coming to the surface.
No one has ever done any kind of documented study of the self-image changes that patients go through before and after cosmetic surgery, although such an analysis would be invaluable to surgeons in the field. As it is, each surgeon must proceed on the basis of experience and intuition in order to handle a crucial aspect of his practice. Gilmore tries to ease the emotional turmoil from the minute the patient walks into his waiting room, relying on the living room ambience and a friendly staff who he says “have good vibes for people” to put the prospective patient at ease. When he sees the patient he tries to demystify his own prowess, stressing the limits of cosmetic surgery and making conservative forecasts of the expected result. He makes sure that the patients realize that they are not going to get a different face or become a different person. He also establishes a sense of security and conveys concern with his touch, which many patients describe as unusually sensitive and gentle, softer than anything they have ever felt before. And once he has established a sort of bond with the patient, he starts reading back information from him. He thinks that he has a sort of sixth sense, a “shining,” when it comes to reading people. Sometimes he doesn’t like what he sees. “If I get negative vibes from a patient,” he says, “then I try to back off from the surgery.”
Muriel Hughes, however, was what Dr. Gilmore likes to call an excellent candidate for surgery. She had been into middle age for a while, but she was tall, slender, and active. Her divorce had occurred seven years ago. “It was an ugly marriage,” she didn’t mind saying. “I knew that I’d made a mistake two weeks after I got married.” She had been supporting herself for thirteen years as a realtor and now had her own commercial real estate firm, so she wasn’t one of those problem patients going through a divorce and trying to stick her husband with a face lift bill before the settlement could become final. A hardworking—“People say I have only one speed,” she said, “and it’s not fast. It’s overdrive”—wisecracking, likable woman, Muriel was not the type to be neurotic about her looks. But there was this cruise coming up—her first vacation in some time—and Muriel all of a sudden got to thinking that she wanted to look better than her best. She didn’t know Jim Gilmore at the time, but she did know Sara Munroe, who was an old family friend.
Sara’s position in Jim’s office is unique. She is a patient relations specialist, and everyone who wants to see Dr. Gilmore has to talk to Sara first. She tells the patients what they can expect from surgery and how much they will have to pay for it. When they come in for the first time, she takes their “before” pictures, which Gilmore will use to plan his surgery, and then escorts them back to her nicely appointed office and discusses the surgery, tells them about insurance and financing alternatives, and maybe even gets into a little talk about postoperative makeup. Since all cosmetic surgery is cash in advance, Sara also has to tactfully collect at the last preoperative consultation. She calls the patients the night before surgery to reassure them, and with those intent on concealing their surgery from their spouses or families, she will make a special note not to mention “Dr. Gilmore’s office.” Sara also makes sure that all patients get cards on Christmas and their birthdays.
An elegantly attenuate, pretty woman with college-age daughters, Sara Munroe was a University Park housewife and a friend of Jim Gilmore’s before she came to work for him two years ago. She has a natural, ebullient rapport with most patients, and because of that they confide a great deal in her. Sara has heard enough to attribute the rise of both male and female interest in cosmetic surgery to that essential characteristic of the American system—competition. To middle-aged women suddenly thrust into single life by divorce, or perhaps just worried about all the young, pretty women their husbands work around every day, the surgery offers a better chance of competing. For the men—30 per cent of Gilmore’s patients—a younger, healthier look shows that they can still keep pace with the young bucks in their firm. And nobody wants to merge with a guy whose eyes are so puffy that they are almost closed.
Sara’s insights are perhaps sharpened by the fact that she, too, is a believer. Jim has done her nose, chin, and face, and Sara wants her youngest daughter to have a chin implant as soon as she gets her braces off. Sara feels that the attention she devotes to her appearance is a form of self-discipline that promotes excellence in other areas of her life and that a face lift is simply an ego boost that creates an easily transferable feeling of achievement. “It’s all totally inward,” she says. “It’s a sense of self-confidence that says, ‘I can do anything I want to do better.’ But you’re still exactly the same person.” And of course, she is always glad to let patients examine her, as living proof that the scars don’t show.
So when Muriel Hughes called, she talked to Sara for some time about her divorce, her business, and the cruise and then made an appointment for that afternoon. By the time she arrived, Gilmore had already performed and eyelid lift on a business executive, given injections of collagen—a new compound made from cowhide that can be injected under the skin to plump out lines and depressions—to a male model with acne scars and a forty-year-old woman with wrinkles at the corners of her mouth, seen a half-dozen pre-op and post-op patients, and examined one man with a growth in his nose that needed to be biopsied. Then he went into the consultation room where Muriel was waiting. “Well,” he begun casually, “what’s on your mind?”
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