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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The next step was getting rid of the hump. Working inside the tunnel he had already created between the nasal bones and the skin, Gilmore inserted a saw that looked like a miniature table knife with serrated edges. Pulling the saw vigorously toward himself several times, Gilmore cut a series of grooves in the nasal bones. Then he inserted a similar tool that had a flat, toothed surface for rasping the bone. Drawing the rasp out every couple of strokes so that the blood and bone fragments could be washed off, Gilmore brought down the hump. That done, he used a scalpel to shave the upper lateral cartilage until it once again merged with the bone in a continuous slope. The only problem that remained was the width of the nose, which now had to be adjusted to the new profile.
This time a long, thin, spikelike chisel called an osteotome went up the tunnel along the nose. Gilmore held it tightly against the base of the nasal bone while Betty McFarling, the scrub nurse, gave it two sharp raps with a big stainless steel mallet. The osteotome was moved up twice, and each time the two blows were administered. The procedure was repeated on the other side of the nose. After removing the osteotome, Jim took the nose firmly between his thumb and forefinger and began to twist it very slightly from side to side. After fifteen or twenty seconds there was a muffled click like the sound of a wet Popsicle stick breaking. This sound signified that the nasal bones, already ringed with a line of fine cracks made by the osteotome, had broken loose from the face. Once again applying pressure with his thumb and forefinger, Gilmore squeezed the nasal bones together like an accordion or a bellows, and found just the width he was looking for.
In what he calls the fine tuning, Gilmore rubbed saline solution on the nose to help him feel any imperfections in the contours. He made a few minor adjustments with the rasp and knife, removing still more tiny fragments of bone and cartilage. Then he sutured the incisions, used a suction device to remove the blood from the back of the model’s nose, stuffed her nostrils with self-dissolving oxidized cotton, and put a small plaster patch on top of her nose. The operation had taken him 45 minutes; it would have taken a novice three hours.
“Do you think I can see Eileen Ford tomorrow?” asked the model.
“I don’t think that would be a good idea,” counseled Gilmore. “Remember that when you first meet people, they form their image of you.”
“You’re My Advertisement”
In the two weeks since her first consultation with Jim Gilmore, Muriel had been doing some research. She had talked to all the people she could think of who had had cosmetic surgery, quizzing them on the quality of their results as well as any complications they may have had. She had talked with five other doctors, inquiring about their fees and recommended procedures. She had read articles in books and magazines. She had communicated frequently with Sara Munroe. She had even intended to cancel her surgery once, because she was working on a multimillion-dollar deal and needed to be on the West Coast, but at the last minute she decided that she could send an associate. Now her surgery was once again scheduled for tomorrow morning, and she was very, very worried.
First and foremost, Muriel was worried about nerve damage. She had called Kim Dawson—whom she didn’t know—of the Kim Dawson talent agency, because she had been worked on by Gilmore and a couple of other surgeons. Dawson had told Muriel that she might expect the same kind of occasional numbness that she had experienced for a couple of months after surgery, and Muriel had naturally been alarmed by that report. “This is not no-risk surgery,” she concluded. She was worried that she wouldn’t be able to get out in the sun during her cruise. She was worried that the collagen injections planned to smooth out her upper lip and the corners of her eyes were still in the experimental stage. She was concerned about the location of her scars. She was concerned that Gilmore’s anesthetist was a nurse rather than an anesthesiologist with an M.D. Worst of all, she was worried about Jim Gilmore’s competence. She had a stack of old Yellow Pages at her office, and she had checked up on Gilmore’s listings. What she had found really agitated her. Gilmore had been listed under “Plastic Surgery” for only two years. “He’s an ear, nose, and throat guy who recently specialized,” she explained. “I like him personally, but I don’t think he has the experience some of the others do. And when you’re paying top dollar, you want the best.”
Jim was late for his final pre-op consultation with Muriel Hughes. A businessman in Gilmore’s office complex had thought he was having a heart attack, so the doctor had rushed to the man’s aid with his cardiac defibrillator and EKG monitor. The interruption had put him a half-hour behind schedule for the afternoon, and by now Muriel was loaded for bear. Impeccable in his light gray suit, light blue shirt, blue and gray tie flecked with red, and gold-rimmed glasses, Jim entered the consultation room where he had previously met with Muriel and shook hands with Muriel and Lyn, who was once again advising her mother. “This scares the devil out of me,” said Muriel right off the bat.
“I think we need to talk about that,” said Jim smoothly.
First Muriel discussed the problem of her cruise, which was about seven weeks away, and Gilmore assured her that there would be no restrictions on her activities. Then she got down to the real bugaboo. “I’d feel awfully foolish if I ended up with some kind of lingering nerve damage,” she said. But just then one of Dr. Gilmore’s assistants knocked on the sliding wood-panel door and reported that the stricken businessman, a CPA, had had chest pains, not a heart attack. The reporting of this incident sidetracked the issue of nerve damage, which allowed Gilmore to begin at his intended beginning. He switched on the slide projector that sat on the round linen-covered table. The projector had a built-in screen, so that when Muriel’s face came on in full color, it look like she was on TV. “That looks like the morning after the night before,” said Muriel.
Jim ran through the various views of her face and then went back to the eyes and stopped. A ten-minute discussion of various alternatives—eyelid lift with brow lift, eyelid lift with forehead lift, eyelid lift with collagen and chemical peel—ensued. “We don’t want to do too much at one time,” warned Gilmore. Finally it was decided to do the upper and lower lids, forgo the forehead lift, and attack the crow’s-feet with collagen.
“How safe is collagen?” wondered Muriel.
“The FDA has studied it for five years,” Gilmore said. “The worst that can happen is an allergic reaction. That’s why we give you a skin test before we start treatment.”
“What about cancer?”
“They’ve run those tests, too.”
“Shouldn’t that be over a period of twenty years?” suggested Lyn.
“They told us silicone was safe once, too,” Muriel added.
Jim explained that silicone is the basis for almost every prosthesis or artificial device that can be implanted in the body. The only problems with silicone arise when it is injected by amateur or inexpert physicians using it indiscriminately to build up breasts or fill out facial depressions. “The problems don’t come from the substance,” he concluded, “but with its usage.”
“Well, what is collagen?” rejoined Muriel.
“It’s a solution made from cowhide.” With this Muriel gave a startled look and then dropped the subject of collagen as if mollified by this frank disclosure of its constitution.
The eyes decided, Jim went to a profile view. With a purple felt-tip marker, he began to draw lines on Muriel’s projected face. Three arrows moving across the cheek toward the ear represented the direction of the lift, while lines around the ears showed the placement of the incisions. Gilmore also pointed out that although the lines at the corner of Muriel’s mouth would become less pronounced, they would not be eradicated. “I want to give you a realistic picture of your result,” said Gilmore.
“Yes, that’s what we like about you,” Lyn said.
Next, Jim explained how he would pull up the sagging muscles in Muriel’s cheeks and suture them into place. “We call this a bilevel face lift,” he said. “A lot of doctors still aren’t doing this, but I think it gives you a longer-lasting result.”
“I don’t want to be experimented on,” interjected Muriel nervously.
“It’s not experimental,” explained Gilmore.
Then Muriel got down to the serious business. “How long have you been doing this cosmetic surgery?” she asked him directly.
Gilmore explained that he had been performing cosmetic surgery as part of his regular practice for ten years, and during the last five years he had begun to specialize in it at the expense of his practice in reconstructive surgery of the ear, nose, and throat. Now his practice was almost exclusively devoted to cosmetic surgery.
“Why did you give up the other?” probed Muriel somewhat suspiciously.
“Quite frankly,” Jim said, “because it didn’t look good for the cosmetic surgery patients to see the cancer cases. It’s not fair for somebody coming in for a nose job to have to come into my waiting room and sit next to a guy with a hole in his windpipe.”
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