She was not quite forty, with striking features and the figure of an even younger woman, and this was her first face lift. Now that the skin had been trimmed around her ears and fastened back in place with rows of nylon sutures and gleaming stainless steel staples, she had started to worry about the mole on her nose. Jim Gilmore, however, didn’t think this was the time to remove it. “Let’s set our priorities,” he suggested gently, “We’ve still got to do your forehead.”
Gilmore parted her hair in a continuous line running from ear to ear right across the top of her head, and then he tied up the strands of long blonde hair into two rows of neat little bundles on either side of the part. He took the scalpel and cut swiftly along the path he had created through her hair, and after a few snips with large surgical scissors the quarter-inch-thick layer of scalp parted to reveal a glistening wedge of the membrane that covers the skull. Blood began oozing from the severed vessels in the scalp, and as Gilmore went across the dome of the head with the electrocautery the veins hissed and sizzled and were sealed off. Then the pace of the operation accelerated suddenly, almost violently.
Moving very quickly, Gilmore stuck first one and then two fingers into the incision and began to pull the scalp away from the forehead, making a sound quite similar to a Velcro fastener being torn apart. Within seconds he had worked his fingers down several inches below the patient’s hairline, and then cut with scissors to a point just above her eyebrows, so that a third of her face just flopped away from the skull like some realistic Halloween mask that could be ripped off, discarded, and replaced. The patient looked up at the ceiling, then down toward the purple canvas espadrilles on her feet. “I don’t know when I’ve been more relaxed,” she said dreamily.
That thin, extremely pliable layer of flesh and gristle that covers our skulls can indeed be as shockingly superficial and impermanent as it appears to be during a so-called forehead lift. But for many of us, like the blonde woman, who was put back together the way she wanted, it is becoming increasingly difficult to separate the well-being of the outer mask from our inner well-being, and that is probably why cosmetic plastic surgery is becoming one of medicine’s major growth industries. And like most medical booms, it echoes rather faithfully the tenor of the times. During the fifties and sixties, for example, we plunged so rapidly into affluence and abundance that we ended up glorifying our heart surgeons and enriching our psychiatrists. During the seventies we kept track of aerobic points, took megavitamins, and self-motivated our way towards physical and mental health, and podiatrists and diet doctors started gaining respectability and making money. With the eighties has come the need for icing on the self-improvement cake, as well as a material edge in a world where competition, both economic and social, has suddenly become much more intense. The eighties are going to be the decade of the nose job and the face lift.
The considerable skills of Jim Gilmore, M.D., board-certified otolaryngologist, fellow of the American College of Surgeons and the American Academy of Facial Plastic and Reconstructive Surgery, and a rising star in the firmament of cosmetic surgery, are generally dedicated to making average-looking people look good, good-looking people look better, and beautiful people look nearly perfect. It is a job that he pursues with the sincere commitment and intelligence of a DNA researcher trying to unlock the secrets of life, even though it is a job that is still largely scorned by much of the rest of the medical community. But at a time when a new face can cost thousands of dollars less than a Japanese subcompact, the rich dowagers and aging screen idols who once endured torment and seclusion in their pursuit of eternal youth have been replaced by hundreds of thousands of ordinary middle-class people for whom new, relatively painless, and rapidly healing procedures have made refurbishing the face a more realistic goal than re-decorating a living room. These are the new believers, the ones who know that good looks can contribute to their good works, and their belief leads them to the operating table like pilgrims to a shrine. Like all pilgrims, each has a tale of his or her journey—tales of love and money, success and failure, life and death. And like all pilgrims, they nurture a hope for renewal at the end of their journey.
“Is it Foolish to Have This Done?”
The lady from Minnesota was spending the summer with her niece in Lewisville, and she had come to see Jim Gilmore in his new offices at Concorde on the Creek in North Dallas. Dr. Gilmore had decided to move from his office in Promenade Center in Richardson, which he shared with several other doctors, for several reasons. For one thing, he had his own ideas about cosmetic surgery, about the aesthetics of the face and what it should look like after surgery, and he didn’t want to be associated with doctors who didn’t share his concerns. For another thing, he wanted a comfortable, living room type of atmosphere instead of the clinical environment he had at the old place. So he hired an agent to find an office that he could rent or an office condominium or perhaps even an entire building that he could buy. He also hired someone to go through his files and make a map that would show where his patients were coming from. As it turned out, about one third were from Highland Park, one third from Richardson, North Dallas, and Plano (the triad of affluent northern suburbs), and one third from out of state. Finally Jim decided on a location right at the LBJ Freeway and Hillcrest Road, where a whole cluster of low, gleaming glass office complexes