“No, Judith. Just … no.”
Lee A. Gibstein, M.D., a plastic surgeon with offices in New York City and Miami, crumpled up the photo of the shiny, preternaturally line-free celebrity I’d brought with me and tossed it over his shoulder. “Oh, c’mon. Why not?” I whined.
“Because you’re a walking advertisement for me, and I don’t want my patients looking as if they belong in Madame Tussauds,” Dr. Gibstein said, setting down his syringe.
I admit: I was having a Moment. The day I visited the doctor, I was convinced that expressionlessness looked ethereal. And I thought it might be interesting to give that otherworldly look a whirl. The good thing about Botox? Go too far and, as with an ill-advised haircut, you have to live with it only a few months. The bad thing? As Dr. Gibstein pointed out, using too much would make not only me, but him, look like a freak.
On reflection, I’m glad Dr. Gibstein didn’t do what I wanted. And as it turns out, in his refusal to play along, he is joined by many of his colleagues. In a sense, plastic surgeons have become victims of their own success. For years they’ve warned women about the risks of going overboard on face, forehead and eye lifts. They’ve urged us to start early with nonsurgical procedures — chemical peels, lip injections, wrinkle fillers and laser removal of spots and fine lines — while we are young and have more resilient skin. But now women are overdosing on those, too.
Too much, too soon
“You can overdo even seemingly minimal procedures,” says Allen Rosen, M.D., a plastic surgeon in Montclair, New Jersey. “We are telling people ‘No’ more frequently, because everyone wants everything; they want procedures they’re not candidates for, and they want too much, too soon.” Although minor procedures carry fewer health risks than piling on multiple invasive surgeries at the same time, as Donda West did, surgeons warn that too much cosmetic intervention of any kind can mar your looks and lead to infections, rashes and other health risks. (It can also empty your wallet, though surgeons tend to downplay that risk.)
The popularity of some major surgical procedures has gone down since 2000: Liposuction has dipped by 14 percent, face-lifts by 22 percent and forehead lifts by 57 percent, according to the American Society of Plastic Surgeons in Arlington Heights, Illinois. At the same time, women are getting 70 percent more nonsurgical treatments.
“It’s like that ad for Lay’s potato chips. You can’t eat just one,” says Elizabeth Ard, 49, an aesthetician in Warren, New Jersey. She started Botox and Restylane injections to zap wrinkles at 40 and two years ago had a thread lift, a less-invasive variation on a face-lift in which surgeons insert sutures into the tissue around the eyes, cheeks or neck, then pull them tight and anchor them with a series of tiny hooks. Ard also had her lower eyelids defatted, but when she asked Dr. Rosen to do the same thing to the upper lids, “he told me no. Same with the Restylane I wanted in my lips.” Ard says she knows she’ll have the procedures eventually, but she’s heeding her doctor’s advice. At least for now.
Looking a little 'done'
I relate to Ard’s dilemma: Just because a procedure is minimal doesn’t mean people don’t occasionally feel the urge to max out on it. God knows I never had much of an investment in my looks; in fact, I used to cling to the notion that every woman has some period in her life when she looks really good … and my time was right around the corner. And I was sort of right. Without cuteness or beauty in youth, I somehow didn’t fall off the cliff as I aged. At the very least, I’ve stayed the same: Years of living like a mole rat, working and never going out in the sun, ensured I had fewer wrinkles than my contemporaries. But now I’m facing a high school reunion, and I feel as if I’ve got to look my very best, no matter what it takes. I was such a shapeless, bespectacled dork back then. Somehow, I got this idea that with enough Botox and Restylane and laser mojo, I had a shot at getting noticed, even if I looked a little “done.”
That’s what led me to sample the laser stylings of dermatologist Bruce Katz, M.D., in his Juva Skin and Laser Center in New York City. I had a few age spots on my face — splotches of brown pigment. Not a big deal, but why not get rid of them? I semireclined in a comfortable chair, a nurse placed goggles over my eyes and I was treated to the feeling of small, extremely concentrated beams — the Alexandrite laser — searing my flesh. Ow. Ow. Ow. But five days later, the scabs fell off and voilà! The skin was pink and a little raw, but after a couple of weeks, there was fresh, glowy skin where my spots had been.
Wanting that line-free look
Great, right? Except that now I am fighting an urge to get everything zapped: arms, legs, chest, the works. I could be smooth and creamy! I know lasers are not a panacea. Dr. Gibstein warned me they are over-recommended and, if used incorrectly, can lead to burns, pigmentation and scarring. Yet right now, the memory of the pain and the smell of my own charred flesh are the only things holding me back from offering myself up for more barbecuing.
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A person doesn’t have to look like Michael Jackson or Jocelyn Wildenstein to be considered overdone; there are often more subtle signs. A writer and former actress who lives in the Land of Too Much Surgery (aka the Upper East Side of New York City) says she has seen them all, including blinding shininess from overzealous peeling and injections (fact: skin with no movement or wrinkles reflects more light) and so much filler used to plump up the nasolabial folds around the mouth that a woman erases them altogether. “The only person who looks normal without nasolabial folds is a 3-year-old. They’re a part of the human anatomy!” says the writer, who asked self not to publish her name, even though she’s pleased with the minor work she’s had done. (Why should strangers know she’s had any work at all?)
And, of course, there’s that miraculously line-free look I begged Dr. Gibstein for. “The goal is not to get rid of all lines; the goal is to look better,” says Michael Kane, M.D., of New York City, one of the first plastic surgeons to use the botulinum toxin for cosmetic purposes. “It’s deeply disturbing when you see some actresses smile, and nothing seems to happen around the eyes. Nothing.”
Beyond any other area, surgeons say, the lips are where young women want more, more, more. That’s despite witnessing disastrous trout-pouts on celebrities — most notably, Meg Ryan — that have scared me away from the idea. Sometimes, women will start out plumping lips moderately, using fat, collagen or a filler such as AlloDerm, Juvéderm or Restylane, and get lips that look natural. But by not waiting until the filler dissipates completely, they’ll get incrementally larger lips the second time, and the third … it’s like putting too much air in a tire. “You can’t make a small lip big. You can make a small lip look bigger,” Dr. Gibstein says. “Nevertheless, there are lots of people for whom bigger lips are never big enough.”
‘Have you done something different?’
So how do women (for instance, me) keep from going too far? “Certainly it helps to have a board-certified surgeon with a busy practice, who doesn’t see you as a paycheck, and whom you can trust,” Dr. Rosen says. “But another sign is if friends are beginning to notice and make comments beyond, ‘Hey, you look great!’ If people point out a specific area, it’s a telltale sign that it’s out of balance with your other features.” People might not say, “Wow, you got a lip full of plastic there! So interesting that your face has stopped moving!” But there might be comments in the realm of “Have you done something different?” Not “good.” Different.
“Patients sometimes forget — and more dangerous, surgeons forget — that doctors should be the final gatekeeper of what should and shouldn’t be done,” Dr. Rosen adds. A woman needs to listen to family and friends when they question her latest cosmetic adventure. And when a physician tells someone to put on the brakes, she should by all means do so.
I no longer want to look like Ms. Perfect McCreamy, but occasionally (indeed, more frequently than I’d like to admit), Dr. Katz’s laser sings its siren song in my ear. Still, when it comes to self-improvement, I have vowed to tiptoe, not leap. I’m headed to that high school reunion in a little black dress, a spray-on tan, professional hair and makeup (you go to these things only once, right?) and, yes, with a little bit of Botox to smooth out the line between my eyes. Although I know I could find a surgeon to erase my crow’s-feet, I won’t. I kinda like that when I smile, my eyes smile, too. Those crow’s-feet are getting more noticeable. But then, I tell myself my classmates will see I’ve had a lot to smile about.
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