Plastic surgery has become far more than a utilitarian act; we see it as a battlefield of good and evil, honesty and lies, body and soul. Roseanne Arnold recently claimed in Vanity Fair that her breast and face surgeries were part of a healing process in recovering from childhood abuse. Healing the soul through the body is a common motif; a woman I know had her eyes done after a bout with cancer. She felt the bags under her eyes were a direct consequence of her illness and that by removing them she could erase any visible reminder and begin life anew. Just last week a friend of mine said of a colleague's face-lift, "It wasn't a face-lift, it was a spiritual lift. It's incredible. Her whole spirit has lifted."
Plastic surgery is no longer just the stuff of popular culture; it has mesmerized art critics as well, our most interesting commentators on standards of beauty. In a long piece for Art in America last year, renowned critic Barbara Rose speculated on the meaning of Orlan, a French performance artist who has made the operating room her art gallery. Orlan has undergone many procedures to alter her face and body. As Rose said: "Orlan's brutal, blunt, and sometimes gory imagery flatters neither herself or the public; it transmits disquieting and alarming signals of profound psychological and social disorder. She absorbs and acts out the madness of a demand for an unachievable physical perfection."
Is that perfection even tangible? "You really can't have a sense of perfection today, because everything in this society is so transitory," says psychologist Marcella-Bakur Weiner, a professor of gerontology at Marymount Manhattan College who has authored several books on aging and body image. "It's like a piece of glitter held out to you and you look at it and, chameleon-like, it has already changed. A new ideal comes in and you're struggling for that. And as you've almost attained it, again it has changed. Perfection in this society is so shifting and amorphous that you don't know what you're striving for. When truth changes every moment it's like living in a household where the mother says one thing Monday and another thing entirely on Tuesday. Our society is like that now—very schizophrenic."
The Perfection Chase
That elusive promise of perfection sometimes reaches so deep into the core of a person that it becomes a kind of madness. We all know about the people who've had 20 or 30 surgeries; and last year alone two plastic surgeons were killed. One Chicago surgeon was killed by a man who said he was upset that surgeons were changing people to look like the Aryan race; a Washington surgeon was killed by a woman who was displeased with her face-lift. And some detractors seem afraid we're going to become a country of Dorian Grays, whose inner lives leave no telling marks on our "perfect" faces.
Why is the whole subject so galvanic? Perhaps it's as simple as the fountain of youth. As I interviewed surgeons around the country, I found myself half-bewitched by the promises of this profession and the beguiling high-tech nature of some of the newest procedures. Like the rest of medicine, plastic surgery has become increasingly refined and specialized.
Invisible Scars
Liposuction can be used to contour bodies, not just remove fat; I saw a photo of a beer-bellied man in Pober's office who was given the look of a muscled washboard stomach simply by artful liposuction. Chemical peels have become an industry in and of themselves: today, the skin is actually made younger with chemicals that increase the turnover of skin cells.
Face-lifts now are performed with incisions behind the ears, or in some cases, through the ear canal itself—a more laborious procedure that leaves no visible scar anywhere. These delicate surgeries are accomplished with laparoscopes, the same instruments used, for instance, in surgery performed on embryos in the womb.
Meanwhile, the plushness of youth can be "regained" by different techniques. Fat suctioned out during liposuction can be condensed, purified, and injected in wrinkles, cheeks, and aging hands—and the extra fat can be frozen for future use. Plastic surgeon Toby Mayer, M.D., in California, grafts fat into the gaunt cheeks of marathon runners. Thinning lips can be returned to Cupid-bow shape by taking skin from a fold in the buttock and grafting it into the lip; this is a technique pioneered by Myron Whitaker, M.D., of the University of Pennsylvania Center for Human Appearance, in Philadelphia.
In Florida, Jane Steinberg, M.D., offers medical tatoos on lips and eyes. It's permanent makeup: the lips are plumped up and lined with color, and the eyes are given permanent liner and brows. Soon we may be able to clone our own skin (a technique already used in burn surgery) and have it stored for later use.
How does this embarrassment of riches influence patients? "There's a difference in the way patients present themselves now," observes George Sanders, M.D., of Los Angeles. "They are more open about surgery and what they want. By and large, it's become very acceptable to have cosmetic surgery." Myron Whitaker says things have calmed down since the '80s, when patients asked for "radical changes, bone change where they were actually changing the fundamental shape of the face by shifting bone. The '90s has seen more face-lifts, more surgeries where you are just taking the person back in time and not changing their fundamental look."
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