Plastic Surgeons Losing Patience With Patients

Definitely check out the October issue of Allure magazine. I was at the hair salon just long enough to read the article on plastic surgery patients who present themselves to their doctors as self-styled experts. This is becoming a frustrating problem for cosmetic surgeons and dermatologists.

These patients – almost all female -- have never graduated from medical school, but they’ve spent a lot of time on the Internet, where the real truth is, and they walk into the doctor’s office armed with stacks of single-spaced typewritten pages of exacting instructions. They’ve created computer morphed “Before and After” shots of themselves. They know all the medical terminology and sound well-informed to the layman. The problem is, they’ve never actually performed surgery, injected Botox and wrinkle fillers, or learned the hazards of many of the procedures they want their doctors to perform.

Nevertheless, they’re insistent. And they’re never satisfied – they have to keep tinkering. Ultimately, they have even more procedures to “fix” the bad results caused by the original procedures. Then they have to “fix” the “fix.” And then “fix” that.

One doctor quoted in the article spoke of a patient who had returned from Mexico with a vial of some kind of bone cement (I’m not kidding) that she wanted him to inject into her face. As any reputable physician would, he refused, explaining that he had no guarantee of what was in that vial. He could literally be injecting her face with anything, and he wasn’t going to be responsible for that. So she waved bye-bye with her perfectly-manicured hand and continued her search for someone who would do it for her.

No doubt she didn’t have to search for long. I've heard of dermatologists in Dallas who very openly perform procedures – or have their assistants perform them – that are unapproved by the FDA and pose serious risks to one’s health and/or appearance. You can probably find their names on various plastic surgery websites that extoll the virtues of such procedures. Go ahead, look them up, so you’ll know who not to patronize.

This problem seems to be a variation of Body Dysmorphic Disorder, which is what makes anorexics see themselves as fat when they’re actually starving to death and Michael Jackson think he’ll be perfect after just one more plastic surgery. Often it’s a focus on one particular physical flaw, but once that flaw is addressed, it can morph into a pathological appetite for perfection that will never be satisfied.

My friend Dr. Brown, who’s known as one of the best plastic surgeons in Dallas (and that’s saying a lot!), tells me he has women come in and tell him exactly how to make over their breasts. A common instruction is, “Make me as big as you can make me!” But Dr. Brown doesn’t do that. Often, he’ll counsel a patient that because of her height and bone structure, he can’t make her more than, say, a “C.”

I think I can safely say he didn’t do Pam Anderson’s breasts. Or the breasts of any woman who aspires to look like her.

Quite a long time ago, I actually consulted Dr. Brown about a possible reshaping of my nose, and the experience taught me a lot about the psychological aspects of plastic surgery. If you look at pictures of me on my website, you’ll probably say, “Her nose looks just fine! Why would she want to change it?” (at least, I hope you'd say that). Well, the reason was one photograph, taken from an odd angle, that really did make my nose loom large. So I told Dr. Brown that I didn’t want to change the shape of my nose, just make the proportion a little smaller.

He listened, then had me come in for some “Before” pictures, both front and side view. The assistant behind the camera looked confused and had to ask me, “Now, what is it that you wanted changed?”

I’ll never know if Dr. Brown had told her to ask that question, but it sure made me think. “If this person,” I wondered, “who sees hundreds of plastic surgery patients every year, can’t even tell that it’s my nose I’m concerned about, then what is my problem?”

Then, when I saw the photos and realized that they looked more like “After” pictures, I told Dr. Brown that I’d decided against having any work done on my nose. He must have been relieved. And I’m glad that he trusted me to come to my own conclusion; if he’d just said at the outset, “You don’t need it,” I might have just answered, “Well, I think I do.”

Unfortunate, overdone nose jobs are as common as paralyzed faces these days. One big difference, though: Botox wears off in a few months, while, to paraphase James Bond, a nose job is forever. And if the first attempt isn’t right, there has to be another procedure, and perhaps another. I’ve seen many hypershortened noses that are beyond saving. Then the question becomes like a bad trip to a casino: Do you want to walk away with your losses, or risk what you have on another procedure, knowing you’ll probably come out worse but might come out better? In that sense, the addiction to plastic surgery seems to me a lot like the addiction to gambling. With this kind of risk, you might lose the ranch or lose your nose – or, like Michael Jackson, you might lose both.

This isn’t to say that a nose job is never a good thing. If you really don’t like your nose, if it’s caused you to suffer comments and heartache all your life, then I say, “Rah-rah, rhinoplasty!” If you’re in show business, and a slight change in your nose will make you photograph significantly better, then go for it, as lovelies from Paula Abdul to Halle Berry have. But find the best surgeon you can, one who will get it right the first time. Find one who will listen to you, and then…LISTEN TO HIM. Have the work done. And then, if at all possible, consider it a finished work of art.

Your life is a work in progress; your face shouldn’t have to be.