The Plastic Bubble

By Chandra Niles Folsom

Cometic surgery is more popular and affordable then ever, but do patients know what they’re getting into? A Westport doc explains his craft.

“Tell me what you don’t like about yourself.”

What red-blooded American isn’t familiar with the signature line from the hit cable show Nip/Tuck? But, it’s not just fiction. Hot advances in cosmetic surgery and TV shows exploiting those advances have made perfection an attainable goal for average people everywhere.

According to the American Society of Aesthetic Plastic Surgery, cosmetic procedures have quadrupled over the past several years with no end in sight. About 11-million were performed in 2007—up seven-percent from 2005.

Non-surgical rejuvenation treatments including peels, fillers and Botox have become as common as a visit to the gym. But, how much is enough and at what point should a patient go under the surgeon’s knife?

According to the American Society of Plastic Surgeons, one in 50,000 deaths were the result of in-office procedures and, last month, Donde West mother of superstar Kanye, became one of those sad statistics. She was 58 years old.

Beverly Hills plastic surgeon Dr. Andre Aboolian was reportedly selected to perform a tummy tuck and breast reduction on Ms. West, until he asked her to first get medical clearance from an internist due to a pre-existing medical condition. Declining his advice, West switched to another Beverly Hills plastic surgeon who allegedly didn’t require the health screening.

“There was a case a long time ago involving a famous comedienne who died after face-lift,” said Dr. James Lyons, a board certified plastic surgeon who practices in Westport. “She had a series of complications that are textbook—she was obese, may have smoked, and had issues with hypertension and possibly diabetes.”

Dr. Lyons, who practices at Yale, has been in the business of making people beautiful for 25 years. But, he doesn’t always advise people to choose the cosmetic surgery route.

“Plastic surgery is not the beginning of the road, but the end,” said Dr. Lyons. “First there is health, then lifestyle and then you can consider cosmetic surgery. When you look at complications that have occurred, most of the time it’s an inappropriate candidate, not a bad doctor. People don’t die from the procedure, but from complications.”

He said that when a sensational cosmetic surgery disaster hits the headlines, it’s a time when most doctors sit back and ask themselves “could this happen to me?”

“The beauty industry has become part of our culture but should never become minimalized to a commodity,” Dr. Lyons said.

Aside from being in good general health, it’s important to make certain that the surgeon as well as the anesthesiologist is board certified. Also, after age 40—medical clearance should be obtained.

So what are people having done—eyes, noses, breasts, liposuction—all of the above?

Liposuction, breast augmentation and face-lifts are the most common procedures for Lyons’ female patients. Male patients overwhelmingly request eyelifts, which produce a more rested appearance.

“I’ve always loved to make people pretty and now procedures are safer and more fluid,” he said. “But, even though television shows have made total body surgery commonplace, when people come in with these requests, I discourage it. Generally speaking, the more insult you do to the body, the more complications can arise. Most importantly, plastic surgery is a cerebral trip –not a physical one. You use physicality to empower yourself and if you do one procedure at a time, you have a chance to embrace and assimilate to each and then may find you don’t want to have another one done.”

So, in which cases was the knife a good move in Hollywood?

Halle Berry, Jennifer Aniston and Winona Ryder all underwent rhinoplasty with favorable results, Carmen Electra and Heather Locklear were recipients of fine boob jobs, Janet Jackson’s liposuction turned out well, Matthew McConaughey’s hair plugs look glorious and imagine 60’s heartthrob Tom Jones with his original nose—he may not have been as lucky in show biz or with the ladies.

It’s not all about luck—these celebrities managed to find surgeons good at their craft. But what if the surgery goes horribly wrong—who is to blame?

“You can’t teach someone how to make something beautiful,” said Dr. Lyons. “When you take techniques and put them in the hands of doctors who don’t have a proper aesthetic objective, then what are they trying to create? What constitutes a proper nose or lip? It’s about subtlety. Three cases come to mind regarding what can go wrong: Michael Jackson, Joan Rivers and the Cat Woman (Jocelyne Wildenstein). I mean, I’ve been a doctor for many years, but when I look at their pictures, it’s just not natural and I wonder: what did they do to get that look?”

In the case of 49-year old Jackson—as a kid he was said to have been mercilessly teased by his dad for the size of his nose and was also plagued by acne as a teen. Who, with a few billion dollars burning a whole in his pocket, wouldn’t pay a visit to the plastic surgeon?

So, let’s break down Jackson’s surgeries:

Rhinoplasties—at least two, chin and cheek implants—including the creation of dimples in both, lip reduction, blepharoplasty—to alter the shape of his eyelids, and skin bleaching. The problems did not result from Jackson’s initial alterations, but from the numerous “tweaks” which followed. Complications arose, most notably, when the cartilage in his nose collapsed. To be fair, the self-described King of Pop’s nose broke once after an onstage fall in 1979, and he was accidentally set on fire during the filming of a Pepsi Cola commercial a few years later.

“Cosmetic surgery is an art form and mimics the region where you live,” said Dr. Lyons. “For example, New England beauty standards are very different from what you see in L.A.”

Spry 74-year old comedienne Joan Rivers underwent her first cosmetic surgery procedure —liposuction—in 1987, ironically just as her husband Edgar was committing suicide. She had walked out on their marriage three days earlier.

Let’s count her surgeries: Two face-lifts, an eye tuck, at least one nose job, liposuction-a-plenty, and Ms. Rivers has been Botoxed within an inch of her life by any standard. She also appeared on Nip/Tuck playing herself, where she asked the surgeons to reverse her numerous procedures. Her character backed out after seeing her “real” face on computer imaging.

“My motto is: better a new face coming out of an old car than an old face coming out of a new car,” the comedienne has stated publicly on numerous occasions.

According to Rivers, her plastic surgeon “Steve” refuses to perform any more bodywork on her.

“When I was younger, I’d do one procedure and never see the patient again,” said Dr. Lyons. “Now, there is a continuum of procedures that go on for a lifetime. My specialty is being played out in the pages of Vogue magazine—I’m thrilled that its perception has completely changed and now is being recognized as medicine. That’s why when things go horribly wrong it reminds us that its not just about running down to Costa Rica to get the cheapest price. It’s still surgery.”

67-year old Jocelyne Wildenstein (aka Cat Woman) was a happy-go-lucky socialite until, after many years of marital bliss, her billionaire hubby had an affair—then another and another. So, at the age of 50, finding comfort and joy in the cheetahs and lynxes who roamed her ranch in Kenya, Wildenstein made the radical decision to transform herself into one.

Which plastic surgery procedures did Wildenstein undergo to achieve that look? Nobody but Cat Woman herself really knows for sure, as she allegedly enlisted the aid of several surgeons. However, the end result of her facial reconstructions certainly succeeded in morphing her into a character from The Island of Dr. Moreau.

“The entire subject of cosmetic surgery is fascinating,” said Dr. Lyons, who is busy writing a book chronicling the changes in the standards of beauty as well as his own experiences as a plastic surgeon. “The standards have certainly changed over the years. Facelifts, for example were at one time pulled very tightly and unnaturally. Now patients come in to have old facelifts redone.”

Do tell.

“In 1985, a woman came into my office with a facelift that was pulled out of shape and way too tight.” He said. “I’m sure she had a wonderful doctor, but back when she had the procedure done, the standards were different. In fact, she didn’t even realize how it looked—she had come in for a touch-up. During the surgery, I opened up her face and redistributed the fat—which falls vertically to the jowls with age. Then I gently laid the skin back down and she looked gorgeous. She still does. The horror stories about cosmetic surgery in no way reflect what’s happening. There are so many advances in procedures and techniques. I try to tell women— it’s not about wrinkles—they can be beautiful at any age. Women need to be in control as it relates to cosmetic surgery. It’s only part of the process that goes along with other things we do to make ourselves healthy and feel good. The era of ‘doctor as God’ is over.”

View or download a PDF of the article as it appeared in the Fairfield County Weekly.