The conversation usually goes down the same way: I explain that I work with two facial plastic surgeons, and the other person will lean in closer, confessing that they/their mother/a random friend was the unlucky recipient of a botched nose job years prior.  “Can your doctors help?” they whisper, eyes darting around to ensure nobody is listening, as if we are two Colombian smugglers trafficking drugs across the border.  Now, I’m biased, of course, but even objectively speaking, Dr. Solieman and Dr. Litner are two of the finest rhinoplasty and revision rhinoplasty experts in the country, and I wouldn’t hesitate to recommend them to anyone (which I do, and frequently).  Because rhinoplasty is a game of millimeters, it’s so easy for surgery to go awry in the wrong hands, and patients usually hesitate to return for–often badly needed–corrective work, having been scared away the first time.  In particularly bad cases, however, when too much cartilage has been removed or breathing has been impeded, corrective work is sadly inevitable.  Drs. Litner and Solieman document the most common rhinoplasty errors and techniques here on their blog Rhinoplasty in Beverly Hills–a fascinating read for anybody thinking about going under for the first–or second…or third–time. 

I just stumbled across this press release, released in June by the American Society of Plastic Surgeons, predicting that cosmetic surgery procedures will top 55 million in 2015.  (FYI, that’s four times the number of procedures performed in 2005.)  It’s kind of scary when you consider that we’re a nation of just over 300 million people…but then I remember that Hollywood actresses and other surgery junkies probably really skew the national average.  Still…that is a hell of a lot of nip/tucks, huh? 

If there’s one thing We don’t like, it’s a judgmental person.  (And people who use the Royal We.  Oh God, We hate Ourselves!)  Jolie believes in a Live and Let Live, To Each Their Own kind of Kumbaya universe, and feels that everybody has enough on their plate without worrying about their neighbor’s portions.  So, I have very mixed feelings about plastic surgery.  As you know, I work with two remarkable facial plastic surgeons in LA, and I love what they do, which is to say fixing the rhinoplasty eff-ups of other surgeons.  In Beauty Confidential, I specifically set out my policy toward plastic surgery: life is too short to obsess over imperfections, so either learn to love ‘em, or fix ‘em and move on.  I still feel this way.

Except, today marks one year since I’ve been living in Los Angeles, and, as so often happens in life, my views have changed without me realizing it.  I used to automatically lean toward the “Hell, fix it!” end of the spectrum.  Now, I pause.

I live in a city full of pneumatic bottle-blondes with pillowy lips and no hips…some genetically cultivated (thanks, Mom!), but most acquired through blood, sweat, and lots of money.  When you wander by the OR on a daily basis and are the only A-cup with soft thighs in a five-mile radius, it’s hard not to think, “Well…maybe…”  Why not a nip here?  Or a tuck there?  For me, the recent, and very real, proposition was even simpler: I know the anesthesiologist (who’s on her third surgery in what seems as many months), am chums with the Dr. 90210 surgeon, can get a free room at the after-care facility, will have the operating room fee comped, can get ample publicity for my book, be on TV again…and have thinner thighs, to boot!  Everybody wins!

(more…)

Do you recognize this woman?  (Looks a bit like Nicolette Sheridan or Uma Thurman, no?)  She’s a composite of Angelina Jolie (straight, narrow nose and full lips), Madonna (almond, wide-set eyes and plumped cheeks), Michelle Pfeiffer (smooth brow and high forehead) and Demi Moore (angular jawline), and she is emblematic of The New Face, as identified by New York Magazine.  In an article titled “How Plastic Surgery Can Give An Older Woman the Face of a Baby,” the old adage that, after a certain age, it’s either your butt or your face, is turned on its ear: guess what?  You can be scary skinny and unhealthily obsessed with keeping your body slim through punishing workouts and increase facial volume to avoid the Skeletor face: plumpers are the name of the game! 

Photo from NYMag.com

(more…)

Thread-lifts jumped in popularity a few years back when Oprah Winfrey promoted them on her show (just like her name-check of thermage sent thousands of women running to the dermatologist to waste their money).  Recently, however, thread-lifts procedures have been waning as patients and doctors are simultaneously beginning to realize that they often can’t support the weight of the skin and are only proving to be temporary fixes.  When I read this post from my docs, I have to admit I was in the dark as to what the hell thread-lifts exactly are; I did a little research, and was pretty grossed out: um, they are basically putting barbed wires under your skin!  According to the Archives of Facial Plastic Surgery, one surgeon reported that, of the 75 patients he’d performed thread-lifts on, 30 had experienced complications, and 14 of those were treated to the horror show of the barbed thread actually popping out from under their skin.  In other news, I need to go pass out now. 

Ashlee Simpson-Wentz confirmed her pregnancy with Pete Wentz last week, rightfully waiting until after the first trimester had passed to deliver the news to all the rubberneckers out here in blogland.  While queueing for my lunch today, I did the unthinkable and flipped through a nearby Star magazine, noticing a piece about Ashlee’s supposed worry over passing her (still ridiculously good) genes to her baby.  It was a fluff little piece, unless most of the very serious journalism in Star, but it did get me thinking…if you’re vain enough to drastically alter your appearance in the first place (we can call a spade a spade, right?), it stands to reason that you must indeed have a mini freak-out worrying about your baby getting your “bad” old nose, or weak chin, or protruding ears, or generous thighs, whatever.  (Insert celebrity name and plastic procedure here!)  After all, with a little pain tolerance and a lot of money, you can easily create a magazine cover-ready face and body, and most patients re-adjust their self-image to fit their new looks after surgery, conveniently “forgetting” what they were born with.  So having a kid pop out with features from the old you must be quite an unpleasant reminder, no?

Out with the old…

In with the new…

Photo from People.com

In other news, Jessica Simpson has never looked better recently: healthy, freshly blond, and just all around pretty.  The bronzed goddess glow suits her!

Seeing as she’s the beauty director of Vogue UK, you might assume Alexandra Shulman to be an enthusiastic champion of various cosmetic procedures, but in this fascinating editorial in today’s Daily Mail, she claims to have never had a single bit of “work” done.  Women are getting Botox and facelifts and Restylane injections, she says, because we want to look younger…but the fact that we’re emphatically not getting any younger makes every tweak a more insistent form of denial.  It’s a wonderfully valid point…but can’t you take it even further and then cast the net of derision over the entire anti-aging products industry?  When you boil it to the core—which is ultimately a terror of aging—what’s the difference between Botox, eyelifts and the bimonthly purchase of peptide and antioxidant creams?

My favorite quote comes at the very end of the article: ‘We broke through the glass ceiling, and we broke the gender barrier, with a tremendous amount of effort, and now we all want to look like Atomic Kittens (a UK pop band),’ she said. ‘Where is the emancipation in that?‘

I was first exposed to cosmetic surgery at the tender age of seven.  I come from a close-knit family, so when one of my relatives had rhinoplasty, several members of the Jolie clan piled into the car for the two-hour drive to LA, all eager to provide moral support.  We dropped E. off at the clinic, chilled, and returned three hours later.  I expected to see her emerge a vision: glowing, regal, perhaps wearing a tiara, definitely in full makeup.  (What do you want from me? I was only seven!)  So not the case—she was carted out in a wheelchair, bandaged, bleary-eyed and drooling.  At the sight of her, I promptly passed out, and a few minutes later the two of us were wheeled to the car.

Despite that dubious introduction to the world of cosmetic enhancements (not to mention the daily West Hollywood weirdness that stems from seeing women whose age could quite literally be anywhere between thirty and seventy…it’s just too hard to tell!), I recently started working with two facial plastic surgeons, Dr. Jason Litner and Dr. Peyman Solieman, something that initially caused all my friends and family to wrinkle their not-always-God-given noses in perplexion.  “But…but…you hate cosmetic surgery!” went the general refrain.  “You change the channel when Nip/Tuck is on!  Knives and needles make you sick!  You once fainted while reading an article about liposuction!” (Indeed, I did.  Thanks for not letting me live that one down.)  I’m a champion of positive body image, but the fact remains that cosmetic procedures are sharply on the rise, they’re not going away, and if you (or your mom, or her coworker) and going to “get a little work done,” I want everybody to be educated about it.

The more I’ve learned, the more horrified I am.  Not at peoples’ desire to objectively improve themselves—that’s their business, and I try not to be judgmental about others’ choices in their appearance.  (I’ve seen firsthand the wonders that can come from somebody with healthy self-esteem tweaking–and then getting over–a singular aspect of their appearance that always bugged.)  What does make me furious, however, are the proliferation of unethical, money-grubbing, unsafe practices; procedures that are blasted through the airwaves on infomercials and on the radio touting this “lifestyle” nip or that “lunchtime” tuck.  Believe it or not, any doctor can perform cosmetic surgery…which often (and nowadays I do mean often) results in gynecologists performing liposuction, dentists administering botox, and surgeons who have done thousands of breasts deciding to “branch out” into rhinoplasty.  Seduced by the desire to look their best, people forget that cosmetic surgery is still surgery.  There are risks, you’re probably going to be under anesthesia (which can easily result in complications), and if you don’t go to a skilled doctor, your first surgery may not be your last.  In the case of breast implants, your first surgery will definitely not be your last; not only are implants warrantied for about 10 years, but capsular contracture (the hardening of breast tissue around the implant) is essentially the rule, not the exception.

I’ve learned quite a bit recently about cosmetic surgery and enhancements, but I figure you’d all like the insider scoop straight from the horse’s mouth, so to speak.  Next week, I’ll start posting Q&As with my doctors giving the real dirt on things like Botox, fillers and catchphrase procedures like Injection Rhinoplasty and the Lifestyle Life.  And so when your aunt starts trilling about that infomercial she saw on “This amazing new procedure that only takes fifteen minutes and makes you look ten years younger and doesn’t even hurt and lets you go right back to work afterwards!”, you’ll be able to gently but firmly explain to her why it’s all total crap.