Sunday, August 20, 2006

To Cut or Not to Cut?

This is a piece from 50 Ways to Leave Your 40's, the book I'm co-authoring. It's from a chapter entitled, "Love Thy Body."

“Love thy body,” we say. Well, what if you don’t? What if you, like many mid-lifers, look in the mirror and pine for days gone by and a body gone bye-bye? What if you don’t WANT those basset hound eyelids, that turtle neck or the sumo belly? And where the heck have your boobs slouched off to now?

“Hey, kiddo,” says the little voice. “You don’t have to look like this. It’s a new century! They’ve got ways to FIX you!”

It’s true. A nip here, a tuck there, a little suction and augmentation and voila! The new you. Why not? Why “love thy body” when you can just “fix thy body”?

You’d certainly be in good company. More and more Americans are pursuing their lost youth in operating rooms, to the delight of the cosmetic surgery industry, which raked in 9 billion dollars in doctors’ fees in 2005. In that year, almost two million people went under the knife for cosmetic purposes alone. This includes, by the way, a dizzying array of possible procedures, from the familiar Facelift and Tummy Tuck to the newer Butt Boost and Vaginal Rejuvenation. If you add to that the number that had “minimally invasive” procedures like Botox injections, laser hair removal and dermabrasion, the number skyrockets to over ten million men, women, boys and girls.

Why do we do this? Why subject ourselves to the risks of surgery, the likelihood of scarring, the chance of a blighted outcome, all for looks?

Clearly our society suffers from a nasty case of Youth Worship. Physical beauty is defined always in terms less than thirty years of age, and everywhere you go, big glossy ads scream "value equals looks!" But it seems to me that by midlife, most of us have done enough living to know better. We’ve learned the value of experience. We see more clearly with the perspective of years. Most of us wouldn’t be 20 again if you paid us. So why do we still try to look that way?

“Well, why not?” argues the little voice. “It’s just a little nip and tuck. It’s not like it can kill you or anything!”

Ah, but it can. You might remember Olivia Goldsmith, author of The First Wives Club, who died following a facelift operation in 2004. It was not even close to her first such procedure, which made her death from anesthesia complications all the more shocking. A month later, another death in the same hospital from the same procedure set the medical grapevine buzzing. Alas, these are not isolated incidents. The American Society for Aesthetic Plastic Surgery cites a 1-in-57,000 chance of death and a serious complication rate of less than half of 1 percent for outpatient procedures. Less than half of one percent. That means, if 2 million people had cosmetic surgery in 2005, a “mere” ten thousand of them had “serious complications.”

What complications are there? First of all, there are the usual risks from general anesthesia, which include airway obstruction, abnormal heart rhythm, brain damage, heart attack, nerve damage, paralysis, malignant hyperthermia, stroke, and death, among others. Then there are risks common to any surgery, including bleeding, infection, pneumonia, blood clots and wound separation. Cosmetic surgery adds risks of skin necrosis, asymmetry, slow healing, numbness and tingling, abnormal fluid collections, and “irregularities, dimples, puckers and divots” (

I had a patient a few years ago who stopped by on her way to the plastic surgeon’s office to show me why she was returning to him 2 months after her “boob job.” In tears, she lifted her shirt to show me her “surgical result” which could best be summed up as “cockeyed.” One breast went northwest, the other, southeast, the result of asymmetrical scarring. The surgeon would have to put her back under general anesthesia and then basically yank and pull on her “augmented” breasts until the scar tissue tore loose enough for him to try to even things up with brute force.

Still want to get that nip and tuck?

Allow me to interrupt myself a moment to say that I have the utmost respect for the Plastic Surgery profession. What they do for kids with cleft palates, trauma victims, and women who have had mastectomies is heroic. What I’m objecting to is the use of plastic surgery for mere cosmetic purposes.

There is no fountain of youth. No magic wand. Rearranging a few skin cells will not reverse the aging process. Next time you look in your mirror, mirror on the wall, consider this: wouldn’t an Attitude Boost be much less expensive and risky than a Butt Boost? Is it possible that you can “love thy body” in gentler ways, or at least “accept thy body” without cutting it up?

Clearly, I have an opinion on cosmetic surgery (in case you couldn’t tell). However, if you are determined to fight nature with a scalpel, you’re going to do it no matter what I say. All I can ask is that you think first, educate yourself on the risks and benefits of the procedure, and go to a board-certified, experienced surgeon.

And then, please, think again.


Ivygrrl said...

I am in complete agreement here. Those with horror stories or who aren't satisfied with their surgery either A) Didn't research their surgeon B) Didn't research the surgery facility C) Have other underlying issues they thought could be fixed with superficial surgery or D) Didn't know what exactly they wanted in the first place. I have had cosmetic surgery to correct what horrid genetics were handed to me. It wasn't a matter of aging, it was a matter of being born with my body not being in a healthy proportion. I am completely happy with my decision because it was thought over for about 12 years and was very leery of bad/cookie-cutter surgeons.

anafaran said...

Oh, this is good, Dr. Peg. I have something to add to this. For a couple of years I thought I was leaving my husband. Some girlfriends would ask why don't you get an eyelift, you're still young, and "they say" if you're going to have surgery it's best done by age 50. I would listen to some and think, yeah, there's that droopy eyelid that has been bothering me for a while, not to mention the triple chin that runs in the family. But I started to get really angry when I went into a plastics guy and the first thing he suggested I do was an eyebrow lift. Hells bells, I never had a problem with my eyebrows. I left his office REALLY depressed. But then I found out I was walking around with deeper problems than a funny face. I was suffering from depression. I went into therapy, and a year later I feel great. I feel great about my life, my face, my post-mastectomy scarring which includes a north/south combo, my husband who perhaps could still use a little help, but you hit it on the head in so many ways. We've been brainwashed, beat down and put off our true paths, ie, to find where our inner beauty and happiness exist, within our reach, and with no bills from the plastic surgeons living in the mansion up the street. Thanks for sharing your wisdom with us, your devoted sisters in search of REAL beauty.

glenda said...

check out shapeofamother on blogspot for women who are trying hard to be proud of their stretched out of shape bodies

dr peg said...

ivygrrl - Thanks for your comment. Sounds like you were careful and smart, and got a good outcome - hooray!

anafaran - Great comment! You're a great example of why surgery can't fix a deeper issue. I'm so glad you learned that without paying a mint in surgeon's fees! I so agree with you that "inner beauty is where it's at." And, besides that, I find a lot of beauty in older faces and bodies.

glenda - I checked out that blog. Very interesting. Kudos to the blog owner! If anyone else is interested, click the link:
Shape of a Mother

dr peg said...

From the Shape of a Mother blog, I followed a link to this site, which is a very interesting effort to de-mystify and de-sexualize normal female breasts

medstudentitis said...

I think this is a great piece on the motivations for plastic surgery and misconceptions about surgery fixing everything. I also think this piece point out that "love thy body" is easily said but not so easily done for many people no matter what their intelligence or life-status is. Personally, I think "tolerate thy body" is a good goal to start with!

dr peg said...

medstudentitis- I so agree. If we could all tolerate our bodies, what happier people we'd be!

The Authors of "50 Ways" Interview on KCHF TV

50 Ways to Leave Your 40s TV interview with Phoenix' Pat McMahon