Skin Deep

Don't like your face? Your breasts? Your tummy? Get yourself new ones. Plastic surgeon Ernest DiGeronimo makes the kindest cuts.

The boomers also bring with them a sense of entitlement, a view that when it comes to self-improvement, there's no reason to scrimp. "They grew up with so many options," Bakur-Weiner says. Now they want the best looks money can buy. Says one 39-year-old woman planning a face-lift in DiGeronimo's office, "I saw the folds on my face, and thought, 'If I do it now, I won't have to do it when I'm 45.' Why should I have these bulldog folds if I don't have to have them?"

The hunger of baby-boomer women, among others, for cosmetic surgery isn't limited to Americans. Many patients from Latin America and the Caribbean visit DiGeronimo's office, too. One of these women, Marie, a 43-year-old white Haitian mother, has come here for eyelid surgery after a 73-year-old friend raved about her own DiGeronimo-performed face-lift. The procedure, the doctor says while pointing to her slightly fleshy eyelids and the bags under her eyes, "will make the difference between having the eyes of someone her age and someone ten years younger." That indeed is Marie's hope, as photos are taken of her before her surgery. "My eyes are the best feature that I have," she says, "and I want to have a younger look."

Woozy from drugs, she lies on the operating table as the doctor draws lines on her eyelids with a blue felt-tip pen to mark the spots for his incisions. DiGeronimo works rapidly, cutting along the eyelid as blood begins to flow, while snipping away the extra flesh. He hoists the skin up with his scissors and drops it on a cloth-covered surgical-tool tray nearby. In order to reduce black-and-blue marks later on, he also uses a "cauterizing" tool -- a type of electric tweezers he controls with a foot pedal -- that singes the exposed flesh, sending wisps of smoke floating upward. He proceeds to slit open the bags under each eye and peel them downward, exposing the repulsive sight of raw bloody tissue underneath the skin. DiGeronimo uses tweezers and scissors to remove the fatty slivers lying there, calmly tugging the tissue, then snipping it loose. "These are the things that make your eyes seem puffy," he explains to a visiting reporter, lifting out what look like bloody baby worms and placing them on the surgical tray.

After the extra skin and fat are removed, DiGeronimo starts sewing the sliced flesh back together. It seems like an extraordinarily delicate task, guiding a curved needle with small scissors, looping the thread through two separated pieces of skin and tying them together, but he remains cool throughout. "When she heals," he says, referring to Marie, whose first eyelid he just sewed up, "you won't even be able to see that scar."

Later, when Marie is wearing gauze eyepatches and being wheeled out to the adjoining parking garage by her teenage son, DiGeronimo leans down to tell her, "It will swell up for four days and you won't look pretty. When you heal, then you're going to look pretty." A few days go by, and her puffy eyes are hidden by Jackie-O-type sunglasses when she comes in for laser surgery to remove some wrinkles near her mouth. Two weeks later, she says of the eye surgery, "It's made a big difference." But despite all the work done, she still feels she doesn't look quite young enough. Now she's thinking about having a face-lift, and DiGeronimo, it's fair to predict, doubtless will be glad to provide it.

Joan, who's 50 years old, has just had her face-lift. A day after the doctor has made incisions behind her ears to tighten the skin all over her face, she is sitting in the examination room with her 53-year-old friend Terry, who had her own face-lift and nose job six months ago. Joan wears sunglasses and a scarf to hide the scars, bruises, and swelling. "I work out at the gym four times a week, I stay in good shape, and I never had a problem being the oldest person there until I noticed my face was starting to deteriorate," Joan notes. "I always had confidence, and then I felt this nervousness when I was dealing with people. Mentally, I needed it [the face-lift]." Her boyfriend and children all told her she didn't need the operation.

Besides, she observes bleakly, "Youth is moving up." She's the oldest person in her sales office, but, she confides, "They don't know how old I am. With my age and experience and credibility, I can sell better." And yet she still needs to look younger, she believes, to succeed at work. She's taken a vacation from her job, and when she returns she hopes her colleagues will think she just looks refreshed. She also feels the change will help her in another marketplace: dating. "I don't know if I'll be with this man forever," she points out, "so I want to look my best."

A little over a week later, she's very pleased with the results. The stitches have been removed and the healing is well under way. "I feel great and I look terrific," she says. "It cost me $5700, and it was absolutely worth it."

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