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Is It Time for Plastic Surgery?

How to choose the right procedures for the right reasons.

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mannequin head with surgery question marks
Margeaux Walter
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I’ve had three plastic surgery consultations — once for a neck-lift, which I didn’t go through with; once for my under-eye bags, which I lost a deposit on because I didn’t go through with it; and once for my upper eyelids, which I had done.

The eyelid surgery was super easy. I had a local anesthetic, chatted with the doctor throughout the procedure and was very pleased with the results. So why did I chicken out on the other two surgeries? They were more complicated and required more downtime. After all, who wants to go under the knife unless they have to?

And in the case of my under eyes, I met a beauty professional at a party two nights before the scheduled operation who convinced me not to have the surgery. “It will accentuate the hollows under your eyes,” the stranger said, assessing my face.

Plastic surgery is never a good choice if your only reason is to look younger. Because you’re not going to. I know that. And besides, on the days I feel really upset about those under-eye bags I can camouflage them with concealer. Basically, I was, and am, happy with the way I look. Especially when I see photos of Diane Keaton and Diane Von Furstenberg, who are aging without intervention. But for those who have health issues or are unhappy with their looks, cosmetic surgery can lead to improved self-confidence, which, if you ask me, is a pretty good reason to opt for change.

In January, lawyer, journalist and The View co-host Sunny Hostin revealed in People magazine that she underwent a breast reduction and lift, as well as liposuction, the past summer. “I feel like a better version of myself,” she said. Now age 52, after years of struggling with back pain and body-image issues as a result of her double-D breasts, which she often had to tape down or try to wrangle into two sets of bras, the choice to have plastic surgery was, as she put it, “a health decision and a self-care decision.”

Let me be real. Just because I chickened out on cosmetic surgery doesn’t mean that one day I won’t opt to do some surgical repair work. I’m keeping my options open. But if I do, I’ll make sure it’s for the right reasons. Is plastic surgery for you? Read on.

  • Any candidate for plastic surgery should go into it for the right reasons. In 2022, the experts at Harvard Medical School — lead by a practicing plastic surgeon — teamed up to publish Cosmetic Surgery, a detailed Special Health Report to help consumers make educated decisions about cosmetic procedures. Their tip? To look better and feel more confident are two good reasons to have plastic surgery. To look like (fill-in-the-name-of-your-favorite-movie-star) or your 25-year-old self? Not gonna happen.
  • While plastic surgery can improve your appearance, it can’t fix larger life issues, such as a broken marriage, a lonely retirement or depression. But if done right, what it can offer is an improved self-image, and you just may see a bigger smile when you look at yourself in the mirror.
  • “Be realistic,” shares industry plastic surgery consultant Wendy Lewis, founder of WLbeauty. “Plastic surgery may turn back the clock, but the clock keeps ticking. You can’t expect magic. There are pros and cons to every procedure, perfection is not a realistic expectation.” Talk to your doctor about what plastic surgery may, or may not, be able to do. Do you really need a full face-lift or will a neck-lift suffice? Are there other, less invasive procedures that can make your marionette lines disappear?
  • Board-certified plastic surgeon Adam Kolker, M.D., who has been named one of New York magazine’s “Best Doctors” consecutively since 2013, agrees. As he told me: “The two primary goals of any treatment are: Is the treatment safe for a particular patient? And will it leave them looking natural? An effective plastic surgery shouldn’t leave a patient looking like they’re a candidate for the Witness Protection Program.”
  • Prioritize. Are you concerned about your under-eye bags and think your tummy could use a tuck? Not in the same surgery, advises Kolker. Figure out which area bothers you most. And again, remember that you’re not going to look like Lily Collins post-surgery, you’ll simply look like a refreshed you.
  • Does it matter if you’re 60-plus? “Regardless of age, there are boxes that need to be checked before anyone, of any age, undergoes a surgical procedure,” adds Kolker. “In theory, a 30-year-old candidate for surgery will need the same medical clearance from their internist as a 60-year-old. Still, in your 60s, there may be more items of concern in your medical history.” That means if you have issues like cardiovascular disease, diabetes or other chronic diseases, consult your doctor for advice about whether or not to have surgery.
  • Have you explored other options? “I always tell clients to try a nonsurgical procedure first as an alternative to going under the knife,” says Lewis. “There are so many injectables, laser treatments and devices today that tackle discoloration, tightening and other issues you might be concerned about. Try them before opting for surgery.”
  • Cosmetic procedures address two things — skin issues like wrinkles, sagging skin and age spots, and the shape of the face and other body parts. Botox; fillers like Restylane and Juvéderm; and lasers, radio frequency devices and chemical peels can help address wrinkles and other skin issues. But only surgery can straighten your nose, get rid of under-eye bags or lift your breasts.
  • Prices for various plastic surgery procedures vary widely. Three friends had mid-face-lifts during the pandemic, when we were all housebound and downtime was at a premium. All of them went to top New York City doctors, whose fees ranged from thousands to tens of thousands of dollars. Top doctors in cities other than New York, Houston, Chicago and Los Angeles are likely to be cheaper.
  • So, as you’re hashing out your list of pros and cons, think about this: Can you afford plastic surgery? And what about the downtime, which for a procedure like a face-lift can be more than two weeks.
  • If you decide that surgery is for you, make sure you go to a board-certified plastic surgeon. Are you going for a nose job? A tummy tuck? To get rid of jowls? Go to a doctor who specializes in the type of surgery you’re seeking. Both Kolker and Lewis suggest going to at least two, if not three doctors, for a consultation to compare their prices, evaluations and personalities.
  • My husband, an architect, says to never pick the cheapest bid on a house renovation. Often, you get what you pay for. I’d say the same about plastic surgeons; choose doctors because you feel confident about their work, not because of their lowball price. And always, I repeat always, ask to see albums of their before and after pictures. Ask to speak in person to past clients and ask your friends who they went to and find out if they’re happy — and you’re happy — with their results.
  • Finally, once you’ve vetted them, trust your doctor. Years ago, Loretta Lynn told me about her face-lift. “I was so scared, so cautious, I must have told the doctor a zillion times, ‘Not too tight, don’t do too much,’” she told me with a laugh. “So, he didn’t. And I had to have a second lift.”

    Would YOU ever consider plastic surgery? Let us know in the comments below.
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