Cosmetic surgery comes out of the closet

Jacqueline Stenson MSNBC contributor

When Sylvia Andis decided to get a face lift, it wasn’t something she tried to hide. In fact, she allowed a local news crew in Miami to document her experience. And a little over a month after going under the knife, she happily attended a “coming-out” luncheon thrown by her girlfriends.

“Patients used to stay in and come out a month or two later and pretend nothing happened,” says Andis, 49, a real-estate broker. “But it doesn’t bother me that people know.”

Once reserved for the rich and famous, cosmetic surgery has become increasingly common among mainstream Americans, and more widely accepted, too.

A nationwide survey of 1,000 adults, conducted last year by the American Society for Aesthetic Plastic Surgery (ASAPS), showed that 54 percent of respondents approved of cosmetic surgery and 24 percent (30 percent of women and 18 percent of men) said they would consider it for themselves. And about three-quarters of men and women said if they had cosmetic surgery, they wouldn’t be embarrassed if others knew.

Times have certainly changed from the days when cosmetic surgery was a dark secret. Some patients today are even flaunting their new looks, particularly in cosmetic surgery hot spots like Los Angeles, New York, Miami and Dallas. Botox parties have become common and some patients like Andis have had post-operative coming-out parties where they strut their stuff for friends and family.

“Cosmetic surgery is not something that’s in the closet anymore,” says Dr. Robert Bernard, a plastic surgeon in White Plains, N.Y., and president of ASAPS.

Andis’ surgeon, Dr. Julio F. Gallo, agrees. “It’s less of a taboo subject now,” he says.

In fact, Gallo, a partner at the Simons Center for Nasal and Facial Plastic Surgery in North Miami Beach, says he doesn’t need to advertise. He keeps busy with patients who are referred from other satisfied customers who’ve spread the word.

Hanging on to youth
Doctors say media coverage of plastic surgery and television shows like “Extreme Makeover” and “Nip/Tuck” have gone a long way toward bringing surgical enhancement out of secrecy.

Another driving force is the desire by baby boomers to hang on to youth, in any way possible, says Dr. Rod Rohrich, chairman of plastic surgery at the University of Texas Southwestern Medical Center at Dallas and president of the American Society of Plastic Surgeons.

“We don’t want to grow old gracefully,” he says. “We want to manage how we age.”

Exercising and eating right are a big part of that. But increasingly, so are nips and tucks. Cosmetic procedures -- both surgical and nonsurgical (like Botox injections) -- have more than doubled over the last five years. About 6.9 million cosmetic procedures were performed in 2002, the latest year for which statistics are available. That’s a 228 percent increase since 1997, according to ASAPS.

'We don't want to grow old gracefully. We want to manage how we age.' — Dr. Rod Rohrich president, American Society of Plastic Surgeons

Numbers dipped from 2001 to 2002: cosmetic surgical procedures increased just 1 percent while nonsurgical approaches dropped 23 percent. Bernard points to the economic uncertainties of the time as a likely explanation. But both he and Rohrich expect demand for procedures to climb in the future, particularly for nonsurgical procedures like Botox and facial fillers, treatments that quickly erase the signs of aging in people as young as their early 30s and can be performed during a lunch hour.

Indeed, people who are starting to show their age are the most common clients. In 2002, people between 35 and 50 underwent the most cosmetic procedures of any age group, 44 percent of the total.

Unlike in the past, where women often waited until their 60s or 70s to get a face lift, today’s cosmetic surgery patients are coming in much younger, often in their mid-40s or so, for their first surgical procedures, says Bernard.

And those procedures are usually less invasive, he says. So rather than a full facelift at 65, a woman may have a cheek lift or neck lift at 45, and then other “maintenance” procedures a decade or so later.

“There’s been a steady march toward less invasive procedures,” Bernard says, a trend he believes leads to better, more natural results and often faster healing times.

“You don’t change dramatically from one day to another,” says Gallo.

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