Say Goodbye to Your Old Face

Sure, right now Rhoda’s face is just a shade on the green side of jaundiced. Her right jaw line rather bruised.

And, yes, two days ago the high school physics teacher from New York couldn’t chew a bagel. Under her matted swish of brown hair lurk staples – “dozens of them” – that give her the heebee-jeebies.

But Rhoda, 55, happily volunteered for this. She even had a party to send her off.

It was a goodbye-to-your-old-face party.

She’s now on day five of recovery in a doctor’s office in Stuart. And in her mind, she’s already planning the next party, a “new face” party.

“Me and my friends, we’re all in our 50s. Everyone decided we were all going to make appointments, but nobody believed how fast I moved.”

Rhoda wasn’t the only one moving. Last year, 61,692 people across the country decided to fight sagging chin lines and pooching jowls by going under the surgeon’s knife for a face lift.

In the last decade, doctors have come up with dozens of ways to touch up your looks. They can zap wrinkles with lasers or peel away mottled skin with chemicals. They can suck fat out of chins, or deposit it in lips.

But when it comes to seriously overhauling one’s visage, the face lift is still the mainstay. The tools and techniques have improved. The cost has dropped from the range of a new Bentley to somewhere closer to Suzuki. And, if done right, the results are a vast improvement over the old actress-in-a-wind-tunnel look.

Still, face lifts are not walk-in procedures. Cosmetic, yes. But surgery all the same.

So before Rhoda’s friends start clearing their calendars, they should heed the advice of those who have been there – and the doctors who’ve done that thousands of times.

First, this isn’t for everyone.

Rhoda’s surgeon, Dr. Robert Cooper, guesses he turns down about half the people who show up in his office.

For some, their health is the problem. They have diabetes or heart problems or their blood pressure is out of whack.

If your body is already working overtime with medical problems, a good doctor won’t operate – it would merely add more stress.

Others come to the office thinking a face lift will solve emotional problems. It won’t. That’s when a doctor has to become a psychologist of sorts. “For example, you don’t want to work on somebody who’s here to save a bum marriage,” Cooper says. “Say the woman has a big chubby neck, the kind I could really work with. It may be absolutely great surgery, but if the marriage goes down the dumper she won’t be happy with the results of the surgery.”

A face lift isn’t a good pick-me-up after a personal crisis either.

“Someone who’s just been widowed from their soul mate of many years – this is a patient set up for post-op depression,” Cooper says.

Cooper describes the ideal patient:

“This person says, ‘I have all this lust for life, I have energy, I have opinions and I look at my driver’s license and say, Who the heck is this?’ ”

A person’s age is not a factor. Though face-lift candidates in their 20s are extremely unusual, the clientele is getting younger, according to national statistics.

Most people who want a face lift are in their 50s and 60s. But doctors are seeing some first-timers who have waited until they’re almost 90 to step up.

Don’t go with the first doctor you find or the cheapest estimate you get. Rhoda asked her friends and acquaintances. A business woman in Boca Raton went with the surgeon who’d worked on her mom. Helen Bransford, a New Yorker who wrote a book on the subject, asked her doctors who they would recommend.

All are good ways to find a reliable doctor.

Next, they checked the doctors’ credentials. They found out where the operation would be performed and, if it wasn’t a hospital, they checked the facility’s credentials too.

Then they visited those doctors and discussed their expectations.

Some doctors will show you pictures of their work. If that’s the case, keep in mind you’ll probably see their best examples. Ask them how many face lifts they have done. Listen for whether they offer alternatives – you may think you need a face lift, when what you really need is an eyebrow lift or work on your eyelids.

“By no means is a face lift the be-all and end-all,” Cooper said.

Don’t make plans for a week, maybe more. We’re talking serious snipping, sucking and sewing – hours on an operating table. Make sure you have somebody to nurse you through the recovery.

Thoughts of a lengthy recovery are exactly what prompted Rhoda to go with Cooper. Cooper’s office space is somewhat unusual to the business. In his Water’s Edge facility, Cooper maintains an accredited operating room and a 10-bed recovery wing.

The [Pavilion Resort] has private rooms with televisions, parlor with satellite TV, a 24-hour nursing staff and a chef to prepare a group breakfast, lunch and dinner. Some clients go for a Penthouse suite which comes with the same amenities but more privacy. Cooper charges additional for each night’s stay – somewhere between $100 and $150 a night.

On day 5, as the aroma from cabbage-stuffed chicken and mustard-basted sweet potatoes rises from her dinner plate, Rhoda is pleased with her decision.

The set-up is convenient and helpful. But it’s NOT mandatory.

What is necessary is a post-op plan.

“A face lift is not something where you have three days down time and then you’re driving the carpool and popping into the office,” Bransford said. “Clear your calendar – certainly for two weeks because the first week you’re healing from surgery and then you need to get your bearings again.”

Most face-lift patients can head home a day after surgery – especially if they have spouses or close friends who can play nurse for the next couple days. Bransford advocates hiring a nurse for the first 24 hours – at least. By her estimation, no pal or spouse, no matter how close or dependable, should be called into this kind of rigorous service.

Many of Cooper’s patients opt to spend the first couple days with his facility’s nurses for that reason.

“But you don’t need a licensed nurse, you need a responsible adult,” said Cooper’s risk manager, nurse Allison Wolfberg.

The tasks aren’t difficult:

Cocktail-straw-sized tubes drain surgical incisions into small containers which must be emptied every few hours.

If you have your lids done at the same time, someone must apply medication to them regularly.

And you’ll need cold compresses on your face to reduce swelling. A compress can be made of ice or packs of saline sold in stores. But the most frequently used compress comes straight from the fridge: frozen peas.

The compress is key to making sure a lot of expensive work doesn’t go south, so it’s important to keep it fresh. And most say that means changing it every 15 to 20 minutes – throughout the day and night.

It isn’t really painful, just uncomfortable.

The patient on Cooper’s table has been there two hours. In that time, he lifted her eyebrows, making a cut in her forehead and a notch in her skull to reattach the skin. He has trimmed a sliver of skin and removed a sliver of fat from her upper and lower lids. He’s sliced her face open down the jaw line in front of her ears, then behind them into the hairline. He’s also cut under her chin.

Cooper uses a liposuction wand to remove some fat from the chin and neck line. He uses a scalpel to remove the fat that has drooped over the years from this 49-year-old woman’s cheeks down into her jowls.

All along, he’s traced the purple Magic Marker lines he drew before surgery, while the patient was sitting upright. When he’s done, he staples all the cuts in her hairline and sews the more visible ones by her ears.

He finishes by lasering away the top layer of her skin – along with the wrinkles that have become part of it.

It’s chilling watching Cooper pull the skin from her face, vacuum and trim and then staple it all back together. But by the end of the operation, while still on the table, she looks a decade or so younger than the “before” pictures hanging nearby. He’s restored her chin line and her eyelids are much smoother.

Of course, in the next few hours her face will swell so much no one will recognize her. It may take months before she feels normal again.

Day one is usually a blur.

Rhoda and her fellows recuperating in Cooper’s ward remember they fell in and out of consciousness, anesthesia still in their system. Their heads propped at 30 degrees from the bed to keep the blood drained from the area.

Day-one patients look like members of the same ugly tribe: eyes-swollen shut, cheeks swollen wide, heads in bandages. They are so bandaged and hard to distinguish from one another that those in the recovery area sport name tags. Chewing is out of the question. Drinking is done only through a bent straw. And oral hygiene is limited to swishing mouthwash through a straw.

“I had an extraordinary doctor, but no matter how much you try to brief yourself, you can’t imagine what you’re going to look like on Day One or Day Two,” Bransford said.

The turning point for Rhoda is day three. Still, all bandages and Band-Aids, Rhoda gets stir crazy and decides she’s up for a stroll – into downtown Stuart. She takes pains to do this in mid-summer – she’s not allowed to sweat or significantly raise her heartbeat. Both are recuperation no-nos.

By Day five, all of Rhoda’s bandages are gone. But she still feels stiff and looks battered. While bathing is OK, a shampoo is still out of the question. She can’t do that with the staples and stitches.

When a crew of four face-lift patients gather in the recovery ward’ s dinner table, all agree that what they’ve been feeling isn’t pain. They’ve got pills if it starts to hurt. But they all report discomfort.

“You have to sleep with your head propped up. You can’t open your mouth real wide. You can’t chew. They put this stuff in your eyes, so you can’t read,” one says, barely nibbling at a scrumptious confection sprinkled in chocolate.

Martha Satomassimo is feeling stiff even a month after her face lift. Sitting in one of Cooper’s check-up rooms, the 60-year-old asks if she can get a haircut yet.

“You can cut, you can perm, the only thing you have to worry about is the sun,” Cooper tells her. “You’ll notice your skin is a little drier than normal. You might have numbness, your skin, it feels like leather, like wood. But do everything. Go out sailing, whatever. Just protect yourself from the sun.”

At one month, Bransford celebrated the fact that she could open her mouth an inch from tooth to tooth, eat a regular meal at a restaurant and no longer used a thin eyebrow brush to brush her teeth.

Be realistic.

A better looking you is possible. A career switch to runway model is not.

About a year after surgery, Helen Bransford described the transformation of her 40-something face this way:

“It’s very liberating. I don’t worry. I no longer walk into every room self-conscious about whether my skin is sagging or drooping. It allowed me to focus on the people around me more. I didn’t expect that.

“Having a face lift doesn’t mean you’re Cindy Crawford overnight. You’re not a babe or anything. It’s just that now you’re the best you can be.”

Rhoda returns home black and blue, which shocks a couple friends who aren’t used to seeing a fresh face job. The bruises eventually disappear, though a feeling of tightness under her chin and numbness around one ear linger for more than eight months.

Almost a year later, while she’s out with her 5-year-old granddaughter, people mistake her for the girl’s mother, she says. A store clerk figures aloud Rhoda is in her early 40s – to which Rhoda confesses she isn’t.

And her friends are impressed, she says. Rhoda believes a couple of them have followed her lead, though they aren’t as candid about it as she’s been.

Rhoda says a stroll past a wall of family pictures earlier this month cemented her good feelings.

“I looked at the pictures and said, ‘Oh my God, I don’t look 10 years younger, I look 15 years younger,” Rhoda says from her home in New York. “I’m looking very, very good and I’m very, very happy.”