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plastic surgery procedures “I always felt like I had this little face with, like, a Mr. Potato Head nose!” Ms Girardi, 25, told Us Weekly magazine, where she made her debut in before and after pictures that showed a straighter, more upwardly sloped nose. “In school, they called me Pinocchio. After ‘The Bachelor,’ bloggers called me ‘horse face.’ ” At 35, I’ve put off my own nose job for years, maybe because it took me so long to believe that my nose was such a problem. It was a good shape and size for my face until fifth grade, when I noticed that when people made fun of me, they’d mention my nose. During a brief hour of peacetime, I took aside one of my bullies and asked him why people were mocking my nose. “Because it’s huge,” he said. Then he told everyone that I had asked that. An immediate visit to a three-way mirror confirmed it: my nose was huge. It had curled into a comma somehow, and was suddenly too high up on my face. I began spending a lot of time trying to figure out the best way to mitigate the damage. I couldn’t scrunch up my nose or it turned into a hook. Raising my eyebrows lifted my nose a little so it wasn’t pointed downward completely, which was good, but it’s exhausting and it’s weird to always look surprised. Smiling too broadly made the tip almost touch the top of my lip, so that I looked simultaneously happy and disgusted, like Gargamel, the cartoon villain. At 13, I started dreaming about a nose job, but my parents wouldn’t hear of it. The nose job I didn’t get that year would have been a cheerleader’s nose, dark holes of nostril evident upon first glance, turned up so that you could see straight into my brain. The nose job I didn’t get in 11th grade would have been straight and long with a tip like a polka dot. On the first day back from summer vacation, six students returned to our all-girls high school with black eyes and tiny bandages across their noses, badges of their parents’ understanding of what it was like to go through life with that nose. My mother said I was beautiful. My sisters said I was beautiful. They have dainty noses. The nose job I didn’t get in college would have been pointy and serious, like my roommate’s and her mother’s. I told the mother I liked her nose and she said: “Oh, this? This isn’t my real nose.” They’d had them done on the same day, by the same doctor. When I was 25, I visited an ear, nose and throat specialist who sat on his stool, awed by my deviated septum. “How can you even breathe out of your left nostril?” he asked. Indeed, from underneath, you could see that my septum leans so egregiously to the right that the left nostril hole is almost completely covered by the outer nostril cartilage. He told me I’d have to fix it eventually, that it would get worse with age. “While I’m in there, I can straighten the whole thing out.” His assistant assured me that insurance would cover it. I would be one of the first people I’d ever heard of to have a nose job because of an actual deviated septum, instead of just using it as a diagnosis code to commit insurance fraud. I made the appointment, then canceled it. I said I’d call back. It’s 10 years later. So why haven’t I? First, it seems painful. Second, I’ve noticed over the years that friends who have had nose jobs end up with a nose that seems to be slowly dripping off their faces, led by the columella nasi, the skin-covered extension of the septum, to the point where you could actually see those two little tabs on the inside of the nostrils that are best left internal parts. BUT really, I’ve avoided rhinoplasty because though it might make me prettier (and I do believe my nose is what stands in the way of my being conventionally pretty), I’m not sure what it will say about me. Following her operation, Ms. Girardi tweeted: “I want my surgery to be looked at as positive reflection of how I feel. If it makes you feel better about yourself then do it. xoxo.” And that’s the problem. Nose jobs are often defensively rationalized as acts of empowerment by those who have undergone the procedure. But a recent study shows that one in three nose-job patients might show signs of body dysmorphic disorder, a psychological condition in which a person is preoccupied with a certain part or parts of her appearance to the point of distress (it affects men equally). The number of overdone noses, breast jobs and too-aggressive face-lifts I see as I walk around Los Angeles, where I live, is enough to make me wonder if we actually needed this study to know that this was an issue. Then again, for every Barbra Streisand or Sarah Jessica Parker who’s thrived with distinctive noses, there are two Nia Vardaloses or Rosemarie DeWitts who should be way more famous than they are. In the new TV season, this pattern is even more evident with the casting of Tara Summers, who plays Sarah Michelle Gellar’s best friend on “Ringer,” and Zoe Lister-Jones, who plays one of Whitney Cummings’s friends on “Whitney.” Both have prominent noses; and both have vibrant red hair to prove that they will remain on the non-threatening sidelines, making sassy and sarcastic jokes.
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plastic surgery news Three years ago, when a 15-year-old British girl decided to get breast implants for her sixteenth birthday, the story made headlines around the world. Since then, media reports have continued to speculate that cosmetic surgery, once the exclusive domain of wealthy older women, is a trendy new option for any teenager with an adolescent hang-up. Dr. Darrick Antell, a top New York City plastic surgeon, says he has seen an increase in the number of teenage patients but cautions against calling it a trend. “One of the main reasons for the increase is visibility: today’s teenagers are growing up with parents who have had cosmetic surgery, so they see and hear about it more. The media has also done a good job of making people aware of the procedures available. Another reason is acceptability. In a way, plastic surgery has come out of the closet,” Dr. Antell says. When details of cosmetic procedures are frequently discussed on talk shows and published in magazines, it’s not surprising that they filter into our consciousness. “Sometimes when I’m out to dinner with my friends, we’ll play a game called ‘What would you have done?’ where we sort of daydream and discuss what we would do if money was no object and the procedures were safe,” says 18-year-old Alison Preiss, an Ontario high school student. While Preiss doesn’t think she could actually go through with a procedure, she says it could go either way. “I could grow up to realize that there are more important things than my nose, or it could really bother me to the point where I decide to have surgery. I suppose it depends on my lifestyle and career choices,” Preiss says. Suzanne Ma, a 19-year-old Ryerson University student, has considered a double eyelid procedure popular in Asia. “I’m Chinese, and I don’t like my eyes. I don’t have double eyelids, so I feel that my eyes look a lot smaller than they really are. My concerns are not entirely for cosmetic reasons. With my heavy eyelids, my eyelashes don’t grow out properly. Some of them get trapped under the eyelids and it’s very easy for me to get an infection,” Ma says.
SAFETY OF BREAST IMPLANTS WASHINGTON — After two days of discussion and testimony about silicone breast implants, a top government health official said he had heard nothing to shake his faith in the safety of the widely used implants. The official, Dr. William Maisel, chief scientist for the Food and Drug Administration’s Center for Devices, said silicone breast implants were safe. “We felt that way before the meeting, and we continue to feel that way after the presentations and discussions over the past two days,” Dr. Maisel said. There are risks to the implants, however, Dr. Maisel said, including ruptures, a hardening of the area around the implants, the need to remove the implants, scarring, pain, infection and asymmetry. “Women should feel assured that the F.D.A. continues to believe that currently marketed silicone breast implants are safe,” he said. Some patients and women’s groups who testified at the meeting disagreed. Diana Zuckerman, president of the National Research Center for Women and Families, a research and education group, told an expert panel that the two companies that manufacture silicone breast implants — Johnson & Johnson and Allergan — had done a poor job of studying patients who got the implants, as the F.D.A. required them to do. “And without proper data, we still don’t know how safe or effective they are and whether there are certain patients at risk for extremely negative outcomes,” Ms. Zuckerman said. Dr. Maisel agreed that the studies conducted by the two companies had failed to follow as many patients as the agency had hoped. One purpose of this week’s meeting was to ask the expert panel what the agency and the two companies should do about that poor follow-up. Some suggested that patients should be paid for participating; others mentioned that doctors should get some money, too. There was some criticism of the 27-page research form that patients who participate in the study are required to complete and whether it could be shortened. Nearly all expressed hope that a registry could be created that would follow all breast implant patients, but such registries are expensive to maintain and complicated to create. The committee also agreed that patients should no longer be told that they should get a magnetic resonance imaging test three years after getting implants and every two years following. The reason for telling patients to get M.R.I.’s is that silicone breast implants sometimes rupture without women being aware, and an M.R.I. can reveal this unseen problem. But many patients ignore the requirements because M.R.I.’s are expensive and it is not clear what they should do when an unseen rupture is discovered; the risks associated with ruptured implants may not be greater than the risks of the operation needed to take them out. “F.D.A. continues to believe, as does the panel, that M.R.I. is the gold standard for evaluating breast implants for silent rupture,” Dr. Maisel said. “But there was consensus among the panel that the requirements for ongoing M.R.I.’s should be removed.” Dr. Maisel promised that the F.D.A. would study whether to follow this advice.
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