A Health Detour
I’m not the kind of woman who has plastic surgery. In my high school, when nose jobs were de rigueur, mine looked perfectly fine without one. During my 30s and 40s, when I noticed signs of "work" on other women, I didn’t feel, to quote Nora Ephron, bad about my neck. Or face.
But the year I turned 50, my undereye bags started bugging me. They became the feature that said "old" when I looked in the mirror. I invested in countless eye gels that promised to shrink puffiness, but if they made a difference, I couldn’t see it. Finally, I appealed to my dermatologist, who told me surgery was the only way to get rid of the excess baggage for good. My reaction: Surgery? Me? Never.
Fast-forward one year, to 2005. I was living in San Francisco and had just finished a career-advice book based on my years as founder of Parenting magazine and head of Time Inc.‘s magazine development division. The next venture on my career horizon was a concept I called TeeBeeDee ("to be determined"), a Web site — tbd.com — designed to help middle-aged people network and find support online. I’d not been this excited about a business idea since my early days at Parenting, but there was one problem: How could I extol the benefits of midlife when I felt as though, thanks to my eye bags, I didn’t look all that great for a 51-year-old?
Then I got breast cancer, and starting a new business or having an eye job became the last things on my mind.
Like many women who are diagnosed with breast cancer today, I learned that, thankfully, my case was not life threatening. After a combination of surgery and radiation, my prognosis was excellent. But having breast cancer led to other health issues. In 2006, I underwent a second surgery to remove my ovaries and cut off the estrogen they supplied (which increased my risk of recurrence). I still bemoaned my puffy undereyes — and I put off the publicity shots for TeeBeeDee’s launch because I didn’t like the way I looked. But I didn’t seriously consider plastic surgery. The prospect of going under the knife again — voluntarily — was unthinkable.
Then my 9-year-old daughter, and I went on vacation in Santa Fe, and a museum guard said to me, "Your granddaughter is adorable!" One week later, when we got back to San Francisco, I called to make an appointment to see a plastic surgeon.
Finding a Doctor
That summer I visited two plastic surgeons who had vastly different approaches. Dr. A, who didn’t charge for the appointment, operated in sell mode, dropping hints about famous patients (without naming names) and disparaging other doctors (also sans names). In the 15 minutes we were together, he never examined my eyes up close; instead he talked to me across his desk, then asked a nurse to show me before and after videos. But a hospital had devoted an operating suite to him, and I left thinking that, despite his arrogance, Dr. A was probably the best I’d find.
Dr. B’s process was different: The consultation cost $150 (to be credited toward surgery if he performed it), and he examined my eyes carefully, photographed me, and spent an hour discussing my options. His surgeries were performed in his office, adjacent to a hospital (a better one than Dr. A’s). I chose Dr. B.
One thing the doctors had in common was their recommendation that I get my upper lids done too, something I’d never considered. They said once I had my lowers looking good, my uppers would start to bother me.
They also both predicted my recuperation would take one to two weeks, at most. Dr. A bragged about doing a TV anchorman’s eyes on a Friday and "He was on the news that Monday, wearing makeup, but fine." I’d recovered so quickly from my cancer-related surgeries, I confidently booked an appointment on a Friday in August, expecting to be back in my office on Monday. And I was back — but that didn’t mean I was okay
Going Under the Knife
I wasn’t nervous before the surgery; I’d had general anesthesia twice in the past two years. The tough part would be skipping my morning coffee, since I couldn’t eat or drink pre-surgery.
The procedure began at 7 a.m., and the next thing I knew, I was waking up in the recovery room at noon. I heard the nurse calling my boyfriend, Stewart, to come pick me up. But then my doctor said, "Jesus, she’s not ready to leave." I later learned that my left eye had swollen so badly he thought he’d have to repair his work right away. He didn’t, but clearly my swelling pushed the boundaries of normal.
The nurse asked if I’d brought the Vicodin the doctor had prescribed. I had, and she told me to take one prophylactically. At about 3 p.m., when the swelling had subsided somewhat, Stewart drove me home. I rested, with ice on my eyes.
When my kids came home from school, my 13-year-old son wouldn’t look at me, and my daughter turned her back, then peeked around with her hand over her eyes. I didn’t blame the kids for averting their eyes; I couldn’t even look in the mirror while I brushed my teeth.
So Much for a Quick Recovery
I did not expect to feel so helpless. My vision is not good to begin with, but for the first two days after the surgery, I was seeing double and everything was blurred. I normally have a cast-iron stomach, but I couldn’t keep anything down: not food, not water, not the Valium the doctor had prescribed to help me sleep. Throwing up (there’s just no pleasant way to convey this) put extra pressure on the stitches, exacerbating my already-extensive bruising and swelling. I also couldn’t fall asleep — or calm my anxiety.
For 48 hours I was completely dependent on Stewart. And I was unable to take care of my kids, something which had not been true after either of my previous cancer-related surgeries. But I’d chosen to have this procedure, so I didn’t feel I was really entitled to anyone’s sympathy. My guilt and shame made me want to hide, but I had idiotically scheduled the operation only a few weeks before TeeBeeDee’s official launch. On day three I dragged myself back into the office.
For the first week, my eyes were so swollen and bruised it was hard to imagine things would ever get better. I felt I’d never look normal again, and it was my own fault. On day seven I wrote a note to myself: "Everyone told me they spent the first day after surgery thinking they’d made a mistake. It’s now been a week — and I still do."
Plastic surgeons always show you their before and after shots, but they never share photos of a patient mid-recovery. I was severely bruised from my left eye down to my chin. A procedure designed to make me look younger had actually caused me to look worse than I ever had.
Well-meaning friends would ask, "Do you know if this is normal?" Of course, that was my deepest, darkest fear: that something had gone horribly wrong and my eyes would never be the same again. Actually, my recovery was normal, but I was on the bad end of the spectrum. Someone has to be, I guess, but I never thought it would be me.
Some Improvement (At Last)
Three weeks after the surgery, I went to Santa Fe for Labor Day weekend. I was exhausted, still looked a mess and was in tears for much of the flight. I’d used up every ounce of stamina trying to work and keep my life going post-op. I am not a person who normally gets blue, but that was a low point. (I’ve since learned that the third week or so after the operation is when patients often feel depressed because the recovery progress slows down.)
After I returned from Santa Fe, I finally started to feel a bit better. Two friends who came to see me actually set up consultations with my doctor. The fact that they didn’t feel he’d been incompetent helped me to perk up.
Yet my improvement was not linear. My skin formed new puckers around my eyes as it healed. And the dark bruising underneath my left eye stayed quite visible for almost six months.
For every press appearance during the launch of TeeBeeDee in mid-September 2007, I needed a professional makeup artist to cover me in layers of thick foundation. I wasn’t trying to conceal the eye-lift — I talked about it openly — but my bruises made me look like a battered woman. Which I was, of course, but by my own hand.
One Year Later
So, was it worth it? It’s pretty hard to justify an eyelift financially. Mine cost $6,500, which included the surgeon, the anesthesiologist and the operating room. (Insurance usually doesn’t cover the surgery, except in rare cases when vision is obscured by drooping skin.) If I had elected to do just my lower lids, the cost would have been about $4,500. I do wish I had timed the operation differently. Bringing on the elevated level of stress while engaged in the launch of my company was foolish. I also wish I had done a few important things before the surgery, such as taking arnica, a homeopathic medicine that’s supposed to minimize bruising and inflammation. (Even if it hadn’t helped, I would have felt I’d done everything I could.) I think I should have gotten a third opinion. When I had breast cancer, I’d cut corners on choosing a doctor. I really liked the first one I interviewed, and she had an opening the next day, so I went for it, and never regretted it. But elective surgery is another matter; you can be really picky and see three or four people. And, finally, I wish, going into the surgery, I had expected the worst instead of assuming the best.
Yet, overall, I don’t regret having the procedure. To me, my eyes now look as they did 15 years ago. I doubt most of you could even tell I’ve had work done, unless you’re a keen-eyed member of The Tribe (those of us who have gone under the knife to improve our looks). Stewart and my friends all tell me I look great.
I’ve recently noticed that several of my friends who’ve already had one procedure have started to discuss the possibility of undergoing another one. This hasn’t happened to me yet and I doubt that it will — but I’m over my political resistance to cosmetic surgery.
Before, when I looked in the mirror I’d think, god, those bags look awful; should I try that new cream? Now I don’t even notice my eyes most days, so that’s a victory. Once in a while I wake up with a puffy lower lid and wish I’d never messed with nature. But there’s no going back, so I don’t dwell. I got the results I wanted: I don’t look different; I just look like a younger version of myself. And now no one mistakes me for my daughter’s grandmother.
20/20 Foresight: What You Should Know Before the Operation
Cosmetic eyelid surgery removes droopiness, pouches, bags, and wrinkles from above and below the eyes. But although almost 186,000 blepharoplasties, or blephs, were performed on over-40 women in 2007, many patients do not have a realistic notion of what they are signing up for.
"Eyelid rejuvenation is not a spa treatment," cautions Michael J. Yaremchuk, MD, clinical professor of surgery at Harvard Medical School in Boston. "The adjective is cosmetic or plastic, but the noun is surgery."
While the procedures are generally safe, there is at least a 5 percent risk that healing will not proceed perfectly, and in some instances patients may require a follow-up procedure or surgery, according to Mark A. Codner, MD, a clinical assistant professor of plastic surgery at Emory University.
Possible unappealing outcomes (all fixable) include lower lid malposition, in which the lower lid is pulled down for a hangdog look; chemosis, swelling of the clear membrane on the eyeball; and blepharitis, inflammation of the eyelids. Also, some patients may bruise and swell more intensely and for much longer than they expect; this is what Robin Wolaner experienced. Ideally, patients should plan to take two weeks off post-op.
What’s the worst that could happen? There’s an outside chance a woman could have a bad reaction to anesthesia. And if a hemorrhage develops behind the eye postoperatively, it could, in rare instances, cause blindness.
Protect yourself by choosing your cosmetic surgeon carefully. "Go online and find out everything you can about the doctor," suggests Alan Matarasso, MD, a clinical professor of plastic surgery at the Albert Einstein College of Medicine in New York City.
Since surgeons "tend to underestimate complications," as Codner notes, find out in advance what your doctor will charge if you need follow-up surgery. Matarasso suggests another form of self-protection: Ask other eyelid surgery veterans, "What did you not know going in that you wish you did?" To start a conversation, hit the bleph message boards on sites such as makemeheal.com or go to Robin Wolaner’s site, tbd.com.
— By Sheila Anne Feeney
Originally published in MORE magazine, February 2009.