Skin Deep

It's late one Sunday afternoon, and Tammie Levy has just gotten off work. Settling into a plastic cafe chair, she clutches a hot cup of coffee, her manicured nails clicking against the ceramic mug. She's barely taken a sip before diving into discussion of her recent surgery. She speaks in a loud, open tone, causing the inhabitants of nearby tables to cast curious glances."They look totally normal," she says pointing to her chest. "They look like the breasts I would have had at 17 or 18. I just got them a little bit later."It's been less than two months since she went under the knife, enlarging her chest from a modest size A to a voluptuous size D. Though softened by the loose-fitting flannel shirt she's wearing, her curves are still evident, and Levy is proud to show them off. Her shoulders thrown back, chest jutting forward, the 36-year-old mother of three laughs and runs her fingers through her hair."I don't see anything wrong with what I've done," she says, who paid $4,300 for her surgery. "I just bought what God forgot to give me."It's a mantra being echoed by a growing portion of the country. According to the American Society of Plastic and Reconstructive Surgeons, some 393,000 Americans opted to alter their appearances surgically in 1994. As prices have decreased along with the social stigma, aesthetic surgery has become an option for the average rather than just the elite. Procedures range from $2,000 for liposuction to $6,000 for a full face-lift; a combination of surgeries can run up to $10,000. Across the country, men and women are flocking to surgeons to be lifted, sculpted, tightened and augmented. Yet while patients and surgeons alike are rejoicing over the beautification boom, critics lament the trend, suggesting it reflects a serious societal illness."It's not any surprise when you look at the messages sent out every day," says Kate Hausbeck, sociology professor at UNLV. "We're told you're not female unless you're sexual. Your body has to look like Barbie's and your skin like a model in a magazine who's airbrushed. It's a tough ideal to live up to, and it's sad we feel we have to.""We're stuck with the society we have and we have to live in it," counters Dr. Mary C. Herte, a Las Vegas plastic surgeon. "We do have a society that's very youth oriented. People in one way or another have always tried to fit that. Adding plastic surgery just gives them another means."While their may be truth in Herte's statement, it still raises a difficult quandary: As with any surgical procedure, cosmetic techniques are accompanied by lengthy recoveries and potentially serious side effects. Is the pain -- and the prospect of perfection -- really worth it?No pain, no gainA mother of two, Sandy had contemplated her surgery for five months before deciding to go under the knife. An avid jogger and golfer, she stays in peak physical condition, maintaining her trim size-8 figure. She's never had any trouble keeping weight off, but found that once she hit menopause and began taking estrogen, her body's make-up altered."I'm 52, and my body wasn't the same body any more," says Sandy, who preferred her real name not be used. "I've always been an exerciser, but I still couldn't put a belt and pair of pants on and tuck in my shirt without looking twice as wide as I am."She had originally just planned to have a tummy tuck and minor liposuction, but after a consultation with her physician, decided to expand the regimen. Her doctor convinced her that she'd be more satisfied with the results if she had a lift done simultaneously. Sandy felt that if she was going to do the procedure, she "might as well do it right the first time."Sandy opted to have her body sculpted -- a combination of liposuction, tummy tuck and thigh lift. During the procedure, she had almost 10 pounds of unwanted fat removed from the backs of her thighs, had the skin restretched and tightened to lay smoother over the fat-free area, and repeated the process on her stomach. Total time for the entire operation: six hours.Just one week later, Sandy is still in the recovery stage of her surgery. For the first three days following her surgery, she was bed-ridden -- catheterized and groggy with pain medication. Each day, a nurse pays a visit to change the dressings encasing her lower body. Beneath the swath of bandages, stitches crisscross her abdomen and thighs like the tracks in a railroad switching yard. Though she's convinced she'll be happy with the results in the long run, right now she's trying to come to terms with the pain versus pleasure ratio."If you asked me this week when I can hardly get out of a chair, the answer would be no," says Sandy. "It'll be three months before all the swelling goes down. So ask me in three months." Levy, on the other hand, has had no post-op doubts. "I don't regret anything," she says. "There's more pain having a baby than this surgery caused."In contrast to Sandy, Levy's recovery was minimal. She had little pain -- mere muscle ache -- and was able to alleviate it with Advil. Within two days of her surgery, Levy was shopping, rifling the racks at Victoria's Secret and Frederick's of Hollywood."I used to wear strapless dresses and I'd have to worry about where I was going to find a bra that would even bring me to a B," says Levy. "I went to a wedding the other day and was able to wear a backless dress with no bra for the first time. There's no padding. It's all me. It's changed my whole outlook."Surgical Self-esteemThough the severity -- and painfulness -- of their procedures differs, Levy and Sandy have one thing in common: they both had their surgery performed to feel better about themselves."Most women (who opt for cosmetic surgery) claim to be doing it for themselves because it makes them feel better," says Hausbeck. "I wouldn't begrudge them that, but I do wonder why we feel like we have to be beautiful to feel good. That's not a mindset that happens when we go under the knife. That happens when you're born a girl in this society."In the ongoing struggle to fit the commercial image held as ideal, Americans drown themselves in a sea of beauty products -- camouflaging gray hair, constructing fake nails and spending exorbitant amounts of money on any product promising a healthier, younger, more beautiful visage. Cosmetic surgery is just another weapon in the comeliness crusade.For over 14 years, Herte has practiced plastic surgery in Las Vegas, basing her practice on those solely interested in aesthetic results. Each day she lifts and enlarges breasts, redesigns noses, vanquishes wrinkles and flattens bellies -- all in a quest to "improve upon nature." It's a quest she's undertaken herself, opting to have an eyebrow lift. Herte says she's seen her own mother's drooping lids and, knowing what was coming, wanted to "put it off as long as possible."Herte chose her field because she "wanted to do magic." In her years of practice, she's heard all the complaints people lodge against plastic surgeons and their patients. With a slight degree of annoyance in her voice, Herte defends her trade."People are accepting (cosmetic surgery) as easily as they accept that they have to go to the gym. It's just like wearing jewelry, working out and taking vitamins. They're all things we do not because we have to, but because we want to look our best."Herte says before agreeing to perform any surgery she talks to patients at length about their expectations. If for any reason she gets the impression a patient is depending on the surgery to change her life, not just her looks, she'll tell her to seek a counselor."Surgery is not going to make your marriage better or relieve all your depression," Herte says. "But most people feel better when they look better. They're more productive. If you don't think your breasts are proportionate for your body type and you're spending all your time and energy dwelling on it, why not alleviate the worry? Then you've got more time and energy to put toward other things."For Levy, nothing could be closer to the truth. She says since her surgery, her personality has changed; she's more confident, self-assured. She's changed her hair, modified her wardrobe and isn't as uncomfortable with what she perceived as an abnormality in her appearance."Afterwards, I would joke with people saying 'God, what do they put in these things, a hormone drug?' I was walking on air. The person you are is on the inside, but when you look better on the outside, it comes out too." "I wish I could have done this in my twenties," she adds. "I wasn't miserable, but I'm much happier now."

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