The Young and the Plastic

Oh, Greta, we hardly knew you. When you were just a legal commentator on CNN, we took comfort in the fact that your face was not a "TV face." Your mouth drooped, your hair hung lank and uncombed, and somehow it made us trust you. We focused on the words you were saying, not how you looked saying them. It reminded us of the early days of television, when the news was delivered by graying men in glasses, chosen not for their babe-magnetude, but for their authoritative demeanor. Greta, when we saw you talking about the O.J. Simpson trial, we thought, "There's a woman who's so smart she doesn't have to think about her looks." And we loved you for it.

How disheartening it was to find out that our heroine, Greta Van Susteren, is as vain and shallow as the rest of us. That she spends her leisure time not musing on writs of habeas corpus, but gazing in the mirror and wondering: Hot or Not?

During the month-long interim between leaving CNN and starting her new job as an anchor for Fox News, Greta looked up from her Sunday newspaper and asked her husband, "Should I get rid of these bags under my eyes?" Though her husband gallantly assured her that she "always looks 25" to him, the 47-year-old underwent blepharoplasty, an eye lift that rendered her virtually unrecognizable. Her eyes, once drooping and baggy but undeniably real, now reside somewhere near her ears, and she has a tight, expressionless look. Her face looks younger, yes, but it doesn't look like her.

"I don't think it was a very good job," observes Dr. Janet Blanchard, a plastic surgeon. "She looks better, but her eyes are still crinkly or something."

The attention given to Greta's new and "improved" look, and her willingness to speak candidly about it, is part of a growing trend. Not only are more people getting plastic surgery, more people are talking about it. A lot. And it isn't just show-business freaks like Joan Rivers, Cher, Michael Jackson and Britney, or bizarre, divorced socialites like Ivana Trump and Jocelyne Wildenstein who are flaunting their eye jobs, face lifts, breast lifts, face peels and Botox injections. It's everyone. Once a source of shame and ridicule, going under the knife has become just another thing you do to make yourself feel better, like buying a new lipstick. "You have to realize this was not a huge decision," Van Susteren told People magazine. "Not like choosing a law school."

To many, the most disturbing part of plastic surgery's new acceptability is the rise in teenagers wanting to reshape their faces and bodies. In 1996, patients 18 and younger accounted for less than 1 percent of cosmetic procedures performed annually; last year, it was 3 percent. The teens are seeking nose reshaping, breast augmentation and liposuction, thinking of them as quick solutions to their adolescent self-image problems. The Federal Food and Drug Administration has guidelines setting 18 as the minimum age for cosmetic breast implant surgery, and the American Society of Plastic Surgeons last year issued recommendations for teenagers considering cosmetic surgery, which include determining the patient's physical and emotional maturity. All the Cleveland-area surgeons we talked to follow these guidelines.

Magazine articles and TV talk shows have sounded the alarm, warning of hordes of teenage girls beating tear-stained paths to plastic surgeons' doors, begging to be morphed into Britney Spears or Pamela Anderson, and adolescent boys demanding Baywatch-style six-pack abs. Some plastic surgeons have claimed that after rumors surfaced about Ms. Spears' splendid new rack, they saw a rise in teen requests for breast implants.

Every generation has its "teens are out of control" phenomenon, whether it's drag racing, rock and roll, drugs, body piercing, tattoos or cosmetic surgery. Is teen plastic surgery a real epidemic, or a media-generated scare? The numbers have clearly been exaggerated. New York plastic surgeon Dr. David Rapaport, appearing on the CBS Early Show, explained that while the absolute number of teens seeking plastic surgery has increased slightly, the proportion -- relative to the overall population of plastic surgery patients -- has actually decreased. Much of the reported "evidence" of the mania for teen surgery is anecdotal. There was the widely publicized story about Jenna Franklin, a British teen whose parents promised her new breasts for her 16th birthday, something she had longed for since she was 12. (The surgeon her parents hired refused, saying "at 16 the breast isn't mature enough, and there are a lot of psychological implications.")

Then there was the cautionary tale -- probably apocryphal -- of a 19-year-old who wanted her "eye wrinkles" fixed. The surgeon balked, and the girl had the procedure done elsewhere, only to return to the first doctor to repair the ghastly results. Daytime talk shows have stoked the supposed phenomenon: According to a survey, the sexy, ratings-grabbing topic of teenage plastic surgery has been the focus of more than 200 Oprah, Sally Jessy Raphael, Ricki Lake and Jerry Springer shows ("I Want Bigger Breasts But My Parents Won't Let Me!") since 1997.

Kate, 17, says her classmates aren't stampeding cosmetic surgeons' offices. "People talk about it, saying they want liposuction or a nose job, but I don't know how many are actually doing it." Kate had a nose job at 16 -- "I always thought my nose was out of proportion" -- and is thrilled with the results. She thinks plastic surgery is a good idea for some young people. "If it's gonna change your confidence, it's worth it."

In the midwest, plastic surgeons say they haven't seen a huge increase in the number of teenagers seeking cosmetic procedures, perhaps because those parts of the country -- compared to New York and California -- are fairly conservative. "In California, it's common to see teenagers getting breast augmentation for a graduation present," says Dr. Brian Windle, an Ohio plastic surgeon. "It's not that common in this market."

Plastic surgeon Dr. George Picha thinks the furor over teenage cosmetic surgery is an overreaction. "Some of [those counted] are teens having cleft lips and palates and other facial defects corrected," he says. It's a stark contrast from Brazil and Colombia, where, Dr. Picha remarks, "girls of 14 or so get cosmetic surgery for birthday presents."

All the doctors we spoke to said they won't perform a breast augmentation on anyone under 18. "They're too young to make a decision," says plastic surgeon Dr. Gregory Fedele. "And there's a good chance there will be changes in the breasts." Rhinoplasty, or nose jobs, are another story: generally, they can be performed at age 16 or so. Surgeons in more conservative areas fully assess young patients' physical and psychological maturity before deciding whether to perform surgery. "Most 14- or 15-year-olds are not ready to handle a surgical procedure," Dr. Fedele says. "Surgery is very stressful -- even for doctors having surgery."

Even if the number of teenagers getting their breasts enlarged and their thighs defatted is still relatively low, many more young people are thinking about surgery as an instant solution to their problems and a fast track to popularity. Tamara Singh, Psy.D., a psychologist who treats adolescents with body-image problems and eating disorders, thinks today's teenagers are more likely to think of cosmetic surgery as a way to bolster their precarious self-esteem.

"In the teen years, kids are pretty emotional, and it's hard for them to separate the emotion from the rationale for doing it," says Dr. Singh. "They think it will be a quick fix. It's a dangerous way to resolve anxiety. It perpetuates low self-esteem." Teens whose parents who are especially image-conscious are more at risk for eating disorders or unnecessary plastic surgery, adds Dr. Singh. She further believes that images in magazines and on television of starved models with perfect, airbrushed complexions make teenagers perceive themselves as flawed. "We have a media culture that pushes extreme slenderness, the ideal woman or man. Even eating disorders are glamorized. We have to tell adolescents that we're all perfect, interesting and unique."

Try telling that to Cindy Jackson, who devoted years of her life and a small fortune to have dozens of operations to look like her childhood ideal: Barbie. "When I was 6 years old, my parents bought me a Barbie doll," Jackson writes on her website, www.cindyjackson.com. "In my imagination, I dreamed of a happy and glamorous life for my doll. Through Barbie, I could glimpse an alternate destiny."

Pamela Zoslov is the Arts Editor of Cleveland Free Times.

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