Dear Michael:

I have had baggy eyes my whole life. It’s not a disfigurement, but it’s always bugged me. So I had plastic surgery to “tighten” them. I feel so different… younger, more confident, happier. I am amazed. I feel so good I have lost the 25 pounds that I have always wanted to and now cute guys are checking me out. I love it. Now my plastic surgeon has suggested that I have Restylane injected into some of my major wrinkles, and perhaps consider a little work to shorten my nose (it’s a big one). What do you think? I am surprised how happy I am as a result of the surgery and wonder if I should continue on this path.

Younger looking in Mission Hills

Dear Younger:

Thank you for emailing me. This is a question I get in my private practice all the time, and I am happy to address it in this column. To me, there is nothing right or wrong about plastic surgery. It is a tool: it cannot bring you happiness or confidence; it can bring you (temporarily) a different appearance. Remember, all plastic surgery is temporary. Eventually, we all age and our bodies and faces will reflect that. The only alternative would be continuous plastic surgery (see: Cher, pages 102-394 of the Plastic Surgeon’s Manual). That said, how do you know whether to start or not? And, for you, how do you know when to stop?

Southern California is a center of body perfectionism. Travel anywhere else in America (the world?) and you are unlikely to see city after city full of people obsessed with pec size, wrinkle lines, gray hair and six-packs. Health and exercise are good, neurotic obsession with physical perfection is not.

The bottom line is: it’s all about body image and how you see yourself. Is your self-image distorted? Does everyone else see a healthy, attractive man while you see that pudgy little boy from third grade? When you look in the mirror, what’s your emotional reaction? Acceptance? Mild criticism? Or is it even too hard to look at yourself in the mirror because you don’t like what you see?

Plastic surgeons often send me clients who are contemplating plastic surgery. The essence of our work is to determine: what do you expect from your surgery? How do you expect your life to change? Do you expect to feel differently about yourself? How? It is my role to help the client see honestly what he or she believes will happen as a result of the surgery. Is it to have a smaller nose or more self-confidence? If it’s the former, then you’re on the right track. If it’s the latter… we have to talk.

Self-confidence and happiness don’t come from plastic surgery, liposuction or an extreme makeover. You can get a great looking body or face out of it, but that doesn’t mean that how you feel about yourself will change. Some people literally feel suicidal when they heal from their plastic surgery. They may look radically different, but still feel like crap inside. All that time, money and pain and they still don’t like themselves, they still feel ugly inside.

Aging is natural. It’s a good thing! We want to live long enough to grow and age and really live. However, in order to sell products and services, our culture has made aging a crime, a mistake, a path for suckers and poor people. We have been brainwashed to believe that there’s something wrong with looking our age. For years, straight women were the targets of this criminalization of aging. Now, gay men are targeted. Trying to continually look younger than we are is a set-up for disappointment and suffering. Our bodies grow and age and change. This is natural… normal… to be honored and even (gasp) celebrated.

I often work with clients referred to me by “ethical” plastic surgeons when the clients really want to change how they see themselves (internal), not how others see them (external). And therapy is much cheaper than plastic surgery! If it’s inner qualities you want to change, you’re better off working with a therapist.

It’s great that you are happy with the surgery you had. It sounds like you used it as a springboard to lose the weight you wanted and now you feel better about yourself. Well done. Your expectations were realistic. Whether you consider more plastic surgery, Botox or Restylane injections, or whatever, please question your intentions and motivations for this or any other alteration to your face or body, and please feel free to email or call me if you want additional assistance in making your decision.