Skin Deep (9 page)

“Beauty doesn't come cheap,” Steve said as they entered the office suite of Aaron Monks.

It was located on the top floor of a handsome four-story office building in Chestnut Hill set back from the highway and surrounded by trees. Dana's first impression was light and air. They stepped through a glass wall entrance into a reception area backlit by windows and decorated in white, gray, and stainless steel, broken up with shocks of color from plants and artwork. Against one wall was a glass tank with elegant tropical fish, hanging in suspension like Christmas ornaments. The intention was to make patients feel relaxed and think
clean
and
fresh.
The kind of office where you'd like to have your face redone.

On the glass and chrome tables were brochures about the clinic and cosmetic surgery. Also a copy of
About Face: Making Over,
authored by Dr. Monks. In another corner was a large floor stand with shelves of various beauty creams. An attractive and exotic young woman sat behind the desk. Her nameplate said May Ann Madlansacay. She recognized Dana's name and handed her a questionnaire. Steve sat beside her as she filled it out. He was in a glum mood which, she guessed, was resentment for her being here. But she couldn't help that.

Across from them sat two women. The older one's face was red, probably the result of microabrasion therapy. The other woman wore a patch over one eye, perhaps in for a checkup following reconstructive surgery. As Dana filled out her medical history, she felt the old Catholic schoolgirl guilt rise like a pimple. The older larger woman was about sixty and would probably kill to have Dana's skin and size six figure.

And the other woman wanted a normal eye again. Dana's own presence here was decadence driven by vanity, she told herself.

Maybe Steve was right: that she had let herself be duped by all the forces that made women discontent with their appearance—forces that commoditized flesh. But, she reminded herself, this may be the only way to get a job that favored youth. Like it or not, we
do
judge books by their covers. And we do vote for the cute kid politician. And we do let ourselves get conned by the baby-faced salesgirl with the nice nose.

Dana finished the form and returned it to the receptionist. After another ten minutes, out walked Dr. Aaron Monks, whom she recognized immediately from television. He was a pleasant-looking man in his late forties, dressed in a crisp white smock. About six feet tall, he had a lean athletic body. He had light brown eyes, dark closely cropped hair, and a small neat head like a cat.

“Nice to meet you both,” he said, and shook their hands.

He had cool lean hands—
delicate instruments,
she thought, that had probably refashioned the faces and bodies of thousands of women over the years. He led them down a bright corridor lined with black-and-white landscape photos. They passed several offices and procedure rooms before arriving at a spacious corner spread with large windows overlooking a pond and golf course in the distance. The windows gave the effect of floating in the sky.

“Can I get you some coffee or cold drinks?” Monks asked, and indicated for them to sit in the cushy armchairs around a glass coffee table.

Dana said she was fine and Steve agreed to water. While the doctor moved to a small refrigerator, Dana surveyed the office. On one wall hung some carved African masks. On another, several framed degrees and plaques from Yale Medical School and the University of Pennsylvania, the College of Cosmetic Surgeons, as well as several professional organizations—the American Board of Plastic Surgery and the American Society of Plastic Surgeons. Also certificates of membership to boards of various philanthropic organizations. Besides being a celebrity surgeon, he had been commended recently for pro bono work on female victims of violence and accidents, also street people lacking insurance and resources for corrective surgery. That impressed Dana.

On a table behind his desk was a photograph of a long white power boat with a palm tree island behind it. And isolated on the rear wall was a single sepia-and-white abstract, which looked Japanese and was probably rare and very expensive like the rest of the décor. Missing were photos of a wife and children. She also noticed that Monks was not wearing a wedding ring.

He handed Steve a bottle of water and sat down staring at Dana, probably calibrating how much work her face needed.

“So,” he said, “what can I do for you?”

“Well, I'm looking into the possibility of getting a lid lift. They're starting to droop, something my mother had”—as Dana continued she could hear the feeble attempt at justifying her needs, her mind flashing on the two women in the waiting room—“I think they make me look older.”

Monks came over to her, pulled up a stool, and slipped on the pair of half-glasses. He studied her face, then pushed back her lids, smoothing back the skin around her eyes. As he did so, Dana couldn't help but study him. Up close he did not appear so young as from across the room. His skin was dry and pocked as if he'd suffered from chicken pox as a child. Crow's-feet crinkled at the corner of his eyes and small pouches and wrinkles underscored each. Also, there was a raised mole on his lower left cheek, looking as if a bug had crawled out of his mouth. His nose was nicely shaped and his lips were full. But frown lines etched his forehead. She wondered why a man who spent his life correcting other people's faces had not had his own done. Do auto body shop owners drive around with dents and broken headlights? The more she ruminated, the more resentful she began to feel. Also the more foolish for being here. This man had built a dynasty on the exploitation of human vanity, but he was above his own craft.

“I'm also thinking of having my nose fixed.”

“Let's talk about your nose first. What about it bothers you?”

“Everything. It's a big, fat Greek nose and I hate it.”

He smiled and turned her in profile. “It does throw off your face.” He ran his finger across the bump. “Do you have any breathing problems?”

“No.”

“Ever break it?”

“No.”

“Then you probably don't have a deviated septum. Should be easy enough to fix—remove the bump and narrow it down.”

“Well, that's down the road a bit. My main question is what a lid lift would do.”

He studied her again, touching her cheekbones and chin, for some reason. Then he felt around her brow, stretching the skin around her eyes. “Upper bletharoplasty would open up your eyes more.” He handed her a hand mirror and with his fingers gently spread the offending skin and in the reflection her eyes did open up. He then smoothed a plane of skin above the brow, eliminating the crow's-feet and the forbidding frown line above the bridge of her nose. “That's with upper lids and Botox for the brow.”

Ten years disappeared from her face.

He pulled down a screen on one wall and from his desk computer projected before-and-after images. “This will give you a better idea. Each of these women had eyelid surgery.”

Several before-and-after images of women rolled down the screen, showing glaring differences as a rejuvenated freshness had been restored to their upper faces. Monks also showed split shots of women with other procedures—upper and lower bletharoplasty, brow lifts, Restylane treatment of the nasolabial folds, cheek implants, chin work, et cetera. Then before-and-after photos of women with rhinoplasty. As the images flicked by, Dana could not help but feel the seductive powers at work—which, of course, was the intended purpose.

“We cannot promise miracles, but you can see the improvement.”

“Some of those women looked pretty young,” Steve said.

“Yes, some are in their twenties in fact. That's because people have begun to regard cosmetic surgery as a preventive medicine against aging. Younger skin is more elastic, the effects last longer, and the recovery period is shorter.”

“But couldn't that encourage obsession?” Steve asked.

“Yes, which is why I make a psychological profile of patients before I operate. One woman who came in was only twenty-seven yet had sixteen surgical procedures. She was a slave to the scalpel, and had spent a fortune.”

“What did you do for her?”

“Sent her home. She needed a psychiatrist, not a surgeon.”

“I imagine all the makeover shows haven't helped,” Steve said.

“No, especially with women wanting to have Nicole Kidman's nose or Angelina Jolie's lips. We also turned away a woman who was obsessed with wanting to look like Jessica Simpson. She had had several reconstructive procedures and was still not happy. She couldn't pass a mirror without being sick at how she didn't resemble the singer.”

“That sounds pathological.”

“Yes, technically a form of body dysmorphic disorder. So, when people come in with photos of the features they want, I tell them that they may be disappointed because we cannot guarantee the exact likeness. And unless they accept that, I won't operate.”

“Is it mostly women?”

“We get an occasional male.” He tapped a few keys. And on the screen appeared a man with a slick black pompadour and a hurt truculent expression. “Rodney is an Elvis impersonator.”

There was a resemblance but mostly in the hair, eyes, and huge white sequined collar.

“That's before.” Monks tapped a few more keys and the screen split with a shot of Elvis Presley on the right and Rodney on the left. It was nearly impossible to tell the difference. “Of course, he had to have had some basics to work with—forehead structure, cheekbone width, length of jaw. It's much harder to take down bone than build up, which can be done with fat injections and implants. That's what we did here.”

“Amazing,” Dana said, staring at the screen. “And you probably added another twenty years onto his professional life.”

Monks moved his mouse and clicked a few keys. “Particularly challenging was this fellow.” On the screen was the image of a rather ordinary-looking man with a short wide nose, long narrow face, and thin lips. Then Monks clicked the mouse and the next slide was a glamour shot of a beautiful woman with golden hair, large open and heavily made-up eyes, high cheekbones, and full red lips.

“My goodness.”

“What's interesting is that he didn't want to look like any particular woman, he just wanted to look feminine, which meant some alteration of his facial structure in addition to his eyes, lips, and nose.” Monks clicked the mouse, and more shots of the man followed in a cocktail dress with short blond hair, in kabuki whiteface and kimono, in leather bondage attire and shiny black hair, and in a huge blond fright wig and lavish makeup.

“A drag queen,” Steve said.

“Yes, and an internationally famous one who does performance theater with a traveling dance and theater company. The challenge was to create female features out of his.”

“Looks like you succeeded,” Steve said, “but it sounds confusing.”

“Well, these men aren't attempting to pass as women except as a hobby or professional art form—as opposed to some private sexual identity thing or gender dysmorphia.”

“Back to Dana,” Steve said. “Where would the procedures be done?”

“Right here. We have our own operating room down the hall and OR staff, including an anesthesiologist and nurses, which, by the way, makes procedures a lot cheaper than at a hospital.”

“Since you raised the ugly stuff,” said Steve, “what about cost?”

Monks smiled. “We do have a financial assistant, but since you asked, for upper lids our standard fee is four thousand.”

“What about a nose job?”

“Seventy-five hundred.”

So much for that,
Dana thought. “What about removing crow's-feet?”

“Any that remain would be a matter of collagen treatments, which is three hundred dollars per procedure.”

“And the nasolabial folds?”

Monks smiled as he studied her face. “Four hundred.”

“A brow lift?” she asked.

“Frankly, I don't think you need that, but our standard fee for a full brow lift is four thousand.”

“Not that I'm considering it, but what does a full face-lift cost?”

“Twenty-five thousand.”

“Oh,” Steve said, probably thinking that four of those a week would equal his annual salary. Also wondering who would pay.

“Yes, it's expensive, but consider the fact that in New York the same procedure can be thirty-five thousand and in Los Angeles you can pay as much as fifty. By comparison, in, say, Big Horn, Montana, you might find a clinic that advertises face-lifts for under three thousand.”

“Yeah, and probably end up looking like a sheep,” Steve said.

Monks laughed.

“Frankly, what do you think I need?” Dana asked.

He studied her for a few moments. “Well, you came in here for your upper eyelids in the hope of creating a rejuvenating effect. You also mentioned rhinoplasty. Then you asked about the brow and frown lines, then crow's-feet and nasolabial procedure. You then speculated about a full face-lift.” He rocked back in his chair and glared at her. “I don't think I can operate on you.”

Dana felt her insides drop. “What? Why not?”

“Because you're not settled on what you want.”

Steve tried to repress a self-satisfied grin.

“But what about just the upper lid lifts?”

“Given your expectations, you might be dissatisfied. Your eyes would look great, but they might appear incomplete with your nose and brow. Or you may start wondering about chin work or something else. I can't live with that.”

Dana was dismayed. “I was just speculating about the other procedures. I think I want the upper lid lift and maybe a nose job if I can afford it.”

“Then maybe you should settle in your mind what exactly you want and can afford.”

“So, where does that leave me?” She could hear pleading in her voice. She could not believe that the same man who did pro bono work for street people was playing hardball with her.