50 Years of Helping Faces of All Ages Smile New York Times November 13, 2005 It was a celebration of imperfection. George Barboza, 31, who was born without a left eye and underwent one operation after another on his face and his left hand, supplied music, playing piano in the corner. Devin Jae Fantauzzi, 19, sat at a table loaded with balloons and candies, eager - after a lifetime of operations to correct her cleft lip and palate - to make a speech, to be the center of attention. And there was Gisela Dossey, 41, who carefully described her old face - the caved-in middle section, beak-shaped nose and bulging eyes of someone with Crouzon syndrome. She let her new one, courtesy of the doctors at the Institute of Reconstructive Plastic Surgery at New York University Medical Center, speak for itself. "I think they did a heck of a job," Mrs. Dossey said. Those three and about 100 of the institute's other patients gathered in a banquet room yesterday at the Union League Club, on 37th Street near Park Avenue, for a reunion of sorts. Each year, the institute, which is marking its 50th anniversary, treats thousands of children and adults who are physically disfigured. Many, like Mrs. Dossey, were born with severe facial defects that impaired their ability to breathe or eat. They were the outcasts of a society obsessed with supermodels and extreme makeovers, often heckled as children and ostracized as adults for their deformities. Yesterday, they came with family members to thank the institute's doctors, nurses and staff members for performing operations and providing services that helped them blend in a little better. They spoke of the hardships of their lives before surgery - the stares in restaurants and the torment in school, the feelings of guilt and shame - and of brighter futures afterward. Plastic surgery was not something they underwent to look more beautiful, but more normal. But they learned something about the nature of beauty along the way. "You can be as pretty as you want to be on the outside, but if you're ugly on the inside, it'll show on the outside," said Ms. Fantauzzi, 19, who is now studying communications and public relations at Valencia Community College in Orlando, Fla. "I don't think people understand that." Patients like Ms. Fantauzzi confidently stood at a lectern at the front of the room to tell their stories. Some showed slides of their old faces and their new lives as they read prepared remarks. Nearly everyone had a scar and a tale with a happy ending. People openly discussed how they used to look, some talking humorously about their noses, their eyes, their lips. But they spoke with tears in their eyes about the gratitude they felt to doctors and to their own families. Packages of tissues had been placed at every table. Mrs. Dossey, who lives in Cincinnati, said her defect was like a blessing, making her work harder at everything she did. She told institute doctors, who performed nine operations on her, beginning in 1985, that all she wanted was to look generic, to blend in. "Thank you for this package," she said, during one of about two dozen presentations from patients. "I really love it." Sage Volkman was just 5 years old when she lost her nose, all of her fingers and an ear in a camper fire in New Mexico in 1986. She had third- and fourth-degree burns on more than 70 percent of her body. Doctors at the institute have performed most of her 78 operations. She is now a 24-year-old graduate student at the University of Utah in Salt Lake City, and says she wants to spend her life counseling burn victims. Her father, Michael Volkman, 60, said his daughter was a fighter who shrugs off stares. "If you have a problem with the way she looks, it's your problem, not hers," he said. A couple of tables away sat Tina Walsh, 41, and her 9-year-old son, Brendan, who was born with Crouzon syndrome, as were many of the patients at the institute. Ms. Walsh said that after he was operated on in 2000, children did not stare as much at Brendan, who is in the fourth grade at River Elementary School in Patchogue, N.Y. "The greatest gift that they've given to children and young adults is the gift of fitting in," she said of the institute. The institute receives financial support from the National Foundation for Facial Reconstruction, a nonprofit organization. Through the foundation's funding and the donated time from doctors, many patients pay little or nothing for their treatment, depending on their financial need. "There isn't a division between the haves and the have-nots here," said Dr. Joseph G. McCarthy, the director of the institute. Dr. McCarthy, 66, a professor of plastic surgery at the New York University School of Medicine who performed many of the patients' operations, walked through the room yesterday, hugging old friends and colleagues. He was part of a crowd of parents and children who stood around a cake with big "50" candles atop its white icing. The group sang "Happy Birthday," and then several children, children with smiling faces, blew out the candles. Cheaper Cosmetic Surgery for the Eyes – Surgical Eyelifts ABC News Nov. 11, 2005 Do your eyes make you look tired? There's a way to get rid of those dark circles without surgery. There's no surgery, but a very big needle. Seven's On Call with Dr. Jay Adlersberg. Cosmetic fillers are gaining in popularity -- most of them are used in the lips and in the laugh lines that go from the nose to the mouth. Now, an expansion of their use to under the eyes. Our eyes are a mirror to well,our age and many of us want to look younger. Recently, plastic surgeons have begun using a new filler that eliminates the appearance of sunken eyes. They need no incisions, no sutures and no dressings. An injection is the alternative, the choice for 28-year-old Emily Ross. First, doctors apply a topical numbing cream. Then, Emily's nonsurgical eye lift begins. The plastic surgeon pokes and pricks underneath Emily's eyes. Inside the needle is hyaluronic acid. A carbohydrate component that's found almost everywhere in the body. When doctors do a standard eye lift, they cut into the eyelid and remove fat. That makes the bag smaller. In this nonsurgical injection, the goal is to camouflage the bags by filling in the depression under the eye. Dr. Mike Nayak, Facial Plastic Surgeon: "You would think that we would've understood this long ago. You know, hey, fill the valley, the mountain doesn't look so tall." But the affects are temporary. The filler can lasts anywhere from three to six months. The cost? Approximately $500 per syringe and more than one might be needed. But it is a brief procedure that takes only 20 minutes to get done. Emily Ross: "Oh, I think it looks good. I can see where its filled in on both sides." Within the hour, Emily is back at work. The side effects known so far are minor: some bruising and swelling that disappears quickly. There are several fillers on the market and more on the FDA pipeline waiting for approval. The hyaluronic acid fillers don't cause allergies but others may so people should discuss them carefully with their doctor. And one should also make sure, the person administering any facial injection is a well trained certified doctor. Cosmetic Surgery 'Concierge' Helps Connect Patients With Doctors The New Service May Be Appealing, But Approach With Caution, Doctor Says WABC - TV Nov. 14, 2005 Rather than try to select a plastic surgeon on her own, New York City resident Barbara Zacco sought out "cosmetic surgery concierge" Wendy Lewis before having a facelift. "She's my guidance through this process, she's the one I bond with," Zacco said. As the demand for cosmetic surgery increases, people like Lewis are helping potential patients connect with doctors -- for a fee, of course. Lewis not only serves as a referral service, she also does all the tedious pre-op research and helps with follow-up appointments. She says her international database of doctors numbers more than 22,000, and includes plastic surgeons and cosmetic dermatologists. "If they wanted to have something done in L.A., but live in London, I know how to find a doctor, how to make arrangements," Lewis said. For example, Zacco lives in New York but wants to have the surgery performed in Florida where she can recover at a friend's house. But she doesn't know any physicians in West Palm Beach. "It's nice to be able to have someone to bounce ideas off that is confidential -- not necessarily your best girlfriend and not someone who wants to know every detail of the whole cosmetic surgery history and experiences with it," Lewis said. Lewis is not a physician, but has worked for plastic surgeons and regularly attends international medical conferences. She doesn't receive fees from doctors; instead she charges clients $350 for an hour's consultation, or a $1,000 for the full package. Patients should use caution when hiring a cosmetic surgery consultant, said Dr. Bruce Cunningham, director of the Division of Plastic and Reconstructive Surgery at the University of Minnesota. He also is president of the American Society of Plastic Surgeons. "Just like everything else, you have to be concerned about conflict of interest and multiple agendas going on at the same time," said Cunningham, responding to reports that some consultants may really just be working for a handful of doctors. "There are no regulations that guide them. They really can do whatever they want." And just like a patient needs to check the credentials of his or her surgeon, the patient also needs to check the credentials of the consultant, Cunningham recommended. Zacco, meanwhile, says she feels that the money is well spent. "Rather than go to an unknown doctor who may not be good for me, I insured myself by going to someone well qualified," she says. An alternative to the traditional face lift Wisconsin State Journal November 13, 2005 As a mortgage broker and saleswoman, Diane Braun of Middleton is often in the public eye and likes to look her best. When Braun's friend went to Dr. Brad Lemke, a Madison ophthalmologist who is also board- certified in facial plastic surgery, Braun, 58, told her, "Ask him about taking off my turkey gobbler." She was referring to excess skin under her chin. A few days later, Braun had a consultation with Lemke, who told her that while he could do liposuction on her neck, she might be interested in a new wrinkle in cosmetic surgery, called Contour Threads. They are a minimally invasive rejuvenation technique approved by the U.S. Food and Drug Administration for foreheads and faces in 2004 and for necks in 2005. "I saw him on a Thursday and went back on Tuesday and had it done," Braun said, "because the opportunity came along and I don't like getting older." With technology developed in the early '90s at Duke University in North Carolina, Contour Threads are sutures made of clear polypropylene, and they have tiny barbs spaced evenly apart. They can be used to lift sagging cheeks and eyebrows and tighten flesh under the neck. Contour Threads are made by Surgical Specialties Corp. of Reading, Pa. Using a 7-inch-long needle, a cosmetic surgeon doing a midface lift makes a tiny incision close to the ear and threads the needle towards the chin and jawline. The threads are always put in pairs, so they can be tied together at the incision site. Then down at the jawline, where the threads emerge from the flesh, the surgeon holds the ends with one hand, and with the other hand pushes the skin up on the threads so that it catches on the barbs. Once in position, the body generates new collagen bundles that surround each thread to help maintain the lifting effect. Braun underwent a full face and neck procedure, with 16 threads used, under local anesthesia. It took 2 to 3 hours. "I can't say it was painless. It was like going to the dentist," Braun said. "I don't like going to the dentist either." Lemke also did liposuction on Braun's cheeks and under her chin. His fee was $3,700, including $350 per thread. "I'd say it's different from a facelift. It's only a touch-up," Braun said. "Most people don't notice." She is happy with the results. "A friend I hadn't seen for a year said, you look refreshed, like you just got up from a nap," Braun said. "The main reason I did it is because I work with the public on a daily basis, and I enjoy looking nice." Lemke, who underwent special training in the procedure, has installed Contour Threads in seven patients since he began offering them in July. He is the first cosmetic surgeon in south central Wisconsin to offer them. "It got a boost earlier this year when a patient appeared on the 'Today' show, and it's been on Oprah a few times," Lemke said. "I've been telling patients it might last half as long as a faceflift and it costs half as much." Lemke said installing Contour Threads "is similar to a conventional facelift, but without the incision. It's very exciting for younger people who don't want the incision yet. It's good for people who don't want to have the amount of downtime of a conventional facelift, where you have to wait for the swelling to go down." Moreover, a Contour Threads patient can go ahead and have a conventional facelift in the future, or repeat the threads procedure, he said. "I don't think it replaces a facelift, but it's something we can offer that falls between surgery and skin treatments," Lemke said. "It increases the spectrum of possibilities for people. For people in today's active lifestyles, it is a useful new treatment that allows less recovery time, so people don't have to interrupt their lives as long. "Some patients go back to work in a couple of days, if they're not meeting the public. You need a week or two off, if you're meeting the public, because there might be bruising or swelling. I tell people, about a week." No more droopy eyes Another Lemke patient, David White, is a 63-year-old corn and soybean farmer from Lena, Ill., about 20 miles southwest of Monroe. Married with three grown children, he was set on the road toward cosmetic surgery after undergoing surgery to correct nearsightedness and astigmatism. He told the surgeon, "My eyes are droopy," and the surgeon recommended Lemke. Lemke performed a conventional eyelid lift on White about two years ago, but White said, "you can only do so much with the eyelids before you have to think about lifting the brow." So in July, White went back to Lemke for Contour Threads on his forehead to lift his eyebrows, and a simultaneous conventional facelift. "It helped my appearance. I think we got a very favorable result," White said. "The face lift was a lot more painful than the browlift. You do have swelling and pain from the face lift for about a week, because there's quite a bit of cutting in front of the ear." He hasn't told his children yet. "I guess maybe I thought they'd think it was silly and senseless," White said. His 67- year-old wife, who has not had cosmetic surgery, supported his decision. "She said I look rested," White said. He has no regrets. "I think for my age, I look as good as I can. Like they say, when you look your best, you do your best. When you look good, you feel good." More beautiful in any color More nonwhite women are getting cosmetic surgery, raising questions of cultural ideals of beauty. The Orange County Register November 14, 2005 Ever since she was 12, Michelle Tran's family has constantly urged her to "fix" her "mat hi," or "little eyes." "They would tell me, 'Go get (eyelid surgery), so you can be pretty,'" said Tran, now 19, of Westminster. Her mom did it. So did her aunts and cousins: eyelid surgery to make their eyes larger and rounder. Rhinoplasty to get their noses higher and thinner. And breast augmentation, too. Ten years ago, the Tran family's love for cosmetic alteration would have been considered rare. Until the late 1990s, cosmetic surgery was primarily a white, upper-income phenomenon. But today, the Trans are among the growing number of nonwhite women who are getting cosmetic surgery, taking advantage of new procedures and specific catering to patients of color. According to the American Society for Aesthetic Plastic Surgery, people of color now account for 20 percent of all cosmetic-surgery procedures, up from 14 percent in 2000. "All kinds of people see reality TV programs like 'Extreme Makeover,' which shows women from all different backgrounds getting plastic surgery," said Dr. Malcolm Paul, a plastic surgeon based in Newport Beach. "It becomes a validated choice and has led to a general acceptance of plastic surgery among all (women) now." On radio stations such as KPWR/105.9 FM, which has a predominantly Hispanic audience, advertisements for affordable cosmetic surgery are abundant. In Little Saigon, dozens of Vietnamese magazines display sprawling front-page color ads for cosmetic surgery featuring sculpted models. Paul, who has been in practice for 30 years, said an increasing number of his patients are of Hispanic, Middle Eastern or Asian descent. Popular procedures requested by Paul's Hispanic and Middle Eastern patients include liposuction, tummy tucks, rhinoplasty and brow lifts. Asian women often ask for blepharoplasty, or eyelid surgery, to create a crease or fold in their upper eyelids, Paul said. And because the women ask for rounder eyes and higher noses – features associated with "Western" or European people – the culturally loaded question that some inevitably wonder is: Is this an attempt to look "less ethnic" and "more Anglo"? Co-workers Jean Park and Shelly Moon had their cosmetic surgeries on the same day last week. Park, 34, of Irvine opted for multiple procedures: a nose reduction, chin implant and breast implants. "My husband likes (it) very much," Park said, giggling as she pointed to her new chest. "He didn't know about the nose job, though, until after. He was mad at first, but now he's very happy." Moon, also 34, of Rancho Santa Margarita had lower-eyelid surgery to remove the dark, puffy bags underneath her eyes. The real-estate agents, both of Korean ancestry, scoff at the idea that they aspire to have "non- Asian" features. "Even in Korea, plastic surgery is very popular," Moon said. "I had friends here who would fly all the way to Korea just to get cosmetic surgery, but now there are plenty of good places to have it done here." "It doesn't matter what color you are – every woman wants to look younger and prettier. That's it," she added. Both women said many of their friends and family have already had cosmetic surgery. In fact, it was through Moon's friend that they were referred to The Image Center, a one-stop shop for plastic surgery, cosmetic dentistry and spa treatments in Huntington Beach. The nearly 3-year-old center is owned by Dr. Peter Newen, a plastic surgeon, and his wife, Dr. Katherine Ahn, who specializes in cosmetic dentistry. About 70 percent of their patients are Asian, mostly Korean and Vietnamese. "It's disturbing to characterize women getting plastic surgery as an attempt to change their ethnicity," Newen said. "To say that a woman is trying to look more 'Western' suggests that ethnic women are inadequate – that being ethnic is unattractive and being white is." Yasmin Davidds, author of "Empowering Latinas," a Hispanic woman's guide to self-love and a healthy body image, offers another take: "As ethnic women become more Americanized, they are creating their own unique, ethnic- Western look," Davidds said. "It's part of assimilation. They are combining the best of both worlds by integrating the best features of each culture. The goal of many ethnic women (getting cosmetic surgery) is to enhance their natural ethnic beauty." If anything, the women are trying to look more like their peers, Newen said. "If you look at the spectrum of Asian women, not all have the single eyelids or wide and flat noses," he said. "There are many Asian women who have the round eyes naturally." The women come in bringing magazine photographs of famous Asian pop singers and soap stars for inspiration, Ahn said. For Cristina Martinez, who got breast implants at 19, the goal was actually to look more Hispanic. "Latina women are known to be curvy, and I had the butt but not the boobs," said Martinez of Costa Mesa. "I just wanted to balance it out and, of course, feel sexier." The 29-year-old clothing designer also had her ears tucked seven years ago. "It's just about trying to look and feel better – something every woman wants," said Martinez. Still, after years of urging from her family to get cosmetic surgery, Michelle Tran said she won't be caving anytime soon. "I like my eyes," the UC Irvine student said. "And I like the fact that I'm the only girl in the family who even looks like my grandmother anymore."
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