Facing a nip-and-tuck craze

Warren Gerard December 11 1978

Facing a nip-and-tuck craze

Warren Gerard December 11 1978

Facing a nip-and-tuck craze


Warren Gerard

The pink, playful nudes on canvas are perfectly formed in the artist’s fantasy and brush strokes; not a wrinkle blemishes their nubile bodies. But in contrast, the floor-to-ceiling mirrors (mirror, mirror on the wall) reflect and reinforce the images of the sagging psyches and faces of those who wait. The reception area of Dr. Harold Silver’s self-contained hospital in a suite of rooms at the Royal York Hotel in Toronto is a psychological masterpiece.

The atmosphere is suggestive. The promise is that sagging faces can be straightened, at least improved, that baggy eyes can be tightened, lines and

crow’s-feet made to disappear, that psyches will be repaired and self-esteem restored. And it’s a promise kept. A face-lift makes a person look younger, feel better—and more and more people are having it done: Canada is on the verge of a boom in cosmetic surgery—a spill-over from what is happening south of the border, where such personalities as Phyllis Diller and Betty Ford have told all and incited something of a cosmetic surgery craze.

Silver, a talkative, articulate maverick in a tight-lipped profession, confirms the trend. He is the busiest and

best-known cosmetic surgeon in Canada, but others back him up. Business is exploding. And it is something that is no longer the mark of vanity only among the rich, the show-biz personalities and aging politicians. Silver has peeled away the years on truck drivers, laborers, office workers, housewives, businessmen, writers and teachers. Ordinary people.

It’s relatively old hat in the United States, where transformations such as that of former first lady Betty Ford after a recent face-lift are enough to send thousands of men and women flocking in search of the same dramatic effect. There hasn’t yet been such a stampede in Canada, which might be

just as well considering that, of this country’s 183 plastic surgeons, only about a dozen specialize solely in cosmetic work. It’s not an easy task to find one either, as most are in Toronto and Montreal, and only three or four practise in the West. Many plastic surgeons, however, perform some cosmetic surgery. In the U.S., especially in California, there have been cases of abuse, but that’s not something to worry about in Canada, where cosmetic and plastic surgeons cautiously regulate their own art.

The face-lift boom didn’t happen

overnight. Silver says it has to do with our youth-oriented society (young is beautiful), the constant blitz of young faces on TV and at the movies. “People are much more conscious of how they look today,” he says. “Look at all the people jogging. You didn’t see much of that 10 years ago.” To prove his point, Silver reveals that teachers, more than any other occupational group, go to him for face-lifts. “Every day of their working lives they are exposed to young people. They become very aware of the young.”

Twenty years ago, cosmetic surgery

was not talked about. Like hemorrhoid surgery, it wasn’t considered in good taste. There was a moral attitude, too— that what God has made, man should not tamper with. But that’s changed. And perhaps no one is more responsible for the change in public perception than Diller, the fright-wigged, wishbone-legged comic of “Fang” fame, who had a face-lift, eye de-bagging and breast reduction. She made a stand-up routine of her new face, which, before surgery, she boasted, could “make small children cry.” Now, she says: “My health is better, my whole body feels better. You look in the mirror each morning and get the message of the day. I don’t have to decode it now.”

More recently, Betty Ford went through her own renaissance when she overcame a dependency on alcohol and drugs and then rewarded herself with a face-lift. It tightened up the chin and neck and erased the puffiness around her eyes. She is a changed woman, inside and out, and she talked about it frankly to the American public.

There’s less talk about such things in Canada (which Silver says is typically Canadian) but recently, Betty Lee, a Toronto writer and editor, told all about her face-lift in a magazine article. “I wanted to get it out in the open,” she says now. “I wanted to know once and for all why I did it.” Today, Lee looks 10 years younger, feels refreshed and has found out why she did it—for self-esteem.

There’s another change. Most surgeons like Silver, who practise only cosmetic surgery, have moved out of hospitals into their own clinics. The advantages are immediate. The surgeon has complete control over his environment and the patient feels better.

Silver has found dramatic changes in his patients over the years. Twenty

years ago, 99 per cent of his patients were women between 50 and 65 years of age. Now the average is between 30 and 45—and 20 per cent of his patients are men. “At one time I thought what I was doing was not valid,” says Silver, “because the feeling was that if patients got themselves together as total entities, they wouldn’t be preoccupied with their physical appearances. But today there is less of a taboo on it. I never ask a patient why he or she wants a facelift; I ask them what I can do for them. I let the patient justify it to himself.”

For consultation, Silver takes his pa-

tients into a mirror-walled room and makes them show him what it is they want done. “I see whether they are fit for surgery and I decide whether I can give them what they want,” he says. “Cosmetic surgery is the esthetic improvement of a normal person. I have to improve them in a way you can’t tell. Most people are realistic. I won’t operate on someone who wants to look like someone else.”

Face-lifts and nose jobs (rhinoplasty) are the most commonly performed cosmetic operations. They take from 30 minutes to one hour under local anes-

thetic and the patient can go home. Recovery period—that’s while you hide indoors—is anywhere from two to three weeks. In the nose job, unwanted nasal bone and cartilage are removed from the inside of the nose. The bones are broken at the base of the nose with a small chisel or saw and then drawn together and the nose is reshaped and sutured.

The face-lift is designed to remove skin that has lost elasticity with age (the younger the patient, the better the results), producing sags and wrinkles. A vertical cut is made in the scalp in the temple region, down in front of the ear, and back up behind the ear on each side of the head. The skin is “undermined” with a scalpel to separate it from underlying fat and muscle and then stretched toward the back of the head until the wrinkles and sags disappear. Excess skin is trimmed away and the rest is sutured around the ears.

For breast augmentation, the surgeon makes a small incision in the fold under the breast, then enlarges the opening to insert a silicone bag containing a plastic gel. He then molds it to the desired shape. Other procedures involve hair transplants, in which small plugs of hair-growing skin are removed from the back of the scalp and re-implanted in the front. Stomachs, thighs and buttocks can also be cut to size, but this is a hospital procedure, involving a stay.

Silver, like most doctors, is reluctant to discuss his fees. In fact, he becomes angry when the issue is raised. “Fees depend on the sort of surgery, the age of the patient, the extent of the surgery and the experience of the surgeon,” he says. But generally, a full face-lift eosts from $1,000 to $2,500 and, along with eyelids and forehead, it’s from $2,000 to $4,000, plus $250 for operating room costs. Betty Lee, who had a face-lift, including chin and eyes, paid $3,000.

A nose job will cost from $700 to $1,500, including $150 in operating room fees. Eyes, upper and lower, cost from $500 to $2,000. Breast enlargement costs from $750 to $2,000, plus $200 for the silicone implants, plus operating room costs. Some surgeons will charge up to $600 for breast reductions, but because it’s considered a physical problem, Ontario government medical plans will pay $380 for the procedure. Prices are slightly lower in Montreal, but in New York they are two, three, four times higher.

Silver’s mark of success is a patient who doesn’t look dramatically changed and who is happy with what has been done. Her friends, his friends, should be able to say: “You know, there’s something different about you, but I’ll be darned if I can figure out what it is. Anyway, you look better.”