Plastic surgery before
The following is a list of things I don’t like about my face: My head is enormous and orthogonal, Fred Flintstone-esque from certain angles. This has rendered many fashionable accouterments untenable. I lengthen the circumference of my ball caps as far as possible, and purchase only the widest, most square-inch-consuming rectangular frames at Warby Parker.
My eyes, perhaps because they are dwarfed by the expansive surrounding flesh, have always been a bit on the small side—their fullness obscured further by droopy, somnolent eyelids, almost like I’m fresh out of a hotbox. (An 11th grade teacher once referred to them as “beady,” and I haven’t been able to love them since.)
I’m basically satisfied with my nose and chin, but like so many Americans who’ve yet to fully fight off their pandemic bloat, a stubborn sliver of loose neck-fat desecrates my profile—always surfacing in humiliating ways when others tag me in Instagram candids.
I wrote these confessions down in a blank Gmail draft while traveling to the Upper East Side for my inaugural plastic surgery consultation. It occurred to me that the doctor was going to ask me what I’d like to change. I needed to get my complaints in order.
Her name is Dr. Dara Liotta. She specializes in rhinoplasty, is certified by the American College of Surgeons, and graciously agreed to ease me through the delicate psychophysical rudiments of a cosmetic surgery appointment. We weren’t scheduled for a full-blown surgery—she was simply going to tell me what she’d do if we were. I did not know what to expect, other than that it seemed unlikely Dr. Liotta would find my craniofacial structure perfect, no adjustments necessary. In fact, nobody in my life has ever offered me a precise accounting of the things they would change about my body, nor have I asked.
I possess my own private theories of what is wrong with my appearance—as taxonomized above—but have largely restrained them to my inner monologue; grist for the occasional self-esteem flatline that occurs, oh, once every three months or so. Furthermore, I’m a 32-year-old cisgender heterosexual white dude who was raised absent the terrorizing institutional dysmorphia that parents and media of a certain generation impart on daughters, which is to say that I feel extremely privileged to spiral about my body as infrequently as I do. (I’m also over 6 feet tall, which seems relevant enough to mention here.)
Dr. Liotta, therefore, was destined to humble me in a way that society rarely has. You could say that I, and the rest of the men at my station in life, had it coming.
There are people I know who have memorized the entire plastic surgery catalog—facelifts of all dimensions—in order to better accustom themselves with the many ways money can purchase beauty. An entire subcategory of the celebrity-gossip media industry breathlessly documents the fluctuations of Kardashian-Jenner silicone deposits, inflating and deflating over time, serving as an immensely satisfying reminder that professionally good-looking people suffer from the same corporeal self-loathing as the rest of us—they just have the financial means to take action.
Again, this is not exactly my expertise. Like a lot of other men, I made peace long ago with the fact that I will always occupy the thickest band of the attraction bell curve, and never felt a strong desire to investigate how a scalpel could juice a 7 to a 7.5, or maybe even an 8. But it is true that millennial men are generally more aesthetically concerned than our forefathers, and despite that hard-fought truce, I couldn’t help but feel a need to impress Dr. Liotta; to bring my apex self—what incels call “looksmaxing”—into her office. That means I emerged from the Lexington Avenue/59th Street stop in full first-date regalia. Chambray shirt, salmon-hued J. Crew shorts, a pair of Lacoste sneakers, hair pomade-smeared and sheeny, sunglasses perched over my beady little eyes. It was an attempt to make her diagnosis as difficult as possible, stacking the deck, like eating nothing but cucumber slices in the nervy weeks before bloodwork. She could call me ugly, but I wasn’t going down without a fight.
If you are unfamiliar with New York City geography, you should know that there are literally hundreds of plastic surgery offices dotting the Upper East Side. It’s the city’s very own cosmetic capital; a blitz of Sunset Boulevard in deep Manhattan. Dr. Liotta’s office is located in a festooned marble apartment building—nestled among the stately brasseries and sushi counters—along a leafy stretch of Park Avenue. The doorman directed me to the basement, where the baroque residential interior gave way to antiseptic, soft-gray hospital corridors. Sure enough, after darting down the stairs and opening a door bearing Liotta’s name and title, I was indeed standing in the middle of the most beautiful waiting room I’ve ever seen. It possessed the contours of a second-floor VIP lounge. A place of proud wealth. Circle-and-square Rothko imitations splashed across the walls, providing a tasteful backdrop for the lush, extremely designed interior; bronze couches and polished coffee tables, a mini-fridge brimming with Fiji water. All of the typical dreary elements of a doctor’s office were missing. I couldn’t find any dilapidated back-issues of National Geographic, nor was there a ceiling-mounted TV blaring PBS children’s programming. In fact, the only real idling entertainment was a thick, goldenrod book containing Andy Warhol’s finest paintings, and a vast network of Sonos speakers tuned to a millennial-lite playlist: One Direction’s “Best Song Ever,” Nicki Minaj’s “Starships.”
Perhaps this is what it’s supposed to feel like when you seek out surgery for brazen vanity, rather than to, say, repair a hernia or widen an artery. Fun, sexy, chic, and unapologetically indulgent; an arena to own your desires, to experience radical selfhood. Unlike all the hospitals I’ve been inside, this place had never witnessed death. The receptionist told me to make myself comfortable, and that Dr. Liotta would be with me in a moment. As I bided my time, a woman in her mid-50s emerged from her own consultation bound by a pillowed neck-brace, gingerly keeping her head parallel to her body. Three words were printed on the back of her magenta hoodie: “YET TO COME.”
A nurse fished me out of the waiting room and escorted me down the hall and into a far less seductive medical chamber, one flanked by a sink and reams of identical cabinets—exactly like every other place you’ve ever had a checkup. I took a seat in the examination chair, and soon afterward, Dr. Liotta, in green scrubs and ears full of diamonds, was hunched over my pores, gently tracing a vertical line down the diameter of my face with a Q-Tip.
She tells me that about a fifth of her patients are men, and are often around my age, which is a marked change in the cosmetic industry. Her theory is that men of my generation have grown up in an environment where plastic surgery has become more accepted and gender-neutral, and therefore more relevant to their own individual pursuits of happiness. In 2018, more than 1.3 million men underwent a cosmetic procedure, with rhinoplasty being the most popular option by far. It felt good to know that I’m not an outlier and that my concerns are part of a broader national anxiety; a modern man, after all.
I outlined my maladies to her (head too big, eyes too small, jawline betrayed by body mass index). Liotta informed me that science has not yet developed a head-shrinking procedure. However, she could think of a few ways to soothe what ails me. The Q-Tip circled down my temple and primped up the corner of my left eyelid. Liotta diagnosed me with something awful-sounding: It’s called “ptosis.” The p is silent.
Ptosis is the medical nomenclature for an eyelid that hangs loose over the orbital bone, obscuring part—or all—of the socket. It affects 1 out of every 842 children at birth, and is almost entirely harmless from an epidemiological perspective. A doctor would only be moved to fix it if, for instance, a patient has wandered into a plastic surgery practice, curious to know why their eyeballs don’t possess a more crystalline smolder.
“You see how the lid is hitting your eye?” said Dr. Liotta, now holding a barbershop mirror in front of me, demonstrating how the flap of skin swoops low and sabotages my gaze. Cosmetic surgery, she continues, is all about light. The scalpel cannot bless you with an entirely new face—you cannot pluck a George Clooney or a Ryan Gosling off the rack—but it can affect the way the visible spectrum bounces off our skin.
“We perceive light as awakeness or aliveness,” she said. “We want to see as much of it as we can.” So, with a bit of tweaking, a surgeon could pin my lashes deeper into my head, allowing a greater density of light to reflect from my pupil—making my eyes appear brighter, and ideally, bigger. Decades of amorphous subconscious thought suddenly emerged into shocking clarity; She’s right! I do always squint when I smile, don’t I? At last I had something to blame, and its name was ptosis.
It went on like this for 20 minutes. Dr. Liotta would path around my face with the Q-Tip, denoting various problem spots and earmarking areas of improvement, always making her suggestions in a custodial, therapy-like timbre. Liotta is a master of two sciences, she told me. The dissection of faces, and the gentle tact necessary to dispense her insight on sensitive matters. Speaking of which, Dr. Liotta paused at my nose—the fulcrum of all cosmetic surgery—and announced, ominously, that the shape is “not bad.” Not bad? I thought. Why not good? Or great? Well, “You see how it comes down this way?” she continued, gesturing toward a slight rightward slalom that tumbles down from the bridge to the nostrils, a flaw I was aware of in some abstract sense, but had never articulated into reality. If Liotta were to straighten my nose—which is to say, fracture the bones and cartilage beneath the skin, allowing them to knit back together in a manner more agreeable with the rest of my facial geometry—then the “light will appear where we expect it to be”: dead-center of my face, in perfect symmetry. Additionally, a few Botox injections in the masseter muscle, which controls the jaw, could sharpen my cheekbones and reduce the “fullness” around my chin. Liotta reiterated to me over and over again, as warmly as possible, that her duty is not to morph the normal into the beautiful; it is to salvage the normal out of the abnormal. We’re all acknowledging our freakishness when we slide onto the operating table. I found that uniting, in some sick way.
The consultation had a second component. In the early days of plastic surgery, I’d simply have had to take Dr. Liotta at her word. She’d make her promises, I’d be booted up with an IV, and—hopefully—awaken a few hours later with a face that matched her promises. But in an era of Facetune, and Instagram filters, and prescribed, hyperspeed dysmorphia, I was not surprised to learn that Liotta had the tools to show me how all of this would look in practice. She shut off the lights, picked up a weighty prom-photo camera, and directed me to a chair in the corner of the room. Liotta was going to take several photographs of me, in panoramic mugshot fashion, before uploading them to an iPad where she could create a portrait of what I might look like after the cocktail of procedures.
“Look straight ahead,” she said. I did the best I could, but the doctor wasn’t satisfied with my posture. Apparently, when asked to stare at the camera, I had cocked my head a few degrees off-center—a fraction of an inch—which Liotta believed to be a trained behavior to compensate for my nose’s asymmetry. It was a Pavlovian response, something instinctual, honed bit by bit over years of slightly disappointing photographs. It’s the one thing that truly haunts me from our consultation; beyond the ptosis, or the cheekbones, or the exorbitant $65,000 price tag all of this would cost. My brain hadn’t known that my nose was crooked until five minutes before the photoshoot, but my soul always had. No matter how we discipline our minds to accept ourselves unapologetically, the body is forever capable of expressing shame.
The photos were hideous. Dr. Liotta told me to expect as much. These are ultramagnified close-ups, captured with whiteout double-flashes, displayed on a tablet in glistening high definition. Nobody looks good in this format. Everything, from my shaving blemishes to the creases of my lips, popped off the screen; proof that all of our beautification routines are completely helpless in front of a plastic surgeon’s illuminating audit. The gentle primping I’d done ahead of my visit never stood a chance.
We both gazed down at my face on her tablet, looking larger and more swarthy than it ever has before, and Liotta got to work. She scrubbed away at the imperfections with her index finger, focusing mostly on my profile. Before long, the new me—imprisoned in a JPEG—was sporting a sturdier brow, a more cursive nose, and a strong, Chad-like jawline. They were all simple edits—in fact, everything Liotta suggested was minor surgery, but when they’re showcased in concert and applied to the same face you fret over in the bathroom every morning, the procedures begin to feel a lot more like a need than a want. She toggled between the before and after images—the old and new me—with the press of a button, further accentuating the difference. A plastic surgery appointment, it seems, is about learning what’s possible, and suffering the consequences.
I have to admit, the jawline caught my attention. It was stony and virile, reminding me of the last time I truly loved my body (I think it was the summer of 2019). To think it could be achieved with just a nip and a tuck?
Dr. Liotta sent the renders to my email address, which I took as both a keepsake and a curse. When we first met, she told me that she begins all of her consultations by asking her patient what bothers them about their face. If I ever return to Park Avenue, at least I’ll have my answer.
Of course, a lot of things about my life would have to change for me to possess the $65,000 I’d need to do all of that. That is, quite literally, triple my yearly rent. So for now, I must leave cosmetic surgery on the pile of desires that shadows every other facet of my life, big and small—the mortgages, the pensions, the spare bedrooms with east-facing windows. My problems with my face are no longer immutable and abstract; there is a solution that transcends the noble lifelong struggle for radical self-love. I’ll carry that weight for a long time.