Body perfect

Well-prepared, self-confident people are the best candidates for cosmetic surgery.

By Ellen Miller

April 6, 2003

For Meg Burchard, liposuction alone didn't lift the loneliness that followed her husband's death. But it was a start.

Tammy Babkoff doesn't claim her life and body are perfect now, but she's glad she finally had the breast-reduction surgery she'd wanted for 10 years.

These women illustrate both the possibilities and limitations of cosmetic procedures, which 6.9 million Americans underwent in 2002 alone, according to the American Society for Aesthetic Plastic Surgery. Based on the nationwide survey, the ASAPS found surgical procedures are up 1 percent to 1.6 million while non-surgical treatments declined 23 percent to 5.3 million. The overall growth in cosmetic procedures is a staggering 228 percent since 1997.

Hoosiers are joining the trend to "get some work done" but we're pikers compared to the number of patients on the east and west coasts. The American Society of Plastic Surgeons reports 206,827 cosmetic procedures in the 12-state region that includes Indiana for 2001, the most recent figures available. The 13--state Pacific/Mountain region that includes California reported 502,615 procedures, while the nine-state New England/MidAtlantic region chalked up 353,579 procedures.

Before you put your body under the knife, be sure your head and heart are in the right place, says Kate Altork, a psychotherapist and cultural anthropologist who until recently specialized in working with cosmetic surgery patients.

If you're considering having something done -- be it breast augmentation, chemical peel, liposuction, a facelift, whatever -- it's important not to rush in, says Altork, who lives in Jupiter, Fla.

Research shows that people think about cosmetic surgery for an average of four years before they commit to it, and that's a good thing, says Altork.

Ideally, doctor and prospective patient will spend time talking, to be certain what the patient wants, what can be realistically achieved, what the recuperation will be like, and what the risks and possible complications are.

Altork and local doctors said surgery is a bad idea when patients present "red flags," including:

. Being in a hurry to get something done.

. Having surgery because someone else had it, or because of pressure from someone.

. Expecting it to be a quick fix for obesity or unhealthy habits.

. Showing signs of a psychological condition known as body dysmorphic disorder, in which people are obsessed with perceived flaws in their appearance, even though they look normal or attractive to others. Surgery rarely satisfies them.

. Having a recent, major life change, such as a death or a divorce. "Once you are on your feet, then you can look at yourself and ask if you are that unhappy with your body," says Altork.

. Having unrealistic expectations of what cosmetic surgery can achieve.

"We can't make someone look like they're 18 again. But we can improve the nape of the neck, or the jaw line, or tighten the skin," says Dr. Dion Chavis, a Northwestside surgeon.

Some people want surgery to help them attract a lover or save a marriage.

"Sorry, it's not going to happen," says Altork. "You won't necessarily get the mate or the great job. But there are people who will tell you: 'I meet the world so differently, now that I feel so good about myself. I have an enlarged social circle and feel more at ease than I did.' "

Burchard is one of those people.

The 65-year-old Marion resident had liposuction on her midsection in 1999, two years after her husband of 24 years, Robert, died of heart disease.

At one time, she'd judged that plastic surgery was for the vain, but she listened when her son, knowing she felt overweight, dispirited and socially discarded, suggested she visit Dr. Robert Jackson, a cosmetic surgeon who practices in Marion and Indianapolis.

Before surgery, Burchard peppered Jackson and his staff with questions. After surgery, she felt lighter, able to breathe more freely. She started walking regularly, eating more fresh fruits and vegetables and associating with new people.

Later, she had Jackson reduce the size of one breast, because she'd felt lopsided since a benign tumor was removed in 1979.

She had a second liposuction to remove fat from her back. She's had Botox injections twice to soften her frown lines and is considering having her facial skin resurfaced.

Burchard says the procedures helped propel her out of grief and isolation.

"It really has given me a psychological boost," she says. "If you can get up in the morning and feel good about yourself, everything around you is better. Your body feels lighter. You have a youthful feel again."

Seeking balance

For Babkoff, a Plainfield hair stylist, surgery to reduce the size of 10-year-old breast implants was a way to feel balanced.

Babkoff, now 42, had gone to a surgeon when she was 32, wanting to firm up her breasts, which had lost volume after she nursed two children. But she felt the size-D implants the doctor chose were too big.

"I complained for years to my clients and everyone," says Babkoff, who got serious about a second surgery a few years ago.

Chavis' scrub nurse is Babkoff's friend and client, and Babkoff asked her lots of questions before meeting with Chavis. About a month ago, he replaced Babkoff's implants with a size-C pair.

Even though she's pleased with the results, she admits she felt guilty before she was anesthetized.

In making the decision to alter your body, it's important to face such feelings, says Altork.

Fear is another emotion to face. Patients must be sure they understand the risks of a surgery or procedure and its possible complications. But there are other worries to work through.

"Many women are afraid of not looking like themselves, or like the rest of their families," says Altork. "If you come from a southern Italian family and have a prototypical Italian nose and face, then if you all of a sudden have a little upturned nose, you will look really odd."

Dr. C. William Hanke, a Carmel surgeon, estimates that 75 percent of his patients who have elective procedures want it kept secret.

Jackson, Burchard's surgeon, says 70 percent of his patients say they don't want anyone to know. "Then, after they have it done, they tell everybody."

Maybe that's because statistics say most people are happy with what they've had done.

In the offices and examination rooms of Hanke's Carmel offices, "before" and "after" pictures show the dramatic, if not necessarily glamorous, impact of cosmetic surgery.

One photo shows a 41-year-old woman with large fat deposits under her chin. The photo beside it reveals a trim jaw line.

"Looking your best"

"Most patients have one hereditary thing they don't like. They just want to look better and feel normal," says Hanke. "There's nothing wrong with wanting to look better. We dress nicely; we don't dress like bums. It's an extension of that, of looking your best."

It may sound contradictory, but people who are relatively happy with their appearance are the best candidates for cosmetic surgery, says Altork.

"I like to hear someone say: 'I really like myself. But I've got these droopy lids. I'm tired of working around these folds. I don't want to think about this. I've got things to do; I'm busy with my life.' " Altork says. "I say, if you are prepared to deal with the surgery, the healing, having to disclose or not disclose, the reality of what you will look like rather than the fantasy, if you can clear those hurdles, I say: all power to you."