Cap Lesesne - Confessions of a Park Avenue Plastic Surgeon

What do I say?

That I know they’re 325 ccs? That the implant casings are “smooth” (as opposed to “textured,” whose surface features tiny ridges)? That they’re of “moderate profile” (the distance of the implants from the chest wall)? That I can even name the implant manufacturer?

“The perfect size,” I replied. “They suit you well.”

I operate on men and women. I physically and psychologically change them, yet I must remain distant. I champion their initiative and sometimes courage to transform themselves, yet I must be keenly aware of, and candid about, their weaknesses and occasionally misplaced motivations.

My professional obsession is flaws. My goal is perfection.

I agree with Aristotle: The pursuit of life is happiness. Figure out what’s important in life, then go for it. If there’s a physical attribute that can be fixed, and the procedure involves minimal risk, and your life will be improved because of the fix, then why not do it? I don’t trivialize the risk of surgery because all surgery entails risk. But I see, every week, how plastic surgery delivers physical results that change people’s lives in positive ways. I love Billy Crystal’s famous Fernando Lamas impression on Saturday Night Live – “It’s better to look good than to feel good.” It’s funny, at first, because it’s about vanity and superficiality. But for many people it isn’t far from the truth. For them, feeling good is looking good. Attractive physical appearance reinforces good body image, and good body image affects psyche. Others see you in a different light. You may be noticed and appreciated more. You’re more likely to get promoted. You get more out of life.

As one face-lift patient told me on a postoperative visit, “This changed my head. ”

* I can’t – though I can tell you a few ways to tell if someone’s had plastic surgery:

1. Unevenly dimpled legs. (Liposuction)

2. Symmetrical scars. (Under the armpits: a subpectoral breast augmentation; in the same position on the hips, backs of legs, or fronts of legs: lipo)

3. Scars just in front of the ears. (Face-lift)

4. A break in the hairline. (Face-lift)

5. Facial skin different from skin on top of the hand or, more accurate (since lasers easily remove hand wrinkles and brown spots), different from skin on the lower leg. (Face-lift)

6. Cheekbones too sculpted for overall anatomy. (Cheek implants)

7. Incisions on the tops of the eyelids, sometimes only visible with the eyes closed. (Eyelid lift)

* In the long run, the forehead lift is probably cheaper.

* Six months later I spot her at The Ivy in Los Angeles. She’s having a romantic dinner with a younger man.

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