All of this beauty maintenance begins to take a toll on a person if they are not careful, and Joan was no exception. She was beginning to look perpetually tired because of the heavy bags underneath her eyes. They were so big that her mother gave her luggage tag earrings for her birthday. Joan knew from experience that Preparation H helped shrink puffiness. She also realized that in New York and LA finding Preparation H would be difficult since there were so many assholes in need of shrinkage.
Luckily, she had a Plan B. Two flights and three camel rides later, Joan arrived in the Middle East wearing a black, shapeless burka with only a tiny slit for her eyes to peer out. It perfectly concealed the problem, and while she was covered head to toe in a garment no one would ever call a “dude magnet” (but then again who wants to attract the likes of these dudes—if that’s what she wanted, she would have just hailed a cab and flirted with the driver the entire way), it was a small price to pay to keep her eye bags out of the public’s view. It wasn’t until she hopped off the camel’s back that she remembered how much she hated getting sand in her shoes at the beach, the oppression of women, and food that looked like it came out of the hind end of a dromedary. These were the deal-breakers that sent her home to the air-conditioned suites of a plastic surgeon who performed eye jobs and served her tea. When Joan accidentally spilled some of the tea on his plush carpet, he didn’t even suggest her hands be cut off, and at that moment she knew she made the right decision to come back to the United States and get this procedure.
Cross into your fifties, and you become the invisible woman (unless you live in Florida; there, you’re a spring chicken). It’s like you’re incognito, without wanting to be. Being old is like wearing Harry Potter’s Cloak of Invisibility, all the time. A good way to tear it off is an eye lift. As one of my doctors (can’t remember which, there’ve been so many) used to say, “When you hit fifty, you need a liftie.” *
You’ve heard that the eyes are the window to the soul? Wrong. For a peek at someone’s soul, get a load of his tax return, under the category of charitable donations. Or watch how he treats animals, the elderly, and children. Or cut him off in traffic.
The eyes are not the windows to but the mirrors of the soul. When you glance in the mirror and see saggy, tired, puffy eyes, your soul plummets to the floor. It’s hard to feel young and vital when you know you look ancient and tired (and I mean that in the nicest possible way). The way your eyes appear—heavy, droopy, and exhausted—turns into the way you feel and behave.
It’s a crime, what aging does to the eyes. Once upon a time, when introduced to, for example, your boss’s daughter who, poor child, was born with all the beauty and charm of a pig, you’d say, “What lovely eyes you have!” Come age fifty, the lovely-eyed among us can’t rightfully expect to hear even the lowest form of left-handed compliment. It’s like robbing a beggar of her last dollar.
Sunglasses help. Anna Wintour, editor-in-chief of Vogue, clued into this decades ago, as did Jackie O. Both ladies decided that camouflage was the way to go, put on a pair of big, black sunglasses and had them surgically attached to their faces. A temporary and slightly uncomfortable fix. Eventually, both Anna and Jackie, allegedly, got a blepharoplasty, otherwise known (affectionately) as the eye lift.
Over 241,000 other women did so in 2007, making it the fourth most popular surgical procedure of the year.
Having awake-looking eyes isn’t only crucial for feeling alive in our own souls. We communicate with our eyes. They tell the world more about what we’re thinking and feeling than even our lips.
Try to be coquettish with your cheekbones. Try to seduce a man using your nostrils. Not even Kathleen Turner, in her heyday, could do it.
Most of us need the help of our sexy bedroom eyes, a flutter of lashes, a glint, a gleam. But when your lids are so heavy that just keeping them open is a chore, you can’t possibly muster a flutter. Your glint is obscured by puffiness. The gleam? Dulled by loose skin.
The sad reality? Your bedroom eyes have turned into bathroom eyes. Down the toilet.
And what about boardroom eyes? You need the steady eye contact and stare-down seriousness that communicate self-assuredness and confidence. Who can pull that off when your eyes look like Abe Vigoda’s? How can you get your message to the world when your lids are hiding your intentions?
Along with a sexy glimpse and a steely glare, the eyes communicate a huge range of meaning, all of which might be lost for the lid-challenged. Here are some “tells” of the eye, according to people who make a living studying facial movements (FYI: the directionals are for righties; lefties can just put them in reverse):
1. When you look up and to the right, it means you’re flashing back to a place memory, like the last half-off sale at Neiman Marcus.
2. When you look up and to the left, you’re drawing a picture in your head, like wondering what sex would be like if your husband stayed awake during it.
3. When you look to the right, you’re recalling a conversation that actually happened, like when you described to your shrink your recurring sexual fantasy about Johnny Depp and an edible jockstrap.
4. When you look to the left, you’re thinking of a conversation you wished you’d had, like how you shouldn’t have replied when the waiter asked, “Would you ladies care for dessert?”
5. When you look down and to the right, you’re talking to yourself, say, about how much you deserve an eye lift.
6. When you look down and to the left, you’re tasting something from the past.
7. When you look straight ahead, and then over to the right, while sticking your middle finger out the window, you’re driving.
8. When you look up, then down, then to the right, then to the left, you’re flirting, which would work much better if you were a) ten years younger, or b) looked ten years younger after an eye lift.
The eyes have it. And “it,” as far as I can see, is the ability to seduce, beguile, and connect with other people. More than any other feature on your face, the eyes do the heavy lifting of communication. Sadly, they also do the heavy lifting of bags and sags. You want the person sitting across from you to focus on the intensity and passion in your gaze. Not whether you’ve slept in the past two months.
Redundant skin. That’s what surgeons call the hood of skin that takes over the upper eye lids as you get older. What causes the sag? Your tiny eye muscles weaken, as does the natural collagen and elastic fibers in your skin. Without tight skin and strong muscles to hold it in place, the adipose tissue that cushions the eye sockets slides down and accumulates. That’s right. You gain weight—in your eyelid.
The visual effect? Like a hypnotist told you, “You are getting sleepy, very sleepy …” and then he left the party without snapping his fingers to wake you up.
It’s disheartening, to say the least, when you feel alive and happy but look exhausted and depressed. Your eyelids themselves are tired. They have to hold up all that extra fat and skin with feeble muscles. Unfortunately, your eyelids can’t go to the gym and pump iron to get stronger. And they can’t go on a low-carb diet to lose weight.
The surgical approach to lifting the upper eyelid is pretty straightforward. You just have to get over two things, psychologically speaking: 1) a doctor will be sticking a knife within millimeters of your eyeball, and 2) a doctor will be sticking a knife within millimeters of your other eyeball.
Some people can get very squeamish about their eyes. I knew a woman who hated wearing glasses with a passion, but she was also deathly afraid of anything touching her eyes, including contact lenses. Whenever she tried to put them in, she broke out in a sweat and had a panic attack. Eventually, she got laser vision correction. The only way she could handle that procedure was to take enough Valium to sedate an elephant.
Be prepared that eye surgery is delicate. It’s tender. And it’s done, usually, with a local anesthetic. You will be awake—though numbed and sedated—while the doctor comes at your eyes with the blade, à la Freddy Krueger.
First step, the doctor will draw an oval along the fold of the upper eyelid as an incision guide. He’ll then give you local or, possibly, general anesthesia. When you’re numb or asleep (my personal favorite), he’ll use tiny surgical scissors and a scalpel to excise the previously marked strip of skin of the lid.
Once the skin is removed, the doctor will cut a smaller oval out of the underlying muscle layer to expose the orbital septum. The orbital septum is a thin membrane that holds the eye and its connective tissue in place, like a Ziploc plastic baggie filled with Jell-O. Your doctor will next make small slits into the baggie to access the two fat deposit areas of the upper lid.
The doctor presses on the eyelid to force the fat out of the membrane. Then, he’ll clamp the fat clump, cut off some of it, and let the rest recede into the orbital septum. He won’t take it all. You need a little fat in there to cushion the eyeball. Next, your doctor will stitch your skin back together nice and tight so that the sutures are right in the crease of the lid. He’ll put some ointment and a teeny bandage on top, and you’re done. Take a deep breath. Then he’ll move over to the other eye.
The upper eyelid lift, both of them, will take an hour, tops. You’ll walk out with no need for blinders or heavy Pirates of the Caribbean patches.
This procedure can be done under local or general anesthesia. Two ways to get rid of the twelve-piece set of bags you’re carrying around under your eye. First, the transcutaneous approach, meaning going in from the outside. The first step: Your eye will be temporarily stitched closed. Next, the doctor will make an incision along the length of the lower lid, right under the lashline. Later, you can easily hide faint scars with makeup.
Next, he’ll cut a hole in the muscle layer, and then using surgical tweezers, he’ll pull back the skin and muscle to access the orbital septum, aka the membrane that holds the eye package in place.
Then, he’ll cut a line in the orbital septum to get at the three fat deposits of the lower lid. The doctor will extract the fat, snip off some of it, cauterize where he cut to make sure it doesn’t bleed, and then let what’s left recede into the orbital septum. He’ll then move to excess skin removal. To judge how much skin has to come off, the doctor may ask you to look up. If you chose general anesthesia, he’ll have asked you to do this beforehand and marked the incision lines with a pen. As with upper-eyelid surgery, the doctor will cut away a sliver of extra skin and stitch you up tighter. And you’re done, except for the other eye.
Doing both of them will take an hour or two. The extra risk with this approach is the lower eyelid healing too low and showing the iris all the way around.
The other lower-lid lift method is called transconjunctival, meaning getting in through the inside of the lid. The lower eyelid will be held open with a retractor. The conjunctiva, the pink part on the inside of the eyelid, is thereby made accessible. You might have a contact-like shield put on your eye to protect it before the doctor makes a horizontal cut along the conjunctiva to get at the three fat deposits in the lower lid.
He’ll clamp and cut off a chunk of the fat, cauterize what’s left to prevent bleeding, and then let the remainder sink back from whence it came. He’ll do it for all three deposits.
Then, he’ll remove the protective shield on the eye and ease up on the retractor. You won’t get any stitches in the conjunctiva. No sewing means a faster procedure time and slightly lower cost.
Depends, as usual, on where you have it done, your surgeon’s experience, and exactly how much skin/muscle/fat needs to be removed. On average, according to the American Society of Plastic Surgeons, eye lifts cost $2,800 per lid pair. As usual, depending on where you live, you can expect to pay double that amount. If you’re having the upper and lower lids done, expect to pay no less than $5,600.
The risks:
You’ll have bruising and swelling after surgery and look like you’ve gone five rounds with Evander Holyfield. (If anyone asks about it, just say, “You should’ve seen the other guy.”) After a month, 80 percent of it will be gone. After three months, you’ll have seen the last of it. And it’s easy to cover with makeup.
Scarring. It’ll be minimal and well placed, but be aware that you will have faint lines forever. They’ll fade and are easily disguised with liner and shadow.
Bleeding. There’s a chance that a cut vessel may leak, causing the dread hematoma, or bleeder. If you have unusual or disturbing swelling, call your doctor. He might have to suction out the blood with a syringe or go back in and cauterize the vessel.
Dry eyes. If too much skin is removed, and what’s left of the lid is stretched paper thin, you might have a chronic dry eye problem. If drops don’t help, the surgical fix is a skin graft on the eyelid.
Blurry vision. Immediately after surgery, you might have blurry vision. Do not freak out! It’s only due to having had your eyes fiddled with for an hour or two. If your vision doesn’t clear after a day or two, call your doctor.
The rewards:
You’ll look younger, more refreshed.
Suddenly, other people will see the real you. The alive, happy, beautiful you that used to be hiding behind puffy, sleepy, heavy lids.
People will stop handing you cups of coffee, saying, “This will keep you awake.”
Increased visibility. When you were twenty, thirty, forty, people gave you the proper attention when you walked into a store or restaurant.
You can wear mascara again, without it smudging on your puffy upper lid.
When you take off your sunglasses, no one asks if you stuck your face inside a beehive.
If you have saggy upper lids as well as a thick cavewoman forehead, you might do even better than blepharoplasty by getting a brow lift, whereby your forehead is pulled back and sutured behind the hairline. It lifts your lids and forehead, and gets rid of the pesky lines between your eyebrows, the vertical crinkles around the brows, and the horizontal forehead gouges. In me, those crinkles were so deep that rock climbers used to get lost in them. I could’ve planted potatoes in them.
Botox Cosmetic injection can achieve a similar result, but a brow lift won’t need to be refreshed every four months. This is a permanent solution to upper-face wrinkles, including frown lines and concentration lines, which I call punch lines (minus the humor). When they appear, I know it’s time for a surgical punch-up.
As with the eyelids, the forehead droops as you age due to weakening muscles and stretched-out collagen in the deep skin layers. A brow lift won’t strengthen the muscles or regrow collagen, though. Rather, it’s like pulling the sheets tight on a bed and smoothing out a lumpy mattress.
Kathy Griffin had this done and said it made her look “months younger.”
Seriously, it opened up her face and made her look younger and brighter.
Forty-three thousand people had forehead lifts in 2007, so Kathy wasn’t alone. She probably had the traditional procedure, called a coronal brow lift.
It’s called a coronal lift because the incision is made across the crown of the scalp, or where WASPs wear their velvet headbands.
The pre-surgery prep will include making a nice wide part, from ear to ear, in your hair about an inch or two back from the hair line. The hair in front will be tied up in a dozen or so tiny ponytails to keep it out of the way.
Most doctors recommend general anesthesia. When you’re asleep, the doctor will make an incision along the headband line, all the way across. Ear to ear. Next, he’ll use a forceps and scissors to separate (or elevate) the skin and muscle away from the skull. For extreme lifts, the entire front scalp will be elevated, from the top of your head, to the temples on both sides, and as low as the eyebrow ridge. The flap of scalp is pulled down over your eyes and nose like a veil.
What your doctor sees: the underside of your forehead, including the three main muscle groups. The frontalis muscles are across the upper forehead. The procerus muscles are between the eyes. The brow’s got corrugator muscles.
The next part of the brow lift operation is to disrupt the action of these muscles. The doctor will cut away small strips of the frontalis, procerus, and corrugator muscles, essentially disabling them. The removal of only tiny bits of the muscles prevents you from making certain facial movements—the ones that cause wrinkles—but not all movement. You’ll lose the wrinkles but not your expressiveness. Win-win.
Onward to sewing your face back on. The doctor next pulls the scalp flap back up over the forehead. He’ll pull the skin tight, gauging the appropriate level of tension. You’ll have about a centimeter of excess skin to trim. When that’s done, the doctor will close the incision, from ear to ear, giving you a new hairline. The stitches will be bandaged. You may or may not have a drainage tube in your temple. In a week, you can go back to work.
Just be careful you don’t end up with that perpetually “surprised look” like House Speaker Nancy Pelosi—who seems to be in a constant state of astonishment.
But if you get a good brow lift, they’ll wonder how you lost ten years and a lifetime of anxiety during your one-week vacation.
Since the hairline is yanked back, this isn’t a good idea for women with high hairlines. Queen Elizabeth I, for example, couldn’t have done this. Her hairline was already coronal high. Also, if you happen to be thinning on top, brow lifts leave an obvious scar.
The modified version of the coronal brow lift is the endoscopic brow lift, a relatively new procedure that uses super-cool gizmos and high-tech gadgets along with the old-school scalpels and sutures.
First off, you’ll have general anesthesia. The hair along the hairline will be sectioned into tiny ponytails to keep it out of the way. The area along your hairline and scalp will be cleaned. Instead of the long incision, for this procedure the doctor will make three to five small holes in the scalp an inch behind the hairline. Through each hole, the doctor will slide blunt forceps back and forth, up and down, to detach the skin from the bone. The skin is loosened on the inside with the forceps.
Once the skin/muscle tissue is elevated from the bone, the doctor next inserts an endoscope through one of the holes. An endoscope is a surgical tool that allows doctors to see what’s going on inside the body. It’s a tube with a light and lens on the end (hence, end-o-scope) that’s hooked up to a TV monitor. Once inserted through the incision holes, the doctor can see on TV what he’s doing underneath the forehead skin.* He’ll leave the endoscope in one of the holes to see and insert special forceps into another to cut away little bits of muscle—under the furrows, between the eyebrows, and just over the eyebrows. Shaving strips off the muscles disables them, preventing the micro-movements that cause wrinkles. So you lose the wrinkles but not most of your expressions.
Muscles successfully handicapped, the doctor next removes the forceps and endoscope, and proceeds to raise your forehead skin higher to get rid of that droopy brow better suited to Cro-Magnons and former East German beauty queens. Most likely, the doctor will use stiches to hoist your forehead a few notches tighter. He might put in little implants that’ll attach to the skull and hold the skin in a higher new position. In either instance, the sewing is limited to the incisions he’d already made. No major cutting needed.
After the sewing comes the bandaging. Then, you’re sent on your way (with an escort, of course). The job, start to finish, will take one to three hours. There’s a lot less cutting with an endoscopic lift, which speeds recovery time and healing. The effect will last until gravity takes hold of your forehead again—probably many years.
The national average is around $3,000, but you can pay a whole lot more, up to $7,000. A endoscopic brow lift will be at the lower end of the range, and the coronal brow lift will be at the higher end.
The rewards:
With a nicely pulled brow, you no longer look like a serial killer …
Or a cavewoman …
Or a brooding poet …
Or your perpetually pissed-off mother-in-law.
You do look wide awake, fresh and unlined, young and alert, and ready for your next adventure.
The risks:
Bleeding/Infection. By now, you know that there’s a risk of bleeding and infection in any surgery. If you do bleed—you can tell by the excessive skin discoloration and weird, localized swelling—the pool can be drained with a needle or fixed with a second operation. Infection? Well, this is the twenty-first century, and doctors know how to treat such things. Usually, you’ll get antibiotics before and after surgery to insure that you don’t get one.
Bruising/Swelling. By now, you also know that when a doctor cuts muscle, you will bruise. You will swell. Depending on how drastic the lift, you’ll be bruised/swollen for at least a week, maybe as many as four.
Pain. The swelling adds to the painful feeling of too-tight skin. This discomfort won’t last long, a week or so, and you’ll be given pain pills. You can safely go back to work after seven days and exercise/lift heavy objects (like a vibrator) within a month.
Numbness. You’ve got a lot of nerves in the face, and some of them might be bruised, stretched, or otherwise damaged during the procedure. Usually, any numbness will go away within a month of surgery.
Scarring. Unless you go bald or your hairline recedes, all your scars will be safely hidden in your hairline. They’ll fade over time, too, but they are yours to keep, forever and ever.
Disappointment. A bad brow lift makes you look like you’ve been trapped in a wind tunnel. Or locked into a G-force simulator. You might decide that your new hairline is way too high or that your eyebrows are floating weirdly in the middle of your forehead. Avoid disappointment by communicating your desires exactly to your doctor. Say, “I want my eyebrows to end up here.” Draw a picture or edit a photograph. And don’t decide you absolutely hate the result until the swelling is completely gone—at least a few months.
Can’t accurately say who’s had a good upper face lift, be it eye or brow, since the best ones are subtle and just make you look fresh and awake. The bad eye jobs, however, are glaringly painful to behold.
Kenny Rogers: He might know when to hold ’em, know when to fold ’em, but he sure didn’t know when to walk away from the operating table.
Joan Van Ark. Her eyebrows are halfway to the moon.
Cher. Well, she always looked out of this world. Now she looks perpetually surprised. Ask her how she is—she looks stunned. Ask her what she had for breakfast—she looks stunned. Ask her what time it is—she looks …well, you get the idea.
Liza Minnelli. Love her. She’s a huge talent. And now she’s got the huge forehead to go with it.
Jessica Lange. Beautiful woman. In her prime, she was almost alien gorgeous. Still looks good, except her forehead is two inches higher than it used to be.
Bruce Jenner. At nearly sixty, he’s got the eyes of a twenty-year-old. The effect? Olympic weirdness.
Sylvester Stallone. Eyes stapled open, to match his mouth.