by Cap Lesesne
He looked at the photos. He shook his head. “That’s not me.”
“Yes, it is,” I said.
“No,” said Jason. “It’s not.”
It was.
I need to do touch-ups on about 5 percent of my surgeries. It happens most frequently with liposuction because you simply can’t feel every nuance of fat. Or the patient may come back because of a scar she doesn’t like, or there’s a slight bump left on the nose. Touch-ups don’t happen often, they’re never major, and they’re done under local anesthesia.
One of my pet peeves is doing a touch-up after lipo – not because I don’t want to do it but because the patient may come to me under false pretenses.
When Nina came in initially for liposuction, she weighed 116 pounds. I lipoed three pounds off her abdomen and hips.
Three months later, she returned, complaining that the lipo hadn’t worked. She demanded a redo.
I put her on the scale. She now weighed 126.5 pounds. If in the weeks after lipo she’d come in heavier than her pre-lipo weight, that would have been normal, the result of swelling. But this was three months later.
I asked Nina a number of questions, finally eliciting that she’d been drinking lots of protein shakes and beer. I promised I’d do a free touch-up for her if she lost weight and got down to her pre-lipo 116.
She never returned. Not infrequently, people think that liposuction is a license to eat badly and not exercise. These people are just kidding themselves. Lipo will never work for them because the fat will always find new places to deposit.
Two weeks after doing a face-lift on Gabrielle, a somewhat homely woman in her early forties, I got a call from her mother, who was extremely upset.
“She doesn’t look like my daughter anymore,” she complained.
It would be a serious complaint if it were true.
I talked calmly to the mother, but she was furious and wouldn’t listen. “No!” she said angrily. “The point isn’t whether Gabrielle looks good or not. It’s that she no longer looks like my daughter!”
I’d been particularly happy with the outcome of that lift; as usual, I’d gone for the natural, subtle improvement, not a dramatic change. Afterward, I thought Gabrielle looked terrific. So did my staff.
But her mother was not assuaged.
She continued to call the office for a week, ranting at me for taking away her daughter. (I did not hear from Gabrielle herself.) She threatened to sue me.
Mother and daughter went to see a lawyer, armed with before-and-after pictures. The lawyer wouldn’t take the case; he said Gabrielle looked great in the afters, and they had no case.
I knew this because the lawyer called me the next day.
“Can I bring in my girlfriend?” he asked.
I did not hear from Gabrielle’s mother again.
Sometimes, there is simply nothing that anyone can do.
Not plastic surgery. Not the exercising of willpower. Not the best of intentions.
If love doesn’t want to flourish, I discovered, it simply won’t.
So what do you do then? If you’re a person who loves life, you look for someone else to love.
I watched it happen.
Jeanette Longoria, my patient many times over (face-lift, eye lift, abdominal liposuction) and now a good friend, is a vivacious woman in her seventies. After she’d been widowed for some time, she became eager for male companionship, and met a retired ambassador from the United Nations. She was crazy about him. He was handsome, charming, learned, interesting, spoke nine languages – and he was crazy about her. He asked her to dinner. When he picked her up at her apartment, he was armed with a huge bouquet of yellow roses. While drinking champagne over dinner, he leaned over and kissed her. She smiled at him.
He called again the next night. Could he take her out to dinner? he wanted to know. This time the roses were pink. On the walk home after dinner, the retired ambassador once again bent to kiss her. She felt cold shivers up and down her arm.
She told me about it on the phone the next day. “What happened?” she asked. I thought I knew but I didn’t say. The retired ambassador had asked Jeanette to dinner again that night. She would report to me what happened.
Red roses this time. Jeanette and the ambassador went to a show, then dinner, and again he kissed her. The hair on her arm stood up.
I saw her the next afternoon. “I don’t know what to do,” she said to me. “He’s everything I love in a man. More. What’s going on?”
“It’s pheromones,” I told her, and she reluctantly nodded, as if she had already figured it out, too. It had happened to me, once. I went out with a lawyer – smart, interesting, pretty, everything – and each time I leaned over to kiss her … nothing.
“You might as well quit now,” I told her. “No matter what you do, it won’t change.”
She shook her head. She knew I was right.
So what did she do about it?
At seventy years old, she wrote a book about finding romance and sensuality at any age. She’s inspired not only her family and friends, but widows, divorcées, and older women around the country, who now flock by the hundreds to her book readings and signings.
Maybe there always is something you can do, after all, so long as you’ve got the attitude.
The Politician and the First Lady
Politicians and royalty – more than movie stars or the very wealthy – are the most secretive people I work with.
I was contacted by the friend of one of America’s most influential and high-profile elected officials. Not by a staff member; it’s never a staff member. They’re not trusted with real secrets. The politician’s friend and I, on my cell phone, worked out all the details for the meeting.
When the elected official came to my office, he showed me what he thought was a melanoma on his shoulder. It looked quite suspicious to me. He was desperately afraid that if word got out, constituents would think he was dying, and it would cost him his upcoming bid for reelection. I did a wider removal than normal and told him I’d send the melanoma off to be biopsied.
“No, you can’t do that,” he said. “It’s not so simple.”
“What do you mean?”
“Well, it’s going to a lab, correct?”
“Yes.”
“People at labs can read. They can see whose name is on it, correct?”
“You don’t want this sample attached to you.”
“That’s correct.”
I nodded. “Would you like me to use my name?”
“Correct. And your Social Security number, of course.”
“Of course,” I agreed.
I sent the mole to the lab, using my Social Security number and name, pretending the sample was my tissue.
It turned out to be a melanoma “in situ” – a mole with some changes – but the wider removal did the trick. The paranoid politician was in the clear.
In November of 2002, he would win re-election.
Deirdre, an investment banker, age thirty-five, came in for breast augmentation.
“I want the biggest implants you can put in that still allows the skin to close around it,” she said.
She was a borderline case. I considered turning her away, something I do to maybe one in seven people who walk through the door for a consultation, when I don’t see the problem they do or significantly disagree with the result they’re going for.
But Deirdre had a wide pelvis and narrow shoulders, and her frame could handle what she was asking for. Structurally and aesthetically it was what she wanted, not to mention what her boyfriend wanted. She was resolute. When patients are unequivocal about what they want, I’ve found, the outcome is usually happy.
Several months later, Deirdre returned to my office, unhappy.
“I want them bigger,” said Deirdre, though it looked as if she had two medicine balls on her chest.
“I won’t do it,” I told her.
She tried to persuade me but I stood my ground. She called a few da
ys later to report, almost petulantly, that she’d found someone near Gramercy Park who was willing to give her bigger implants. Finding a surgeon willing to perform virtually any procedure is not something to be proud of, I wanted to tell her, for patient or doctor.
Deirdre was not a risk I wanted to take.
In October of 2002, my friend Janet Carlson called from Los Angeles. “Nancy Reagan would like to meet you for lunch,” she informed me.
“Any time that pleases Mrs. Reagan would be fine for me,” I said. I held the first lady in high esteem.
While crossing the country, I worried about our conversation. I like to try to put people at ease and I was interested in meeting her. But what would I say? Everything had been said. It was an incredibly difficult stage in Mrs. Reagan’s life. Obviously she was suffering terribly as she watched her beloved husband endure the advanced stages of Alzheimer’s disease. Whatever anyone may have thought of his or her politics, theirs was one of the great American romances of the last half century. I’d read his book of love letters to her and found them inspiring.
What subject could I bring up to interest her? Her work for a drug-free America? Her growing interest in stem-cell research? The upcoming midterm elections?
Somewhere over Kansas I remembered that her stepfather, Loyal Davis, had been a brilliant neurosurgeon, chairman of the surgery department at Northwestern University, and president, for years, of the American College of Surgeons. When I’d trained at Duke, there was a Loyal Davis Ward. That was my icebreaker.
When I got to L.A., I picked up my pal Janet and we proceeded to Spago, the famous Wolfgang Puck restaurant on Sunset Boulevard. Mrs. Reagan sat at a table in the far corner surrounded, at a casual distance, by Secret Service agents. From the front of the restaurant she looked tiny and frail.
Janet and I walked over and she introduced us. The first lady was tiny and frail, but smartly dressed in a red tweed suit. She showed physical signs of aging, of course, but she was still beautiful – good bone structure and a twinkle in her eyes; her personality shined through. She was sharp and intelligent and had a singular poise. She emanated a quietness to her physical being, and a worldliness. On that day, more than anything, Mrs. Reagan appeared sad. Almost as soon as we’d exchanged pleasantries, her daughter, Patti, an attractive brunette, fifty, swooped into the restaurant and sat down with the three of us. You could see right away how fun she was, but her electricity, especially in that setting, threw me off guard. When something unexpected happens in the OR, I am always prepared; for the unexpected in life, I’m not nearly so adaptable.
“I was a problem child,” said Patti, natural as can be. We’d hardly gotten past Hello my name is Patti Hi I’m Cap when she offered the frank self-analysis. I was fascinated by her. “Just before my father was inaugurated governor of California,” she said, “I ran off with the drummer for the Eagles. Just before my father was inaugurated president, I did a spread in Playboy.” She paused for only the briefest moment; it was touching, almost funny, how public her disturbances had been, and impressive how aware of it she was.
“And now,” said Patti with a smile, “I’m happy to take care of my dad and to be with my mother.”
It was a moment of almost unbearable feeling – at that table, at that moment, there was so much love and regret, acceptance and maturity, intimacy and reflection. More than anything, though, I could feel the sadness that mother and daughter were both experiencing about their respective husband and father, a foreboding.
I felt it was time, so I asked Mrs. Reagan about her stepfather the surgeon. Her eyes lit up. She launched into a series of stories about her dad’s days at Northwestern, and what it was like when he came home after a long day at the hospital. The somber mood at our table had broken, if only for a while, and we started to have a good time. I thought of how basic a bond Mrs. Reagan and I shared – both having grown up in the Midwest with hardworking doctors for fathers, fathers whose devotion to their patients and profession meant they often didn’t have time for their family.
A friend of mine – a noted screenwriter and also a patient – entered the restaurant and spotted me, walked toward the table … and his eyebrow raised at the ominous federal agents surrounding my lunch partners and me. He then recognized the first lady, introduced himself, and did me a big favor. “Mrs. Reagan, this guy here is the only honest plastic surgeon in town,” he said. As soon as he left, another friend – heiress to a great retail fortune – also walked in and noticed me, and she, too, came over. She also knew Mrs. Reagan, it turned out.
“Nancy, this is the man I was telling you about,” she said, then turned to me. “Please hold me a spot.”
She smiled and left.
You can’t buy advertising like this, I thought. One of the Secret Service agents eyed me suspiciously. I wondered if he thought I’d planted friends to appear at appropriate intervals and say nice things.
Mrs. Reagan looked at me wistfully. “Oh, plastic surgery. I would love to do something, you know. God knows I could use it. But I could never have it while my husband’s sick. Can you imagine if I had any work done – and he died?” Now she focused on me forcefully. “He demands my full attention. I just can’t.”
After two hours of nostalgia and lunch and a chance to forget the trouble that awaited her back home in Santa Barbara, Mrs. Reagan, along with her daughter, said so long to Janet and me and parted, their Secret Service detail in tow.
That night, I returned to New York on the overnight. I drifted off to sleep thinking of Mrs. Reagan and what might happen to her.
Several months later, I was doing late-afternoon paperwork in my office when Tanya buzzed me. A call from the New York City Police Department, a Detective Amarosa. I picked up.
“Dr. Lesesne, is Deirdre MacNeil your patient?” he asked.
“Yes.”
“When did you last operate on her?”
“About eight months ago.”
“Can you tell me her breast implant serial number?”
My stomach dropped. Why was he asking about her breast implants? How did he know she had breast implants?
“Breast implants don’t have serial numbers on them,” I replied. “Only the size in cc’s printed on the bottom of the implants.”
Pretty much anything that came out of his mouth next, I braced myself, would be bad.
“Why?” I asked.
The detective went on to tell me that her dismembered body had been discovered buried in a suitcase. The breast implants complete with serial numbers, a remnant of unlicensed plastic surgery, were the only clue they had to go on.
We’re All Alike
I was invited to a wedding in Turkey. My friend Cemile’s daughter was getting married. I had done a face-lift on Cemile back when she was married; she’d since gotten divorced. It was a Muslim wedding, a chic and elegant crowd, with guests from every part of Turkish society. The sun was setting over the Sea of Marmara, illuminating the Dolmabahce Palace. The ceremony was incredibly short – maybe two minutes in all – with the mayor of Istanbul presiding. After he pronounced the couple husband and wife, a flock of doves was released over the Bosphorus.
Dinner and dancing would last until morning. There were devout Muslims there who didn’t drink, though they were dressed in Western fashion. Across the grand room, I spotted the sister of a woman I’d done a breast augmentation on three years before. But after the woman’s husband had become a fundamentalist, he’d insisted she have the implants removed. She came to my office. At first I resisted: The implants were perfect – soft and natural-looking. But the woman demanded, and nothing I was going to say would dissuade her. Forlornly, I took them out – the only time in twenty years that, short of a medical concern, I’ve removed implants.
The wedding reception that Cemile and her ex-husband were throwing for their daughter was more elegant than opening night at the Metropolitan Opera. What a gorgeous moment this was, especially for Cemile.
Or should have been.
&
nbsp; In her yellow Givenchy dress, Cemile came over to me. “Would you dance with me?” she asked. I said of course. Cemile’s eyes were grateful as I led her out onto the dance floor.
When we were out there, Cemile moved her mouth close to my ear. “My ex-husband is here with his young girl,” she whispered. I looked at her. She smiled.
I danced with her all night long.
We really are all alike.
Sure, I deal often with the superrich and the famous and the fabulous, with patients whose very livelihoods depend on looking gorgeous and youthful. The universe they inhabit operates, in many ways, almost nothing at all like the one inhabited by the vast majority of the world. But – as I said earlier – everybody’s got something. I do, you do, they do, we all do. Something that annoys, something that disheartens. That commonality cuts across wealth, status, ability. And the reasons my patients seek cosmetic surgery are (with the occasional odd exception) few and fundamental. To buy time. To recapture youth. To banish insecurity. To prolong a career. To stave off depression. To gain entry to new experiences, new business, new relationships. When they call me, when they’re sitting across from me in my office, when they’re lying beneath me on the table in my OR, it’s because there’s something that’s driven them to distraction. The very rich and the not rich, the average-looking and the drop-dead gorgeous.
We’re all alike.
Now and then, at the end of an especially long day, a day when I’ve been up at five in the morning, completed three face-lifts and find myself at the office past nine doing paperwork, an image of my father, Dr. John Lesesne, the family internist, comes to me. He is in his office working late, just like me, doctor to doctor. His dedication – the quality that kept him from me so often growing up that I resisted pursuing medicine until I couldn’t any longer … his dedication has become my dedication. By the time he was my age, he had a big family, and I do not. But his love of medicine is now mine. His intense work ethic is now mine. His single-minded devotion to patients is now mine.
