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Rhode Island Monthly Magazine*

Magazine staffer Pippa Jack tests out Botox© and Juvederm©

It was an unusual story assignment: Go see a plastic surgeon. Learning at noon I’d be meeting a top-tier doc in two hours, I reminded myself to brush my teeth after lunch. Oh, yeah, and malinger in front of the bathroom mirror to organize my inner list of complaints about my looks. You know, the stuff you resist even thinking about—let alone voicing aloud to strangers.

Pippa Jack meets with Dr. Sullivan

Dr. Patrick Sullivan, however, knows his way around lots of knife edges, and other people’s vanity is just one of them. Chairside manner seamless, his Providence office well-appointed and discreet, he gently suggested where I might benefit from a little work—not necessarily the places I’d identified—without ever making me feel unattractive. Or frivolous. A needleful of something here, a jab there, it would all take less than an hour. Oh, and he could fit me in the next day.

And so began my whirlwind experience with cosmetic surgery, at least the quickie version for the knife-shy. A couple of months ago, Sullivan used Botox©, a protein that famously freezes muscles, and Juvederm©, a hyaluronic acid filler that plumps up skin, to temporarily transform me into a younger person. Or, if not a younger person exactly, certainly a smoother, more attractive one.

Despite a sense of foolishness—didn’t we have something more important to do?—I enjoyed the consult. Sullivan had spent an entire day earlier in the week in the longest surgery of his career, helping rebuild one side of a child’s face. Reconstructive surgery and cosmetic surgery, he said, are two sides of the same coin, and skills learnt in one discipline can be applied in the other. As we discussed my under-eye circles with surreal earnestness, I felt almost useful.

Botox is used to smooth crow's feet

One sleepless night later, my bags and I were back, full of misgivings and sitting in a chair reminiscent of a dentist’s office. A numbing ointment soaked into my face while I held a cold-air gun trained on the area he would tackle first. A nurse unpacked a vial of Juvederm from its reassuringly pastel box. Sullivan, all business, handed me a mirror to go over what we’d discussed.

At thirty-seven, with too much sun exposure but reasonably good genetics, someone my age wouldn’t have dreamed of seeing a plastic surgeon a decade ago. But these days, I’m at an increasingly popular age to start the kind of minor fiddling that injectables represent. That’s because, effective though they are in the right hands, these substances have subtle rather than dramatic effects. They’re perfect for people who are not too far into the aging process, who don’t really want to alter their appearance, just turn back the clock a few years. And keep it there. Which this stuff can do—provided, of course, you have the means to stay topped up.

Botox© prices, Sullivan warns, keep rising because manufacturer Allergan has a monopoly. It could have been cheaper if I’d gone elsewhere. But Sullivan is the kind of doctor that Allergan used to trial their new filler, Juvederm©, when it first came out with the product. He’s certified in plastic surgery, which isn’t a requirement for giving these injections, but probably should be (google “botched injectables” and you’ll see why). He takes this stuff seriously. And he’s a perfectionist, which, let’s face it, is perfect.

In minutes, we were at the pointy steel nitty-gritty of it: three vials of Juvederm© injected deep into my skin to plump my lips and smooth out my tear troughs (the bags under my eyes), my naso-labial folds (the parentheses around my mouth) and the downturns of my mouth.

A nerve block was an option; I refused, reasoning it would be quick. It was.

Afterward came two needlefuls of Botox©, a walk in the park compared to the filler, just light surface pricks in the center of my forehead and around the outside of my eyes. I was done.

It’s fair to call this a lunch-hour procedure; I was back at work that afternoon, just a little flushed and swollen. But by the next day, when Sullivan called to check up on me, it was clear I wasn’t going to have the smoothest recovery. I’m a bruiser, which I’d exacerbated by, against orders, taking a blood-thinning pain killer (naproxen sodium—but aspirin and ibuprofen will do the same thing). With purple stains down one side of my face and massive, swollen lips, I spent the weekend swanning from children’s birthday parties to baby showers, provoking looks of concern everywhere I went.

Within a week, when I saw a nurse for a check up, things had mostly calmed down. But it seemed there was some thinking I should have done on issues of beauty, self-worth, respect for the body—feminism, really.

Within two weeks, in a follow-up with the doc, the regret had disappeared with the last of the swelling. When Sullivan suggested a touch more Juvederm in my top lip to even out a tiny asymmetry, I was happy to go along. This was a guy I could trust.

Because, as I got used to the subtle change in my face, I began to love it. It looked like me: a deeply refreshed me. I was impressed by the slight brow lift—yes, Botox can do that—and by the difference filling the creases around my mouth made. My crow’s feet disappeared overnight (the Botox takes a week to kick in, then wham! smooth skin) and my mouth, the thing I was most nervous about—we’ve all seen those pictures of Meg Ryan—was a revelation. I’ve never worn lipstick; it always looked silly. But with a top lip plumped out to be ever-so-slightly bigger than the lower one (conforming, says Dr. S., to the ideal standard of beauty), Berried Treasure suits.

And there’s this: The smooth, untroubled Botox© brow seems to chill other people out. When you fail to frown in a situation that might have called for it, people relax.

I started to get compliments: on my haircut, losing weight, “looking happy.” At first, feeling vaguely guilty about people’s searching looks—I didn’t want them to think they’d developed Capgras Syndrome—I’d happily correct them. Their reactions would be part of the story. Turns out many of my women acquaintances wanted to talk about it, everywhere I went. It was exhausting.

So of late I’ve been fobbing people off. Partly, I think, this is inherently private stuff. And partly, I’m beginning to fear the day I wake up to crow’s feet.

Friends who have had work done (quite a few came out of the woodwork) have prepared me for how it will go. The filler wears away slowly, fleeing first from the parts you move the most: your lips. I’ve got a month or two more there, although it will linger longer other places.

Botox© fades more abruptly. Four months at most after the shots and the wrinkles are back. One friend described it as aging in fast forward.

I’ll be honest: The thought makes me panic. Lately I’ve caught myself reasoning that, being single, investing in my looks is only practical. I could stop buying clothes, cancel the DSL, get another roommate.

A younger self would be horrified that I’d even be tempted to spend money on something like this. But there’s a reason people call it addictive; it’s freeing to look in the mirror and find that inner litany silent. At my salary level, it would be hard to afford, even harder to justify. But you never know—maybe I’ll get a raise. — Pippa Jack

*Reprinted in part with permission granted by Rhode Island Monthly Communications, Inc. ©2008