Euphemistically nuts

Angela asked me today by email, "When do you go to the beauty clinic in France? Are you nervous about that?"

I replied, "It's a euphemism to call it a beauty clinic. It's a scalpel slash skin shop. The surgery is Dec. 4. Nando has suggested that we rest and sightsee around Provence until my checkup on Dec. 13, because, according to the doctor, "you probably don't want any business appointments before then".

She is the only one who knows so far. It's not that I am embarrassed; it’s that I don't want to worry my dad. I haven't told my sons because when I broached the subject in an abstract way a month ago:
- From Boston, Max's reaction was "You're nuts. You're not going to do THAT."
- From Los Angeles, Sacha's reaction was "You're nuts. If you do that, you have to do it in California."

The telltale . . . crow

Nando showed me the photograph we had taken with John and Nicole six weeks ago. "Look at this,” he said. "You are the only one in this picture who doesn’t need a facelift." It was true; in the photo, at least, my laugh lines had curled around to frame my smile, so you couldn’t see the sagging skin. The camera -- or was it the lighting? -- tempered my crow’s feet, and the angle was such that I was the only one without a telltale roll under my chin.

"Ah, if only I looked like that in real life," I said, "I’d be nuts to bother with surgery."

Cosmic versus cosmetic

“Do I really look that awful? I always kinda liked my smile."

"This facelift is not a moment too soon,” he assured me.

Next day, reading about the situation in Afghanistan, I was reminded of the way life has of putting things in context. A little over a week ago I was fretting about a banal blood test. The seemingly inexhaustible supply of horrors on the nightly news is a reminder that it hardly seems worthwhile to waste one’s energies thinking about a stupid medical procedure -- and a voluntary one at that.

Cat's claw

We were clearing the table in the kitchen this evening. Nando watched me as I leaned over to pick up the dishes. "What happened to your face?” he demanded.

“What do you mean?”

"You look like you’ve been burned there, on the left side."

“Oh, you mean HERE.” I touched my left cheek below the cheekbone. That’s where the skin has buckled, sort of, and in the unflattering kitchen light it looks ugly. "Hey, this is the bad side of my face,” and I smiled in a half-grimace.

"Oh don’t do THAT,” he groaned. “Wait, hold that smile. Let me get a camera.”

“No camera!”

"Okay, let me draw what I see.”

His design showed a face that looked like a cat had clawed its way across.

Dog-docs

The nurse admonished me to stay lying down for five minutes until she came back to approve of my departure. Otherwise, she said, I’d faint anyway and undo all the good done by lying down in the first place. She must have seen how white I’d gotten during the procedure.

I then raced out to change places with Nando. He got the documents, I got the dog.

The test results -- having to do with how fast our blood clots, yuck I don’t want to think about it -- will be ready Thursday.

Drawing blood

We had our blood test this morning. This was a big ordeal for me. We decided to walk to the hospital, about 2.5 km away, perhaps less. Because we were bringing the dog, I woke up at 7 to feed him so we’d be ready to go by 7:30. We were at the hospital by about 8:10. Nando waited outside with Homer so I could go first. The first line had seven persons ahead of me, the second line had 23, but it moved faster. When it was my turn, I looked the nurse boldly in the eye and said, "I faint with shots. I need to lie down when you draw the blood."

"Lie down all the way?"

"All the way."

So there was another five minute wait between the time they led me to the bed & blood room, and the time two nurses appeared to do the job. They were good, I have to admit, and it was fast. And no, it didn’t hurt. But that’s besides the point in terms of my psychological reaction.

Regal versus wrinkled

Joan’s regal English beauty is worlds apart from my smaller, livelier facial alignment. Her face is almost ironed over in its smooth alabaster perfection, but she was animated as she repeated for the umpteenth time that the facelift was the best thing she had ever done and she was sorry she hadn't done it sooner and if she had to decide again, she'd do it yesterday.

"You'll see," she predicted, as we stood side by side looking at the mirror in her office. What I saw was a tall, handsome, fashionably-dressed woman with chestnut hair sleekly pulled back -- a woman perhaps in her 40s -- standing next to a short woman whose dark brown hair went off in all directions, whose pointed features were set in the context of wrinkled, tired skin. This second woman might be smaller but she was definitely older. I am technically two years older than Joan but the mirror screamed more.

Crinkles on the Cote

As long as we were on the Côte d’Azur, we stopped to see Joan in Monaco. Yes she looks great, but her forehead is so . . . serene. It doesn’t crinkle. She shrugged. "That’s a small price to pay for the rest of it. Who needs forehead wrinkles anyway?"

"Me," I thought. The expressivity of my face is -- has always been -- important to me. That and my smile. Oh! What if I can’t smile as before? What if my smile isn’t framed by dimples anymore? It’s true that those dimples have turned deeper over the years and now run halfway up my cheeks -- sometimes when I’m not smiling. But they are part of ME.

Cabbage in Cannes

Delos brightened. "Yes, a woman in Cannes. She might be available. I don't know what her hours are but this is her phone number. If you are able to see her this week and tout va bien, I could schedule your surgery the first week of December. Say, Tuesday, December 4. Would that be all right?"

I started to say, "We will discuss this and get back to you" at the same time Nando was saying, "That sounds good for me. Doesn't that work for you, Cipo?" ("Cipo" is short for "cipollina", or "little onion," my husband’s public term of endearment for me. It may sound strange in English, but it’s not so different from "ma petite choux", or little cabbage, in French).

Gulp. I withdrew my objection because, after all, we might not get in touch with the anesthesiologist. Or we might get in touch and something would prevent our going ahead. Or we might be okay for anesthesia but not okay for the surgery. That is, I might not be okay for the surgery.

So I smiled grimly and we ended the visit with an exchange of email addresses, a flurry of salutations in French and Italian, and a shaking of hands all round.

Cann-es-thesiologist

I had stumbled over the mention of "removing staples" and was circling round that phrase in my mind, not paying a lot of attention to the rest. But Nando DID want to go ahead. He was chafing at the bit. He couldn't wait. "This anesthesiologist -- can we choose someone in Milan? Do you work with someone in Northern Italy?"

Dr. Delos shook his head. "No. My anesthesiologist is here in Marseille, and accepts appointments only on Tuesdays and Wednesdays."

Today was Wednesday. We would be driving back to Cannes after our appointment, and I was tied up there the rest of the week, after which we'd be driving back to Milan. I wanted to arrive early enough Friday evening to pick up Homer from the kennel.

But Nando wasn't one to give up easily. "Do you work with any other anesthesiologists? In Cannes, perhaps? Nice? Monte Carlo?"

Surgical shopping list

"If you decide to do it, you will be given all this information. Ne vous derangez pas. Don’t worry. But to answer your questions: yes, the stay at the clinic is included in the price, and I do the procedures right here. This is my clinic. Your wife must come the day before the surgery and stay overnight. In your case, I would not charge you for staying here the night with her. She must also stay the night after the surgery. Because of your diabetes and blood pressure, you might also want to stay here the second night with her. I would not charge you extra for that either."

"Meals are included {I am sure he smiled to himself when he said that. No one in their right mind wants to eat after this ordeal}. I check you here two days after the surgery and then a week later, when the staples are removed from your wife. All your costs here are included. The only extras are the medicines I ask you to bring with you when you come for the surgery, and the cost of a consultation with an anesthesiologist once you decide you want to go ahead."

Speaking franc-ly

"If we both decide to do this, how much will it cost?" My husband wanted to get to the bottom line at this point.

Delos jotted some numbers down on a notepad. "Eye bags alone are FF 18,000. A facelift for your wife is between FF 50,000-60,000. For the two of you together I charge FF 60,000. I can do both of you the same day and you would share the same recovery room."

My husband likes things spelled out clearly. "Does that include the hospital stay? WHERE do you do the surgery? Do we have to come the day before? How many days do we have to stay? Are meals included? Do we have to return for a checkup after the surgery? Is anesthesia included? What costs are NOT included?"

Facing leather

There were a couple of leather albums on Delos' desk, along with his computer, phone, electronic gadgets and neat stacks of papers. The doctor opened one of these albums to a page where men and women looked out at us with heavy eye bags on the left, and almost nothing on the right. I say "almost nothing" because the places where the bags had been looked like something had been there. But they didn't look unaesthetic, and they certainly all looked natural.

"How come I don't get to see before and after pictures of facelift patients?" I thought to myself. "Probably because monsieur le docteur figures I don't need convincing. Joan and Nicole did all that work for him."

Extra baggage

I returned to my seat and Delos to his place behind his desk. I looked at my husband. Nando cleared his throat. "As long as I am here with my wife, umm, I wonder what you think about the bags under my eyes. Is there something you can do? You should know that I am a diabetic and I have high blood pressure, so I don't want a major operation."

"Hmm," said Delos. Now it was Nando's turn to get up from his chair and be inspected in the sunlight.

The verdict: "There are two ways to handle this problem. One is to cut and pull up the skin; the other is to scrape away the fat. The first solution won't work well with you because of the structure of your face and eyes. You will wind up with white permanently beneath your irises and you will look strange. I advise the second solution, because it is simpler and does not require general anesthesia. The whole thing takes 20 minutes and you can walk out the same day."

An old bag

"Hmm, you don’t have any 'borses' (bags under your eyes)."

"I have a small face, though. I don't want to do anything that will interfere with my smile. My smile is my best feature (I smiled to emphasize my point) and I don't want to be pulled so tight that it's hard to smile. And my eyes are already small and a little slanted. I don't want them pulled tight either."

"I don't share the same philosophy of my American colleagues. They believe in pulling the skin tight. I don't pull the skin. I work with the muscles under the skin. The result is more natural."

Up in smoke

"Yes, hmm, the skin above the eyes, the wrinkles here (touching my dinosaur tracks), the neck. How old are you?"

"I'm 54."

"Her neck is terrible," my husband chimed in. "Especially at night, when she is tired, the skin hangs down. Her whole face looks haggard."

"Hmm," said the doctor. "Do you smoke?"

"Never put a cigarette in my mouth. Barely drink. No drugs. And up until three years ago I was running six to eight kilometers a day."

"Good, good, you don’t smoke. Smoking is bad because it slows down the circulation of blood that supplies oxygen to the skin. It impedes healing and encourages the formation of scars. The result is disastrous for healing wounds of any kind. It also cuts the time a facelift lasts in half.”

That was kind, I thought. He makes a recommendation that affects his business negatively.