ET, pee, and me

4:10 am. I have to get up to pee again and now I can’t get back to sleep. It’s not the pain exactly because I can’t say precisely what the "pain" is. I do feel like my head has gone 10 rounds with Mike Tyson and Nando says he feels the same. My surgery was only 3.5 hours, not 4 as originally anticipated, and that’s good. The anesthesiologist, arrogant as he is, must know his stuff. Whatever he had given Nando to make him feel like a jolly pepperone, it’s like the scene in "When Harry met Sally": I want whatever he ordered!

That evening and the next morning, Nando asked me several times how he looked. Like a raccoon. Dark half moons under his eyes and dark above them. A thin line of what had to be blood along his lower eyelids. Stitches? I couldn’t see them. The rest of his face unchanged. Actually quite lovely; his skin relaxed and firm, his forehead unwrinkled.

"And how do I look?"

"Oh, you don’t want to know." He had inspected himself in the mirror but didn’t think I’d be inclined to do the same. Blonde young nurse also advised against it.

"You look like ET right now. You should wait a few days."

The operation

At about noon Blondie came in and said, "Now it’s your turn." It felt very unhospital-like to trot after her in my bare feet and my little white babydoll nightgown. Shouldn’t I be on a stretcher or at least a wheelchair? We walked the few steps across the hall to the operating block and I obediently lay down on the operating table. That was already a gas; how often do you get to WALK to your own operation?

I don’t recall Dr. Delos being in the room, though he may have been. The anesthesiologist was on my right and he asked me to hold out my arm. I knew what was coming; I welcomed the anesthesia (considering the alternative), but felt obliged to tell them about my psychological aversion to needles. "You should know I have a problem with needles. I faint when I see them. So I will look the other way." He gave me a piqueur. The nurse said, "Now really that didn’t hurt so much." I agreed but pointed out that psychological reactions are beyond our direct control and have little to do with "pain". That’s all I remember.

Fat farming

I knew from Helene that he would be taking fat from one of my legs and injecting it into the lines running from my nostrils to the ends of my mouth. The fat above the knees is the best for this, she had explained briskly. I immediately thought of my plump expanse and decided it was DOC quality. The fat they’d be taking, in a process identical to liposuction, is grand cru fat, I mused. Why can’t they take a LOT of it? The deal is, they stick a needle into the leg and siphon off the fat. Then they run it through a machine to harvest the grand cru and they throw away the rest. They process the fat to make it right, and then they inject it into my mouth from the inside.

Hungry for humor

Of the other two single bedrooms, one was occupied by a woman who had been "lifted" that day. I never saw her, only the bed with the covers undone and a light on. The third bedroom was unoccupied.

Eight pm. On the early side for a normal dinner but wasn’t it a bit late for people who were supposed to stay light the night before an operation? At five minutes to eight, a knock on the outer door. Dinner? No, a bristling blonde French woman whose hair was tied back in a chignon. "Bonjour. Comment allez-vous?" (Hello. How are you?)

"Bon soir. Je pensais que vous etiez le diner. J’ai faim." (Good evening. I thought you were our dinner. I'm hungry).

Learner and lower

Yesterday afternoon when I was ironing, the song "I've grown accustomed to her face" popped into my head. Not by chance, since we leave for Marseille tomorrow.
I've grown accustomed to my face.
It always makes my day begin.
I've grown accustomed to each line,
Each wrinkle, thick or fine,
The sagging cheek,
The jawline weak.
They’re second nature to me now,
Like breathing out or breathing in.
I'm disadvantaged as a woman
If I don’t rejuvenate,
But the thing that most concerns me
Is if what I buy I’ll hate.
I've grown accustomed to the me that I am used to see,
Accustomed to my face.

Facelift, flashes, fear

The last month of this wretched year of death and fear. Yesterday I had an appointment for my monthly leg waxing at my local beautician's, and I told the young woman proprietor and her assistant that I was getting a facelift, and that they were the only ones to know outside of my husband and the doctor. They reacted positively, encouragingly. As soon as I mentioned the fact, their eyes flashed to my face and I could just HEAR them thinking, "Brava. Good move. You need it, signora." They insisted that I stop back to show them the results as soon as I returned to Busto.

Inner and outer

Among our guests were two Italian men, both 62 years old. Both still had their hair, neither was fully grey, neither wore glasses, both were physically active men who had little apparent extra weight. But the difference between the two! One was bouncy, active, energetic, almost falling over himself to be noticed. Nando had described him to me as a cross between Mickey Rourke and Al Pacino, and that was an uncannily accurate description. The other man radiated grey -- not his hair, not the pallor of his skin, but the way he moved, sat, conversed. He was withdrawn, hunched over, internalized. In the photos, the one seemed closer to 40, the other to 70.

"It’s all the way you feel," I insisted to Nando. "It’s what’s inside, how you project. That’s more important than the facelift." But I looked at the faux "before and after" of myself and wasn’t entirely convinced.

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.

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.

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."

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.

Sun streaming on wrinkles

Now the preliminary chitchat was over, and the serious session could begin. The next question was who had recommended him? I mentioned Joan’s name. "Ah, Joan, the English woman." He smiled at the memory. Good, so he had considered her a success.

Third question: "What do you want to DO?"

My husband and I looked at each other. "My face?" I said. It was more a question than a statement. The doctor asked me to stand near the window where the sunlight was streaming in. He looked at my face intently and pulled a little this way and that.

Fear and furniture

I had a dream about Mom and Dad and furniture from the house of my childhood last night. The furniture was the most meaningful part, though (as often happens in my dreams), I reminded myself while dreaming that there was something amiss, that Mom was dead and it didn’t make sense for her to be IN the dream.

I figure the meaning has something to do with my desire for a home, for sanctuary. But there is no sanctuary these days. A terrorist cell was discovered in BUSTO this past week. And the fear of anthrax is apparently palpable everywhere in the US, especially urban areas.

Fear on a macro level is one thing; fear on a micro-let’s-talk-about-me level is another. We watched part of a television show about facelifts this week. After five minutes my head was light and I wanted to puke. Maybe I will wind up doing one but I definitely do NOT want to know what is being done.

The full monty

The rest of the evening, while my husband and John talked puts and calls in the forex market, Nicole described in detail every cosmetic intervention she has had in the last eight years. Dr. Delos’ artistry had been such a success, it seems, that she had gone on for breast reduction surgery, a tummy tuck, blepharoplasty on her eyelids, further work on her forehead, liposuction on her hips, and within the next year or so, bien sûr, she would be doing another full facelift.

Marseille wasn’t the most exciting place in the world for Nicole, so she had opted to do most of these successive operations in Paris. The shopping is better, there is more nightlife, restaurants are top-notch, and Paris is unquestionably one of the most beautiful cities in the world. "But I think I will go back to Dr. Delos for my next face leaf-t," Nicole concluded. "Perhaps John comes also to do surgery for the bags under his eyes."

Was this an omen?

By a nose

When we met in the lobby of Milan’s swankiest hotel, Nicole eyed me up and down and said in her clear but rapid French, "But ClauDEEa, have you had a LEAF-T?"

She’s not used to seeing me with makeup, I thought. Thank goodness for the discreet lighting of expensive hotels, I thought. What I said was, "Funny you should mention that. I haven’t, but I have an appointment later this month with someone about that very subject. Dr. Delos in Marseille. Joan K, who lives in Monaco, had recommended him."

"Mais Dr. Delos,” gasped Nicole. "He is the one who did my nose and my first leaf-t. I was the one who recommended him to Joan."

It was my turn to be surprised. "Then you think he is good? That’s a relief. He did a wonderful job with your, um, nose. But tell me . . . does it hurt?"

Breathe after burning

The nightmare is over and I am back safe at home. I was there for all of it: in DC when the Pentagon was attacked, across the river from Manhattan on September 12 with the still-burning remnants of the Twin Towers -- like ghost limbs after an amputation -- filling the air with smoke, at Logan Airport in Boston in a situation of utter panic and confusion in one of the first flights to take off from that unhappy terminal.

Right now, something as self-centered and frivolous as a facelift seems like a sugar-coated compensation pill. I tried calling Dr. Delos’s office several times today but the line was always busy. So I faxed them, proposing the date of Wednesday Oct. 24, as I expected to be on the Cote d’Azur for a trade fair the third week of October. You have to keep going. You have no choice.