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May 1995

Nipping and Tucking in Tinseltown Hollywood and plastic surgery started out together, and now, it seems, there
can't be one without the other.
By Joan Kron

Oscar time is high season for cosmetic surgery in Los Angeles. No matter who ends up winning—whether it's Jodie or Jessica or Winona or Miranda or Susan—Hollywood's beauty doctors are usually the ones who come out ahead. Even before the nominations are announced, many film folks "who expect to be in the running or know the TV cameras will be on them at the ceremonies" check in for face and body work—eye tucks, face-lifts, or liposuction, says someone who should know.

At the eleventh hour, there's a rush for wrinkle treatments. "It's not exactly a quiet time in my office," says Beverly Hills dermatologist Arnold Klein, a collagen specialist. "Fewer wrinkles never hurt when you're on-camera." (If his patients win, says Klein, he often receives cases of champagne. "It's Academy Awards for them, but it's Christmas for me.")

Then comes the second wave. "Our patients tend to respond more after the awards have aired," says L.A. plastic surgeon John Williams. He and many of his colleagues consider the Oscar telecast a potent motivator, attracting a stream of new patients—many from out of town—to Southern California's approximately 333 plastic surgeons.

"There's an assumption that if you have the surgery done in an entertainment location, you'll look like an entertainer," says Santa Monica plastic surgeon Steven M. Hoefflin, who estimates that one-third of his patients come from outside Southern California.

Aspirants often arrive for their consultations clutching pictures of stars they admire. Julia Roberts may reportedly command $14 million for a sequel to Pretty Woman, but her face, though distinctive, "is not a face people want to emulate," says Edward Terino, a plastic surgeon based in Los Angeles. "She's not thought of as a classic beauty, even though her features are extremely interesting and attractive." Patients often cite specific facial features and then mix and match. Roberts's mouth is mentioned occasionally, but most coveted are Kim Basinger's lips, Jodie Foster's nose, Sophia Loren's eyes, and Sharon Stone's cheekbones.

Frequently, the physical characteristics that patients envy, such as Melanie Griffith's pouty lips and ample bosom, owe more to plastic surgery than to Mother Nature. But that should come as no surprise. Ever since Louis B. Mayer advised the budding Greta Garbo to get her teeth fixed and to lose weight because Americans didn't like their movie stars fat, Hollywood bas been turning the barely dumpy into the exceedingly dishy with diet, exercise, massage. electrolysis, hairdressing, makeup, teeth capping, chemical peels, and, yes, plastic surgery—although actors would sooner confess drug addiction than surgical modification.

On their way up, stars like Merle Oberon and Marilyn Monroe had facial surgery to photograph better. On their way down, stars like Joan Crawford, Lana Turner, Burt Lancaster, and John Wayne had work done to photograph younger. "Actors' faces are their fortune—and as they age, their misfortune," says Richard Aronsohn, an ear, nose, and throat specialist who has practiced cosmetic surgery in Hollywood since 1958. When Joan Crawford and Bette Davis finally began looking their age, the only leads they could get were in horror films. Most actors, of course, want to postpone that unappealing career track as long as they possibly can.

"No one is more cutting-edge on plastic surgery alternatives than "visual entertainers,'" says Hoefflin, referring to television and movie performers. He estimates, conservatively, that "50 percent of them have had or will have aesthetic surgery." And, he adds, "they will be the first to fly anywhere in the world for treatment."

But Hollywood's plastic surgeons work hard to keep these patients at home—catering to their desire for pampering, privacy, and, some would say, excessive procedures. Hoefflin (who transformed Michael Jackson with several nose operations) has no hesitation about changing a patients looks drastically "if the patient feels strongly enough about achieving a certain result and it is surgically possible and safe." And Jackson isn't Hollywood's only plastic surgery overachiever. Gloria Swanson had several face-lifts. Phyllis Diller has had so many procedures she supplies a list (to any one who asks) of the doctors who performed each one. Dolly Partons recent autobiography, Dolly, thanks no fewer than four plastic surgeons.

The highly visible makeovers grab attention, but it's the constant maintenance surgery that keeps Hollywood's beauty doctors busy. "A little eye work. The tilt of the nose. So minuscule it's almost unnoticed. It's as if the doctors are on retainer," says one veteran plastic surgery nurse. "The youth and renown of the patients would surprise you," she says conspiratorially.

Even an earthquake of 6.6 on the Richter scale could not close down the operating rooms for long. Los Angeles rumbled to a standstill at 4 A.M. on Monday, January 17, 1994. Later that morning, at plastic surgeons' offices throughout the area-roadblocks, collapsed freeways, and aftershocks notwithstanding-many patients scheduled for elective surgery showed up. "We had patients waiting outside our door on Monday morning," says an assistant to Hoefflin, who was in the operating room using backup generators within 48 hours. Other doctors were operating on Monday. "I picked up post-op patients Tuesday afternoon," reports Nola Rocco, proprietor of the Hidden Garden, a Beverly Hills recovery facility. As they say, the show must go on.

The film industry and cosmetic surgery have been codependent since they were both in their infancy. Modern cosmetic surgery took off after World War I, utilizing techniques developed to treat casualties of modern warfare. The film close-up dates from the same period. It was invented by director D. W. Griffith and cameraman G. W. "Billy" Bitzer. "The close-up eradicated the distance between viewer and actor," writes Jib Fowles in his 1992 book about celebrity, Starstruck, allowing moviegoers "to study every feature, every tic of feeling." And every imperfection.

Creating the illusions while managing the imperfections required legions of specialists, as anyone who reads film credits knows. But makeup, lighting, special lenses, and lens coatings—such as Vaseline and gauze—can correct only so much.

Film actors became willing guinea pigs for each new surgical development and often lived to regret trying such "advances" as paraffin injections. "We dreamed about some alchemy to fill hollows and wrinkles," says Edward Lemont, one of Hollywood's earliest plastic surgeons and an expert in treating the complications of paraffin, (In his 70s, he no longer practices, although he continues to teach.) Actors braved nose surgery in the 30s and 40s (when perfect profiles were prized). Unfortunately, noses were often "overdone," says Lawrence Seifert, assistant clinical professor of plastic surgery at UCLA: "Scooped, pinched, and turned up. Chicken McNugget. Everyone had the same nose." In the 50s (when the television camera exaggerated every wrinkle), male actors suddenly "discovered facial folds, bags under their eyes, baldness, ears sticking out, traumatic scars, a crooked nose" and wanted them fixed, said the late plastic surgeon Michael Gurdin in a 1983 interview. In the sweater-girl 50s and the braless 60s, actresses were among the first women to have breast implants. In the late 70s, just as more skin was being exposed in films, liposuction came to Hollywood, direct from France, where it had been developed.

Plastic surgeons believe Phyllis Diller was the most influential star for Middle Americans—as strange as she may appear to some. She took plastic surgery public when denial was Hollywood's modus operandi. (And, in large part, it still is.) Franklin Ashley, the doctor who performed Diller's first face-lift, in 1971, considered her his legacy, says his widow. Because of the star's honesty, says plastic surgeon A. Richard Grossman of Shennan Oaks, California, the public's attitude about cosmetic surgery "went, in one decade, from fear to acceptance to desire."

For years actresses who wanted to avoid surgery endured the "Hollywood lift," a face-tugging device rigged up by makeup artists with glue, silk thread, and rubber bands. But it was hard on the ears and would sometimes snap in the middle of a scene. "I haven't made one in years," says Michael Westmorc, the makeup designer and supervisor for the Star Trek television series and movies.

The advent of larger movie screens—and better-quality film made surgical nips and tucks more necessary than ever before. "A tight close-up magnifies the face hundreds of times. Even the smallest mole shows up," says Westmore. "In the old days, we used heavy makeup base; today we're using thinner makeup, and you can really see the texture and coloring of the actor's face."

In Hollywood now, plastic surgery is not the last resort of aspiring actresses—it's often the first. "It's as if their bodies, their faces, are tools of their profession," says L.A. plastic surgeon Peter Bella Fodor. "Perhaps it's a rationalization, but they say, 'I would do better if this or that were changed.'" The performers' managers or agents often advocate surgery.

I'm not reticent about recommending breast reductions or augmentations to a client," says Shelley Browning, the president and CEO of Creative Partners, a Los Angeles talent-management company. Browning, a former model, calls herself an "architect of development." "One of the key roles we perform," she says, "is to make sure clients look as good as they can." She concedes "there are certainly stars who are less than physical perfection. The first ingredient of success is incredible talent. No amount of plastic surgery can make someone without talent a star. But I do believe that when you are beginning, you need everything going for you."

Actors frequently elect to have surgery when "they are up for a particular role and want to look closer to the age of the character, or just want to look like themselves—but better—on test shots," says Steven Hoefflin. The business is so competitive, he says, that one star's rejuvenation often drives her competitors to take similar measures.

Once a face is well-known, though, it cannot change much. "The most emphatic way in which stars can alienate themselves from their audience is through the brutally simple, ineluctable process of aging," writes Jib Fowles. He goes on to quote Marilyn Monroe's insight on the subject. "When my looks start to go," the actress once supposedly said, "so will most of my fans."

"Characteristic features must be maintained," Hoefflin says. "An actress with lovely eyes, whose eyes start sagging, wants to maintain them." In such cases, plastic surgery may not be mandated contractually, because of liability problems, but it is subtly (and not so subtly) encouraged. A few years ago, when a cinematographer complained about the way a fortyish Oscar winner was looking in the dailies, filming halted long enough for the star to have an eye-lift. "We paid for it," says one of the producers.

During the making of The Bonfire of tile Vanities, Julie Salamon writes in her book The Devil's Candy, "The men...were brutal in their analysis" of Melanie Griffith's looks. "The cinematographer [Vilmos Zsigmond] kept carping, "She doesn't mind those lines around her eyes? Those bags?'...He thought to himself, 'How could Sherman McCoy be in love with...an old bag?'" Someone suggested using Preparation H: '"That'll shrink 'em.'" Griffith, who was 34 at the time and a new mother, did nothing about her eyes but took three weeks off and had breast implant surgery instead.

"It is very common for young actresses to proclaim that they'll never have plastic surgery—as if they'll never get old," says John Williams, who was briefly married to Eva Gabor and who has operated on scores of famous faces. "But almost invariably, when they do begin to age, they change their minds. Some change so radically they become obsessed with what we can do for them."

Hollywood surgeons delight in trading stories about this or that patient who appeared on TV insisting that she had never had—and would never consider having any plastic surgery. Doctors say actresses lie even to them. "Zsa Zsa Gabor sat in my office," says a prominent plastic surgeon, "and told me she had never had anything done—and I could see the scars."

Certifiable holdouts such as Diane Keaton and Anne Bancroft are not exactly plentiful. "Five years ago, I would have said no way," Jessica Lange said in a recent interview with Women's Wear Daily. "But as you age, you start thinking, Well, there's always that option."

"I don't know of one woman out here who doesn't think about it while driving," says actress Lesley Ann Warren, 46, describing her daily face-lift rehearsal in the rearview mirror "one hand on the wheel and one hand pulling your face back." Best known for her role as the chorus girl in Victor, Victoria, Warren has, so far, resisted surgery. "I have been conscientious about the way I've chosen to live," she says, citing healthy eating, homeopathy, Chinese herbs, and psychic healing. She believes that because of her habits, "my looks and my age don't match." But she does worry about what will happen when she reaches her 50s. "There may come a time when the pressure of the loss of beauty becomes more than I can bear," she says.

That will all change if Barbra Streisand proceeds with the film property she is developing. It is a remake of The Mirror Has Two Faces, a 1959 French film. Streisand's version is about married college professors whose lives undergo great change when the wife's plastic surgery transforms her into a great beauty. Streisand—not surprisingly—will direct, produce, and star, but it has been rumored she won't need surgery for the part. The transformation to goddess (or so the gossip goes) will be done with digital imaging. Says a Streisand spokesman, "If [that] decision has been made, she has not made it known."

If the Chanel No.5 model can morph into Marilyn Monroe in a TV commercial, then Barbra Streisand and a whole generation of actresses can be given virtual-reality nose jobs and face-lifts. The question is, If Streisand falls in love with her morphed movie image, will she want to translate it into flesh? If nothing else, the film promises to be a shoo-in for an Oscar in the category of special effects.

Monroe's Doctrine
Marilyn Monroe had plastic surgery, although there is certainly no unanimity on how much or who did it. In 1949 Monroe was a $75-a-week contract player" who was "getting nowhere fast." According to Patrick McGrady, in his book the Youth Doctors, after overhearing someone refer to her as "a chinless wonder," Monroe had a tiny chin graft.

The work was performed by the late plastic surgeon John Pangman. However, Donald Spoto, in Marilyn Monroe, the Biography, credits late plastic surgeon Michael Gurdin with inserting a "silicone prosthesis in her jaw...to give her face a softer line" and "removing a slight bump of cartilage from the tip of [her] nose." According to A. Richard Grossman, a plastic surgeon who worked with Gurdin in 1964, Pangman also gave Monroe breast implants. They were probably made of Ivalon sponge, the toublesome material that predated silicone gel. Other sources say Monroe may also have had now-forbidden liquid-silicone injected into her breasts. Shortly before her death In 1962, "Marilyn's breasts were infected. They were oozing," says Rosemary Ashley Eckersley, the widow of Franklin Ashley, Hollywood's other prominent plastic surgeon of that era. "Marilyn wanted Frank to do something about them, but he wouldn't."

Face-lift Films
Hollywood's denizens may have amnesia when it comes to their personal experiences with plastic surgery, but filmmakers have used cosmetic surgery as a plot device in more than 60 films since World War I.

Many scenarios revolve around spies and criminals who need new faces to escape detedion, or around characters who have been disfigured. Joan Crawford portrayed a woman whose face was disfigured—on just one side—in the 1941 film A Woman's Face. During most of the film, audiences saw only her good side.

The surgeons in these films are often diabolical, drunk, or deranged. But, boy, are they skilled. A back-alley doctor in Dark Passage (1947) transforms an accused murderer—played by a nondescript looking actor—into Humphrey Bogart. In Seconds (1966), amoral surgeons transform a melancholy businessman into a youthful (and taller) Rock Hudson. Shattered (1991) concerns misguided surgeons who rebuild the face of an amnesiac auto-accident victim (the wife's lover) so that it is the spitting image of her dead husband's.

Only a handful of these films deal with what Hollywood knows best-rejuvenation and subtle cosmetic improvement. In Ash Wednesday (1973), Elizabeth Taylor let makeup people give her a double chin and worse so she could play an over-the-hill corporate wife. The film uses real face-lift footage (though none of it actual Taylor face-lift footage) and honestly depicts postoperative swelling and bruising.

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