Beauty before age

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Beauty before age
December 9, 2007
By COLIN STEWART
The Orange County Register

"Yes, I'm a grandmother."

Then Sandra Longnecker sighs. Her image of a grandma Ò "a little gray-haired lady with a soft bosom who bakes" Ò is straight from the mid-20th century. But Longnecker's life Ò and her looks Ò are far more contemporary.

She exercises. She works (as manager of UC Irvine's Gottschalk Medical Plaza). She's blond, athletic, and, except for a few wrinkles around the eyes that hint at her age (which she gives as "very high 50s"), not much like the grandma ideal she grew up with.

She is, in short, the new face of aging.

Check that. Longnecker is the new expectedface of aging.

Notions of how American women Ò and to a lesser extent, men Ò are supposed to look as they age are changing as fast as medical technology allows.

In hindsight, it's easy to see that the early 20th-century rise in the use of hair coloring Ò a technology that had been around since prehistory Ò was a quaint prelude to the trend, starting as a little secret involving a woman of a certain age and her hairdresser. It was followed in the 1950s by increasingly popular nose jobs, in the 1960s by breast enhancements and in the 1970s by tummy tucks. In this decade came Botox. And skin fillers. And a growing menu of choices that now includes stomach restructurings, eyelid lifts, hair replacements, "cosmetic" surgeries for the vagina and the penis, braces for adults, chin implants, pectoral resurrections, skin peels, and ÷

It's nothing less than a biotech fountain of youth, with many of the products (Botox, the most popular single product in cosmetic medicine) and procedures (liposuction and laser eye treatments) invented or developed in Orange County. Billions of dollars are being spent on creating new age-defying products, and plastic surgery is growing in popularity in medical schools.

But the flood of age-fighting products and procedures has reshaped more than millions of faces and other body parts. It's also changing our minds or, more specifically, our imaginations.

When it comes to looking our chronological age, the expectation Ò particularly for people living in the more comfortable areas of Orange County Ò is don't let it happen.

Consider this: Smooth-skinned, blond, toned Longnecker is the same age that Irene Ryan was in 1961.

And who is Irene Ryan? She was Granny on "The Beverly Hillbillies."

Nobody tracks how many people get plastic surgery in Orange County. But other numbers are known. The place once known on TV as "The O.C.," complete with enhanced women, men and teens, in real life, has the nation's third-highest concentration of plastic surgeons, trailing only South Florida and, perhaps unexpectedly, San Francisco.

It's part of a supply-demand chain that stretches from wealthy places like Longnecker's neighborhood on Balboa Island to the med school at Orange-based UCI Medical Center in Orange, which has trained about a dozen new plastic surgeons in the past decade.

Longnecker, in fact, owes her clear skin in part to a Reliant laser treatment performed last year by Christopher Zachary, M.D., chairman of UCI's Department of Dermatology.

"I like the results," she says. "The color is better, and people ask me what I've done to my skin."

But the county's embrace of artificial looks is part of a trend that has seen cosmetic procedures shift from something only for the wealthy Ò and ripe for mocking Ò to something widely embraced throughout popular culture.

In the 1997 movie "Austin Powers: International Man of Mystery," comedian Mike Myers made fun of bad teeth, which used to be a normal part of life. Now, such teeth are somehow unacceptable. Similarly, hair coloring used to be something that "only your hairdresser knows for sure," but is now acceptable for men, women and children.

Experts say to get used to such cultural shifts.

"In the same way that hair coloring has become acceptable, or even de rigueur, wrinkles are going to become a thing of the past," predicts Ava Shamban, M.D., of Santa Monica, who was the dermatologist for the "Extreme Makeover" television show.

"You never see gray hair on women anymore," says Mary Gilly, professor of marketing at UCI's Merage School of Business, who colors her hair. She speculates that that's what first led people to accept artificial enhancements. "Perhaps it isn't Botox that's the gateway drug," she says. "Maybe it's hair color."

Hair coloring is a given for blond, smooth-skinned Gail McClory, 59, formerly of Huntington Harbour and now of Lake Havasu City, Ariz. It's barely worth mentioning Ò a routine touch-up every three weeks.

She puts plastic surgery in the same category as hair appointments and cosmetics, but with a longer interval in between.

So far, her looks have gotten several boosts from plastic surgeon Donald Altman at Irvine Regional Hospital and Medical Center. In the past nine years, he has performed a brow lift, a face-lift, and a tuneup face-lift on her.

And she adds, "I'll probably be back in another 10 years" for more work. After all, she doesn't want to look like her grandmother.

At McClory's current age, her grandmother had jowls and wrinkles.

"She looked like a grandmother," she says.

And, by modern standards, so does McClory, who is herself a step-grandmother.

"I'm not going to be called 'grandmother,'" she says.

"That seems old to me. I'm 'Geegee.'"

Not everybody embraces the growing popularity of cosmetic medicine. Some see it as an unhealthy denial of nature.

Hours of watching perfect faces and bodies on TV and in movies has an effect on people's self-images. In fact, Zachary, the UCI dermatology chairman, says our culture is creating a generation of young women who will feel that their own normal bodies are defective.

"They won't need laser therapy, they'll be needing psychotherapy," he says.

Gilly adds: "I just saw video of Betty Ford when her husband died. She's still blond at age 89! At some point, it just seems silly."

Plastic surgeon Altman says, "It's OK to age gracefully and to be accepting of one's inherent appearance."

But he has learned to respect patients' wishes for making changes in their bodies, within the limits of what's medically appropriate, he says.

Some plastic surgeons and dermatologists go much farther than Altman would. They urge patients to embrace the image of a bright, ageless future that can be achieved by frequent visits to the doctor's office.

"We're almost halting the aging process," dermatologist Marta Rendon of Boca Raton, Fla., told a recent Las Vegas conference on cosmetic medicine, which was organized by the Aliso Viejo-based market research company Medical Insight.

Shamban, the "Extreme Makeover" dermatologist, echoes Rendon's optimism. "You're no longer stuck with what you're born with. In America, we have the right to transform ourselves. It doesn't matter who your parents are. It doesn't matter where you came from. You can become whatever you want, and this really has carried over into (cosmetic medicine)."

It's an upbeat attitude that not everyone shares.

"That is powerful rhetoric with a distinctly American quality," says Marjorie Jolles, assistant professor in the women's studies program at Cal State Fullerton.

"We don't like to be told we have any limits, and the body represents perhaps the most stubborn limit of them all. No matter how hard we try, we simply cannot will our genetic makeup to be other than what it is."

So far, most people still steer clear of cosmetic injections and plastic surgery.

"A survey of 10,000 people found that approximately 40 percent of women today are considering some form of aesthetic treatment. That's really amazing," says Robert Grant, president of the Allergan Medical division, which makes Botox and Juv»derm. "And 25 percent of men are considering it."

Those statistics also mean 60 percent of women and 75 percent of men aren't thinking of undergoing any form of cosmetic treatment.

Still, everyone is affected by the changes new cosmetic technologies have produced in people's expectations for what an aging face will look like.

"Who would have thought women in their 40s would be fabulous?" Manhattan plastic surgeon Thomas Romo says, "but there's a whole magazine (More) promoting the beauty of women in their 40s, 50s and 60s. It's incredible to me that that's where we're at now."

The change in expectations affects both young and old.

"Eighty is the new 50," says Sandhya Gandhi, M.D., owner of the Spa Retreat medspa in Lake Forest. "There is nothing between 60 and 70. People all say they're 50."

Newport Beach dermatologist Dore Gilbert adds: "People start with Botox injections in their 30s. It picks up steam in the 40s, peaks in the 40s and 50s, and tapers off in the 60s."

Shamban adds to the numbers confusion: "If 50 is the new 30, what does that mean for 30-year-olds? They don't want to look 50."

"I see a lot of women in my office now who are 30, but they're worried Ò they're totally worried. They don't want to look like they're 50, and they're going to start now.

"A 30-year-old woman came in with two kids and said, 'I was thinking about Botox.' And I said, 'What about your acne?'"

Alissa Machesky, 37, of Lake Forest didn't worry about the future, but she disliked how she looked in a bathing suit after giving birth to, and nursing, three babies. So last month she had what she calls a "mini Mommy makeover" Ò a breast lift and removal of loose skin on the lower abdomen.

"I don't want to be perfect," she says. "It's just nice to be able to wear my clothes better."

For true believers, cosmetic medicine is as acceptable as cosmetics for enhancing natural beauty. The question isn't whether to use it, but when.

"I'd like to delay plastic surgery as long as possible," says Nancy Klemm, 43, of Corona del Mar. She has Botox injections every five or six months to remove a wrinkled, fatigued look that she dislikes. To tighten the skin on her neck, she has also undergone a laserlike Thermage treatment, which bathes the skin in radio-frequency waves.

The prospect of further technological improvements in cosmetic medicine is on her mind.

"Ten years from now, we'll see what they'll have come out with," Klemm says. "Maybe I'll never need plastic surgery."