Does This Make Me Look Operated?

What do Sharon Osbourne (56), Vanessa Williams (45), Jennie Garth (36), Daisy Fuentes (42), Brooke Shields (43), Simon Crowell (49), David Hasselhof (56), Linda Evangelista (43), Janice Dickinson (53), Lisa Rinna (45), Lori Loughlin (44), and Courtney Cox (44) all have in common?

Fewer wrinkles!

It's not a coincidence that there has been a slew of Botox "confessions" from Hollywood celebrities in the last few months. It coincides with Allergan's (the manufacturer of Botox® Cosmetic aka Botulinum Toxin Type A) marketing push launched in 2007 and formatted as a hybrid public service/infomercial/giveaway featuring well-known personalities.
Olympians Mark Spitz (58) and Nadia Comaneci (47) both gave lecture tours on “Your Personal Best” this fall. Virginia Madsen (44) hawked Botox with her mother in "Freedom of Expression."

By her own admission, Madsen got the job by a slip of the tongue in an interview shortly after the surprise success of her Oscar-nominated film role in Sideways (2004).

But it is really just stating the obvious: Aging Hollywood faces have help from knives and needles.

Short of the kind of admissions currently being featured in magazines, how do you know who's telling the whole truth?

It's all in the ears.

Rhytidectomies do the heavy lifting and offer the most clues. In a traditional facelift, an incision is made in front of the ear extending up into the hairline and down around the bottom of the ear and then up behind it, usually ending in the hairline. (For an excellent pictorial tutorial of the actual surgery, go here.)

Shall we play I Spy? I spy with my little eye....operated auricles.

A pixied earlobe is the distorted result when the reattached lobule is pulled down and forward onto the cheek. A fine example is Micky Rourke's (56) left ear; both are shown. A competent facial plastic surgeon will preserve the shape of the lobe you with which you were born. Otherwise, a big earring is the answer.

Poor scar placement and poor incision planning can be covered up with hairstyling– less so if you are David Gest (55). Over time, John Cleese's (69) aging facelift has relaxed into something appearing fairly natural, but his misplaced post-auricular scar in probably still very visible. (Check out the big kiss scene in Fierce Creatures, 1997).

The pre- and post-auricular skin of the ear is specialized: it is thin and nonhair-bearing. In some (especially men) the facial skin does not match identically with the ear skin. Removing this patch of pliable, hairless skin can have unnatural results....like shaving your ear.

Perhaps more subtle is temporal hair loss or the sacrifice of the tuft of hair at the upper junction of the ear and face. As with Sophia Loren's (74) right ear, it can give a man or woman the appearance of wearing a wig.

The incision can go behind the tragus, that little cartilaginous bump in front of the ear hole, or in front of it. Female stars like Joan Rivers (75) usually opted for behind, in order to camouflage the scar. Poorly handled, the natural definition/indentation in that area is lost, blunting of the facial-ear junction.

Sometimes the tragus itself is distorted and pulled forward by the tension of the lift and/or the thickness of the redraped skin (this settles out over time as it has for Madonna, 50).

And whose operated ears do I Spy here?




After a traditional facelift, some of these stars may appear wonderful in photos, but as soon as they try to move their faces they look a bit Frankenface. The old-school operated look is something smooth and taut, but not young. The new look is all about volume, not subtraction. Volume is the very essence of facial youth and next-generation surgery is all about adding it.



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I Spy answers:

Early Intervention (Authentically Aging)

Today's topic deals with those first steps– no, not the toddler ones, the surgical ones. Is it ever too soon, too early? Or, the earlier, the better? Read on...

The statistics vary, but the percentage of 20-something patients seeking out anti-aging therapies is on the up-tick. And it's not just lotions & potions that they are after. It's also the non-surgical procedures like laser treatments and dermal fillers and botox.

Premature aging is really the venue of pack-a-day smokers and girls who own tanning goggles, yet full-blown age-orexics are popping up everywhere. Hollywood has it's share– just read the tabloids to see what Lindsay Lohan, Jessica Simpson, Nicole Richie, Britney Spears, etc. are having done– but the antiaging obsession is affecting younger and younger women all across the country.

A young woman may pursue a series of light glycolic peels and microdermabrasion over several months to encourage skin cell turnover; Intense Pulsed Light therapy (IPL) laser treatments to eliminate broken blood vessels and sun spots; lipodissolve for cellulite; a little bit of Botox to forestall furrow lines between the brows or crowsfeet; and finally, Restylane or Juvederm to soften any smile creases should she be so reckless as to grin a lot (see above). And of course religious application of a topical retinol (vitamin A) preparation at night and sunblock, moisturizer and topical vitamin C everyday.

(You could also institutionalize yourself transfixed, motionless, and out of the sun ala Oliver Sacks's patients in Awakenings. All of the above will keep the face looking younger, longer.)

These would-be patients are completely preoccupied with the quest for sexy, ageless skin. Physiologically they don't want to leave their 20s. Middle-age has become no-woman's-land. Where does this antiaging fanaticism originate?

In the last decade cosmetic procedures have moved out of the exclusive domain of the surgeon's office into day spas, salons, you name it. It's now ubiquitous amongst the beauty industry. More and more surgeons have responded to the competition with...well, injections, laser, etc. for those who request it– whether or not it's medically indicated.

It's been described by one provider as akin to giving a kid who's underaged a sip of beer: "Okay, take a little taste of this. Better you try it here than at some party." No one involved in this is going to put the kibosh on it.

And today's young woman is raised in a media-driven culture. There was a time when Vogue's top fashion models were actual society beauties well into their 30s and beyond, who could afford the dresses they were wearing. Now haute couture is sold on the backs of emaciated 16-year-old giants. Hollywood has only character parts for the 'aging actress' while the surgically rejuvenated ones try desperately to fit into roles written for cellulite-free 25-year-olds. Television shows most of all exemplify the media's ever increasing tendency to marginalize the middle-aged female.

When people think of facelifts, images of aging Hollywood stars with their faces pulled as tight as their red carpet gowns might come to mind. But some of these 'ageless beauties' hung on with the help of subtle early intervention; threadlifts were said to have long ago helped the facial contours of Catherine Deneuve (63) (she's since had a lot more). And Nicollette Sheridan (43) clearly had work done when she turned 40. Sharon Stone (49) had her first facelift in her mid-30s immediately after wrapping Basic Instinct.

What constitutes subtle? Endoscopic browlifts have replaced the old-fashioned hairline deforming coronal forehead lift (Elizabeth Taylor) and nearly scarless lifts allow plausible deniability. Top-flight aesthetic surgeons have refined the techniques used for early surgery to a fine art. The best are now able to combine several minimally invasive procedures to give a final result which surpasses that of traditional facelift surgery IF the patient starts early– in her late-30s to mid-40s and her skin is in great shape.

Key here is the integrity of younger, intact skin. Pampered epidermis is elastic and resilent before hormone shifts kick during a woman's 40s. So these 20-somethings do have some validity to their concerns: rejuvenation really is all about the skin.

Can you age-proof the body? Not really. You can turn back the clock, like daylight savings time, but the clock is always running. It is a youthful conceit to believe that medicine has conjured up a surgical Dorian Gray.

So what's a girl to do? The most effective anti-aging interventions are well within the pocket book of every 20-something. Wear sunscreen liberally, year round. Indulge your inner movie star with polarized sunglasses when you venture out. Exfoliate daily and avoid smoke like the deadly wrinkle-producer it is. Save some of your money for another decade or two when gravity really kicks in.


Hear Anne live on the Kevyn Burger show Thursdays featuring Knifestyles of the Rich & Famous.