/ 20 November 1998

An about face on plastic surgery

Angella Johnson : View From a Broad

They say that money can’t buy you love. Well, it can at least get you the body and face of your dreams. I had been considering cosmetic surgery for some time – nothing radical, mind you, just a little liposuction on the adipose tissue in my stomach.

But it took the recent wave of local celebrities confessing that they have been under the scalpel, one actress going so far as to have her face lifted for real in the television soap opera Avenues, to send me scouting for a surgeon.

Someone suggested I telephone Dr Siegmund Johannes at his Randburg clinic, and I was told it would be five weeks before a gap could be found in his busy schedule. “Well, if you want the best, that’s the time you have to wait,” said his receptionist.

In the meantime I had a little chat with Hennie Roos, often described as the doctor who made cosmetic surgery accessible to Jane and Joe Bloggs. I wanted to know if it was safe for black folks (we are prone to keloid scarring).

“Oh, I see many black patients,” he replied easily. “But not so much for facial work because black skin does not age as quickly. They usually want liposuction or to fix pigmentation problems from incorrect use of skin lighteners and cosmetics.”

Roos, who performed the surgery on Ave- nues, listed two of his more famous black clients – journalist Nancy Dube, beauty editor of Base and True Love, and Tselani Tambo (I heard she screamed through her lipo).

He claims there has been an explosion in demand for cosmetic surgery over the past two years, due largely to the popularity of glossy American television soap operas.

Many people also believe looking younger and more vibrant will help secure their jobs. It’s not just vanity, argued Roos, “It’s a fact that beautiful people have a better chance in life than ugly people.”

About 75% of his patients are women – three years ago the figure was 99%. Most want liposuction, followed in popularity by facial surgery, eye and eyebrow lifts, breast enlargements and tummy tucks.

Men also favour fat removal from the stomach, breast and neck. Face lifts, pinning back ears (so as not to look like Prince Charles) and hair implants are also popular.

It all sounded so painful though. I began to wonder if surgery was really for me. Maybe I could just do more crunches and sit-ups.

But when the day finally arrived for my one-hour consultation with Johannes, I found myself nervously sitting in his air- conditioned Olivedale surgery. He was running 30 minutes late having just stepped off the plane from New York, but looked cool and unruffled in his silk shirt.

I took in the decor of his office, with its numerous tree-size potted plants and statues of elephants in bronze, stone and plaster. Two vases packed with roses – one red and the other orange – added a burst of colour.

“So, what is it that you want to have done?” he asked pleasantly.

Suddenly lipo and a tummy tuck seemed too ordinary. I heard myself blurting out: I want to fix the dark sunken cavities under my eyes, get rid of my laughter lines and fix my nose .

The weird thing was that my face is the only part of myself that I’ve always been reasonably happy with. I really expected him to repeat what the man in his waiting room had said – that I was beautiful and didn’t need to change a thing.

Instead Johannes launched into a detailed explanation of how he could “refine” my nose by shaving down cartilage, breaking bone with a fine chisel (ouch!) and re- draping skin.

“We don’t actually break the nose,” he corrected. “It’s more of a crack along the sides.” (Oh yippie! So much better, I’m sure.) After the operation my nose would be plugged (oral breathing only) and splinted for a couple of days.

I was promised no visible scarring and advised to take seven to 10 days off work, though several weeks would be preferable. What about swelling and bruising? Well, for about 10 days I would have the mother of all shiners, and have a six-week to three- month wait for my nose to shrink.

Johannes gave me a hand-held mirror to peer into while he prodded and pulled at my face. “But you must be realistic about what can be achieved. I can only work with what you have.”

Were there any changes he would not do?

“If you brought me a picture and said I want that nose … to look like Cindy Crawford for example. I would not take you as a patient. Or if it was for vanity.”

Excuse me, but what else was all this if not vanity?

“Vanity is doing it for someone else like a boyfriend or husband,” countered Johannes. “Surgery is the best vehicle to get what you want out of yourself, but it should not be abused.”

He kept talking about lifting my bust as an analogy of how facelifts work. (Was that a hint or something?) One more mention of breasts drooping and he’d have his nose re- sculpted by my fist.

As for my dark circles, they would entail cutting into the eyelids and snipping away excess skin. Any scar would be hidden in the natural folds. “I would not do a full face lift (I’m glad, because I did not ask for one) as your neck is fine and chin line is still well defined.”

Just as well then, because the whole thing would cost about the price of good car. What with hospital, surgeon and anaesthetist’s fees it could leave a R25 000 hole in your savings.

Theatre is the most crippling at R31,50 per minute, then there is R500 per night in hospital (would need to stay for two). My nose would take an estimated two-and-a-half hours, and lids the same.

But it would be cheaper if he did it at a provincial hospital, which cuts it again by less than a half – still a tidy sum. At this point he suggested that I might consider collagen injections to soften my laughter lines (which, by the way, I’m very fond of).

“The downside to this is that the human protein (WHAT?!) would be very temporary and you will have to come back several times to get additional injections.

Back up there, buddy. I wanted to know more about this protein. Did it come from dead people?

“Surgery is more definite and long term, but you are going against gravity. The sutures are like a bra holding up the face,” he continued as if I had not asked.

Where does this collagen come from?

“From pigs, but it’s state-of-the-art stuff,” he said mildly disconcerted.

What if I was Jewish?

“Some does comes from people’s skin – after tummy tucks for example. But don’t worry, the protein is extracted and processed until it is virus free and nonallergic. There are no risks.”

Yeah, so why do I feel like heaving up my lunch?

What the doctor and I did not discuss was the potential downside of cosmetic surgery, such as infections and bleeding – especially after face lifts and breast enlargements. Though thankfully, these are apparently rare – less than 0,5%of patients.

He did, however, warn that not even surgery would last for ever. Five to 15 years down the road I would probably need to top up (I’d probably end up like those lunatic woman who change their face to suit the outfit or the husband).

Later that night I stood naked in front of the bathroom mirror and concluded there was no way in hell I would let anyone put knife, chisel or suction hose to my bod. Let gravity take its course. I’ll fight fat, but not mother nature and the march of time.