Worried About Wrinkles, Wattles and Thunder Thighs? Here's a Complete Guide to Overhauling Yourself

updated 08/24/1987 AT 01:00 AM EDT

originally published 08/24/1987 AT 01:00 AM EDT

Do you loathe your nose, despair of your derriere, chafe at those chinny chin chins? You are not alone. Thousands of people are deciding they would rather face a plastic surgeon than the mirror's daily disappointments. Last year Americans spent more than a half billion dollars to correct nature's nasty tricks. Since 1984 the number of facelifts has risen 23 percent. Tummy tucks are up 55 percent and demands for body contouring by liposuction (rhymes with hypo, not hippo), a European method of vacuuming fat from beneath the skin, have increased an astonishing 78 percent. Joan Rivers, Carol Burnett and Mariel Hemingway have each confessed to vanity work. Phyllis Diller has all but donated her body to surgical science.

"People are more egocentric today," says Toronto otolaryngologist (ear, nose and throat specialist) Peter Adamson. "They want to look as young as they feel." Or, as Phyllis Diller's faceman, Michael Elam of Newport Beach, puts it, "You can be as healthy as a horse, but if you look like one, that's another story."

As wondrous as today's cosmetic wizardry may seem (anyone for removing a lower rib to narrow your waist?), such surgery has its downside. It is costly—most procedures are not covered by insurance. It hurts. Recovery can take months. And the operations are sometimes risky. Infection is one of the greatest dangers, but consider the case of the New York woman who awakened from a tummy tuck to find her belly button two inches off-center. On rare occasions, cosmetic work has been fatal, and not just for the patient—it has been reported that three plastic surgeons have been murdered by male clients who were dissatisfied with their nose jobs, but the story may be apocryphal.

And don't expect such vanity surgery to change your life. "If people expect an operation to bring back a lost love or turn them into a rock star, they are bound to be disappointed," says Los Angeles plastic surgeon John Goin. "The best candidate has a healthier motivation: This will help me feel better about myself.' "

Herewith, then, a primer to current cosmetic overhauls, and the prices (depending on where you live and the methods used) for a total body beautiful.

Crowsfeet do not fly away with facelifts. A shot of silicone or collagen (purified protein from cow skin) is commonly used to combat tiny age lines around the eyes. To smooth industrial strength grooves, a growing number of surgeons are injecting fat (usually drawn from the inner thigh) instead of collagen, which doesn't last long and can trigger allergic reactions.
Cost: $150 and up

Facelifts are no longer simply a matter of cutting, hoisting and sewing. Today, some surgeons are hiking and tightening underlying face and neck muscles to combat future sagging; others say the risk of nerve damage during that procedure is too great. In another technique, fat is first suctioned from the face, loose skin is pulled back toward the hairline, trimmed and sutured, then fresh fat is injected around the cheek, chin and mouth to plump up areas that look sunken. Expect a swelled head for at least three weeks. Learning to recognize your new self may take longer.
Cost: $2,500-$10,000

A narrow, short, turned-up schnoz, commonly called "California pert," was once the nose of choice. But now, a more natural-looking nose is coming into surgical vogue. The newest procedure is an open peel operation, in which the nose skin is peeled back to allow the surgeon to resculpt cartilage and bone structure. (Before, surgeons worked by feel, going through the nostrils.) To bulk up a puny proboscis, extra cartilage or bone can be grafted from your inner ear or one of your prime ribs.
Cost: $1,600-$6,000

Not ready for a full facelift? A furrowed forehead can be smoothed and sloping eyebrows raised in a tricky procedure that calls for cutting into the hairline, delicately separating nerves and muscles from the skull bone and gently tightening the forehead skin. Scarring can be severe. Numbness may last for months.
Cost: $1,000-$3,500

Eyelifts are now the second most popular procedure among men (Nose jobs are No. 1). To do away with flaps, folds and puffy pouches, cuts are made along the crease of the upper eyelid or the lower lash line. The skin is peeled back, excess fat is snipped away and the incision is closed with fine stitches. Seeing is believing.
Cost: $1,000-$4,000

Need a search party to locate your cheekbones? Cheek implants (silicone pads) come in three sizes and can be inserted in 30 minutes through incisions in the mouth or the lower eyelid. Tissue eventually grows into and around the implants, which prevents them from straying. Fortunately.
Cost: $1,500-$3,000

Looking for a fat lip? To thicken skinny lips, fat harvested from one part of the body can be injected deep into the lip muscle. Full lips can be trimmed by removing a strip of skin from inside your upper or lower lip.
Cost: $1,500-$2,500

Male lawyers are among the rising number of professionals in search of more commanding chins. With silicone implants, it's a 45-minute open-and-shut case.
Cost: $1,000-$1,500

If you think (and Donna Rice, among others, did) that it's what's up front that counts, pay attention. Small breasts can be enlarged with silicone pads or polyurethane implants. (The most common procedure leaves an arc-shaped scar under each breast.) Reduction of oversized breasts, however, calls for major surgery. The scar from this process is anchor-shaped from the nipple down to the crease below the breast. If sagging breasts are your problem, excess skin can be clipped so that the pouch containing the breast tissue is raised and tightened. Thanks to gravity, however, what drooped once will eventually droop again.
Cost: $1,000-$5,000

Upper arm flesh that looks like laundry flapping from a clothesline can be excised only with surgical scissors. But most surgeons recommend against the surgery because the scar leaves an unsightly seam.
Cost: $1,000

Buttock implants are common in South America, but in the U.S. exercise is considered the best antidote to the flat bum. If you insist, the loose skin of the buttocks can be hiked up in surgery.
Cost: $2,400-$3,000

All the uplifts money can buy won't hide reptilian hands. Experiments with a carbon dioxide laser to erase age spots are ongoing. For the moment, hands can be cut, tightened and sutured on the underside of the wrist, although there will be a visible scar to explain.
Cost: $300 and up

Tired of holding everything in? Well, cut it loose! Liposuction can remove love handles and fat from the belly, but not the resulting sag. Those extra folds must be snipped and tucked in major surgery, which leaves a scar from hip to hip along the bikini line.
Cost: $4,000-$6,000

Do people compliment you on your jodhpurs when you don't even own a pair? Liposuction is well suited for those saddlebag pouches of fat clinging to upper thighs. If skin is sufficiently taut, it will shrink back into place. But liposuction won't remove stubborn cellulite. Sorry.
Cost: $800-$2,500

Panicking over the return of the mini? Knee fat can be siphoned in less than five minutes, and loose fat can be removed from calves in the same manner. But get out your slacks: Either way, legs will be bruised and swollen for at least three weeks; full recovery takes up to six months.
Cost: $2,000-$3,000

Spidery veins, those broken capilaries that lurk on calves, thighs and behind knees may save on textured hosiery. If you'd rather go bare, they can be zapped with a micro-laser or flooded out with salt solution injections. But in many cases, new patches of tiny capillaries will eventually appear.
Cost: $75-$150 per half hour

Fat can be sucked from ankles too, but buyers beware: If ankle skin is not elastic, you'll be trading thick ankles for baggy ones. Ankle-thinning surgery is not recommended for cosmetic purposes.

Alas, there is no alchemist's potion, no exotic instrument, no sorcery conjured that can shrink a pair of megapods. At least not yet.

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