Flashback 1997: Here's the ugly truth about plastic surgery

"Janie" by Clarity Haynes (National Portrait Gallery)

     I had surgery Wednesday, and while I'm healing thought I'd share some of my surgical stories from over the years. If my surgeon finds himself reading this, rest assured that I have a far more positive view of the medical profession now that I'm carrying around a good-as-new spine, and hip and now, please God, shoulder.

     For a while I was writing a lot of stories about medical procedures. I watched a heart transplant, which was thrilling, and a lung transplant, which was less so, since the patient died.
     I sat in on plastic surgeries: a nose job, a breast lift. I spent 10 hours at the Cook County medical examiner's office observing autopsies. When they brought the baby in, I decided to take a coffee break instead of watching, a decision I'm immensely grateful for today.
     For those eating their morning breakfasts, I'll spare you the details (though there will be some graphic images later, so you might want to finish your poached egg before continuing), other than to say that the procedures were pretty grim viewing.
     Particularly the nose job, which was more than grim, it was grisly. At one point I felt myself about to faint and wanted to retire from the room with my manly decorum intact. "My pen is running out," I lied, slipping toward the door. "I'll be right back; I've got another in my clothes" (I had changed into one of those green hospital scrub suits).
     "Oh, here," said a helpful anesthesiologist, pulling a pen from his pocket and waving it toward me, "you can use mine."
     "No, no, thank you," I said, backing out in to the hall, where I sat for five minutes with my head between my knees. "I need to use my own pen."
     Imagine the comment after I left: "Now there's a strict union for you."
     Of all the procedures I've witnessed — and I'm including the young student podiatrists from Dr. Scholl's College working on the stinking feet of the homeless in a closed room — nothing was as revulsive as a liposuction, a procedure brought back to mind last week by news of a California woman who died after liposuction surgery.
     The California case took place in March, but was just revealed recently. The doctor removed 20 pounds of fat from a woman, who bled to death while the surgeons allegedly did nothing.
     In the 15 years or so it has been performed in this country, liposuction has become an incredibly common procedure — it is the most common form of plastic surgery — and, in my view, testimony to the greed of the medical profession, since it is entirely unnecessary.
     During a liposuction, an aluminum probe — a cannula — is inserted through an incision in the skin into the fatty tissues, which are sucked out by a vacuum pump. It is a very high tech way to lose weight and as sensible as a dentist cleaning your teeth by removing them, scrubbing them down, then putting them back, surgically.
     The official party line on liposuction is that it is used for pockets of fat that can't be reduced through dieting. That's a lot of hooey. The woman whose liposuction I saw was zaftig. She was heavy. Not heavy in certain isolated pockets. Heavy all over. What she needed was to eat less and exercise.
      That's how you lose weight: eating less and exercising. It isn't easy, but it sure is preferable to going under the knife.
     The California woman who died was 150 pounds on a 5-foot-3-inch frame. That isn't isolated pockets. That's fat.
      Liposuction, as the surgeon I watched performing it noted, is "an indelicate procedure." The doctor got that cannula under the woman's skin and really worked it. The table shook. In my memory, the surgeon put his knee on the gurney to get better leverage, but that has to be a phantom of my general revulsion at the procedure.
     "Doesn't that damage nerves?" I asked the surgeon, as he worked up a sweat with the cannula. "Aren't they delicate?"
     "Nah," he said. "The nerves are tough — the cannula just pushes them out of the way."
     Right, I thought. Of course it does. Absolutely.
     I wish the patient could have been awake to see just what was being done to her — the plastic surgeon, laughing and joking as he worked. "This is the schmaltz," he said, holding up a jar of reddish-yellow sludge and using the Yiddish term for "fat."
     Anybody contemplating such surgery should, at the very least, watch it performed first. Don't be satisfied with a film. Get yourself into the operating room. Dieting will suddenly look very attractive. Exercise will take on an appeal it never had before. The pounds will fly off.
     Because I can promise you: Nothing will turn you off to plastic surgery as much as watching it will. A life of obesity seems positively jolly compared with the reality of liposuction. Any elective procedure should first be observed before being considered. I've got a good-size eggplant of a Jewish nose jutting out from my face, but after watching a nose lift, I can honestly say that I wouldn't go through a nose job if my wife and the assembled array of the world's womankind gathered with their arms linked and in unison begged me to.
     Every line I see in the mirror, every new wrinkle and sag, will be a welcome visitor compared with the alternative.
     — Originally published in the Sun-Times, May 7, 1997