Carol Wilkinson, a 55-year-old Mandeville resident, has had microdermabrasian, Botox, Juvederm and laser resurfacing procedures. Lydia Laine, a mother of three, receives ongoing intense pulsed light (IPL) therapy sessions, with plans for a tummy tuck and breast lift in the works. Though their vocations are worlds apart — Wilkinson is a medical sales representative; Laine is a film actress and member of the Screen Actors Guild — the women share a common motivation for their cosmetic procedures. For Laine and Wilkinson, looking good isn't so much a luxury as an economic necessity. In their industries, appearance is one of many factors used in deciding whether or not they receive a paycheck. Due to advances in cosmetic surgery, it's also a factor over which they have some control.
"This is an extremely competitive market," Wilkinson says. "I am working with people who are 30 years younger than I am. I feel like I am judged a little on my appearance, just as a product at the grocery store is judged by its packaging. You represent your product."
Laine shares these sentiments. "In my age category (33 to 44), the competition is stiff. There have been a couple of times that I have nailed auditions and been perfect for the part, and what it came down to is size. I think that [cosmetic procedures] increase my viability in the industry."
Doctors who perform cosmetic procedures report an increase in patients for whom optimum physical appearance is a vital component of career longevity. Dr. Mark Peters, a plastic surgeon in Houma, lists real estate agents, nurses, pharmaceutical representatives and personal trainers among these patients. However, Dr. Nicole Rogers, a cosmetic dermatologist at Old Metairie Dermatology, points out that even workers in fields that aren't traditionally image-oriented feel pressure to look their best.
"With the point we're at in our economy, everyone wants to keep up and make sure they're not being outdone by the younger people," Rogers says.
Patients who have cosmetic surgery in order to remain competitive in the professional world often can't afford to take weeks off to recuperate from surgical procedures like facelifts. Fortunately, a number of noninvasive options can refresh the face's appearance and delay the need for surgical intervention.
"Noninvasive things like Botox and fillers [Restylane and Juvederm] are an affordable and popular option to help patients rejuvenate their appearances," Rogers says. "A combination of retinoids (topical vitamin A derivatives) and fillers to even out the jowl can buy you some time before you even get a facelift."
Restylane, a dermal filler consisting of hyaluronic acid (a molecule identical to those found in human cartilage), gives immediate results and requires little to no down time, says Dr. Felix Bopp, a plastic surgeon at Bopp Dermatology.
"In the aging process, we lose subcutaneous fat under the skin," he says. "Restylane replaces it to restore the full, youthful look of the face. I prefer to use Restylane and Juvederm in the creases that extend from the nose to the corners of the mouth, in the cheeks to reinflate the skin, under the eyes, in the creases of the forehead. ... It can also help with smoker lines that come into the lips, or to fill out thinning lips."
Restylane costs about $600 a syringe, Bopp says, and most patients require one to three syringes. By "layering" the injections incrementally over one another and spacing them three to four months apart, Bopp can create precise results that last up to 18 months. Patients may experience slight swelling or bruising, but most return to work the same day they receive the treatment.
"You don't have to miss any work, and that is key," Bopp says.
While fillers can replace the fullness of the lower face, and Botox can relax crow's feet and deep creases in the forehead, neither of these treatments target the most egregious symptom of the perennially overworked: bags under the eyes. For that, there is a blepharoplasty, or eyelid lift.
"Blepharoplasties, where you take the extra skin from around the eyes so people don't look so tired, are pretty common," Peters says. "It opens the eyes up a little more."
During the upper-eyelid procedure, the surgeon excises excess skin, along with any herniating fat that is causing a bulge in the eyelid, Peters says. "There can be situations where there is so much extra skin that it affects the peripheral vision."
The lower-eyelid blepharoplasty is essentially the same procedure but is slightly more involved and may include repositioning the eyelid. The upper-eyelid blepharoplasty costs about $5,000, Peters says, and the cost for both the upper and lower blepharoplasty is $7,000 to $8,000. It takes about two weeks to heal from a blepharoplasty, but the effects are close to permanent.
"The results tend to last a very long time," Peters says. "You are taking as much skin as can be taken. There is not usually enough laxity of the skin over the remainder of a lifetime to produce a change to the degree of needing surgery."
Rogers cites hair transplantation as another surgery with permanent results that helps "turn back the clock." The procedure has become much more sophisticated since first being performed in 1952, and patients no longer have to fear the telling, Ken-doll hair clusters of the past.
"When people say, 'I've never seen a good hair transplant,' they are right," Rogers says. "They can't tell when it is a good one."
Men, women and people with older, less natural-looking hair-graft transplants can benefit from hair transplants. Those in the early stages of hair loss can delay or, in some cases, prevent the need for surgery by taking prescription medications like Rogaine and Propecia.
"Propecia helps patients hold onto the hair they have," Rogers says. "Ninety percent of men can get regrowth from the medication alone. But they can start with hair transplants as early as hair loss bothers them."
The procedure is performed under local anesthesia and takes most of the day, Rogers says. The surgeon removes a strip of hair follicles from the back of the head and divides it into individual follicular units. Using a specialized blade, the surgeon creates hundreds of individual nicks in the balding area, where she inserts the follicular units one at a time. After six to eight months of settling into their new home, the transplanted hairs start growing. Optimum results are visible within a year, Rogers says, at which point patients may decide on a second surgery to restore even more hair fullness. Depending on the number of grafts, the cost ranges from $4,000 to $8,000.
"The goal is to create a pleasing hairline," Rogers says. "It definitely takes attention to detail and a sense for the aesthetic."
This aesthetic sense, coupled with the desire to make their inner visions of themselves match the physical reality of their appearances, motivates Wilkinson and Laine just as strongly as any professional ambitions.
"I would most definitely be having these procedures if I were not in the [acting] field," Laine says.
Wilkinson cites increased self-confidence as one of the intangible benefits of cosmetic procedures.
"I am glad I did them," she says. "I do think they have made a difference in my ability to stay competitive in my field and get hired. I don't necessarily think they make me look younger, and that's not my goal. My goal is to look the best that I can look."