The no face-lift French?

Mireille Guiliano, the woman who taught three million of her readers that “French Women Don’t Get Fat” (Alfred A. Knopf), was back at her computer with her latest work, “French Women Don’t Get Facelifts.” Her thesis is that all of us should accept aging like French women do with style and attitude, and the book is filled with advice on how to achieve this end. If you need any convincing that her thesis is correct, she points to Catherine Deneuve, who at 70 remains as vivacious as she was in many of her starring roles. Although her claims about French women and plastic surgery are not factually correct, she does give us much to think about in our own attitudes towards aging and the role of plastic surgery, and in challenging our assumptions her ideas are worth our consideration.

Apparently, there was strong reaction in the Parisian plastic surgery world to the claims in her book. In 1926, one of the pioneers of cosmetic surgery in France, Dr. Suzanne Noel, wrote a book, titled “Aesthetic Surgery,” in which she advised her readers to “Do it, don’t talk about it,” and that attitude has persisted. Much of the research underlying a major breakthrough in face-lifting, the defining and lifting of the SMAS (the firm tissue underlying the fat in the cheek and neck) was performed in an anatomy laboratory located on the West Bank in Paris. A good friend of mine at Columbia University trained with one of the most famous craniofacial plastic surgeons of his day, Dr. Daniel Marchac. Marchac was also well-known for the beautiful face-lifts that he did. As for Deneuve’s timeless beauty, a French friend of mine familiar with Guiliano’s work commented that Deneuve doesn’t represent the typical 70-year-old French woman, just as Sandra Bullock is not your average 49-year-old American woman. Clearly French women undergo plastic surgery procedures as much as anyone else, so what can they teach us about our own attitudes towards the art?

Cosmetic surgery should not be about changing one’s appearance, or dialing the clock back to a different age. At its best, plastic surgery procedures, from Botox injections to body contouring to face-lifts, are about self-image and confidence. When the motivation for a cosmetic treatment is about improvement and enhancement rather than dramatic transformation, the results are most satisfying. In consultations with my cosmetic surgery patients, I try to focus on the features they have that make them unique and improve and rejuvenate their appearances within those terms. Looking natural and comfortable is always the goal, avoiding an “operated-upon” look. When a face-lift patient comes back and tells me his or her friends and family remarked on how rested or vigorous he or she looks, I take the greatest satisfaction. In the end, it’s about giving people the confidence to feel better about themselves and age gracefully, which is the real message of Guiliano’s book.

Learning to accept what we actually are – that’s truly aging with attitude. Sometimes we can benefit with a little help along the way and that’s where plastic surgery is at its most effective, whether you’re French, American or anything else.

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