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  Contact New York plastic surgeon Dr. Sherman for eyelid surgery today.
Diary of an Eye Job:
Louisa Kamps talks to a thirty-year-old woman opting to get rid
of her excess baggage.
The Consultation
Thursday, October 24
With her dark hair, wide mouth, and strikingly sexy, big brown
eyes, thirty-year-old Dana Oster, an anesthesiologist at New York
Hospital-Cornell Medical Center, seems an unlikely candidate for
an eye job. But seated in the Fifth Avenue office of plastic surgeon
John E. Sherman, MD, Dana and her husband, Jonathan, are
firming up the last details for her laser transconjunctival blepharoplasty
- the permanent removal of fat from under the eyelids - scheduled
for the next day. Since she arguably does not require any alteration,
Dr. Sherman makes his case vigorously to me. "You can see the pockets
she has," he says, gesturing to moderate puffiness beneath Dana's
eyes, which makes her look, if anything, a little underslept. "That
varies depending on how much fluid she has - whether she's premenstrual
or she's eaten Chinese the night before."
Dr. Sherman lists the advantages of the operation for Dana:
Since the laser - rapidly replacing the scalpel as the instrument
of choice in plastic surgery - will incise the conjunctive, the
pink membrane on the inside of the eyelids, there will be no visible
scarring; since the laser's heat cauterizes blood vessels as it
cuts, there will be minimal bruising; and, because of Dana's age
and the relative elasticiy of her skin, she will not require laser
resurfacing on the outside of her lids, as some patients do, to
make her skin retract after the fat is taken out. Ectropion - a
turning out of the skin of the lower lids that can be caused by
the removal of too much skin - is a serious potential complication
of the operation, Dr. Sherman explains, but he says he's
never heard of it happening to a young patient with this method.
"Of all the operations we do," Dr. Sherman says, "this is
the most predictable. In sports terms, it's a slam dunk. You don't
see patients like her. She's got great eyes. She looks great before
the operation, but she'll look even better after."
Later the Same Day
The Osters and I walk from Dr. Sherman's office to a nearby
coffee bar, where Dana talks animatedly about her decision to have
the operation. Since she sees critical surgery patients as well
as cosmetic ones in her own work, she's aware of the risks involved
in any kind of operation, and describes herself as "conservative
as far as elective procedures go." She has mixed feelings about
plastic surgery: "I might look at someone and be, like, My God.
Her fifth boob operation?" she says. "But if they derive something
from it and it helps them internally, you really can't judge. I
try not to, anyway."
Dana says she's been aware of the bags under her eyes since she
was a child but has never been acutely annoyed by them or felt they
were a tragic physical flaw.
It's the kind of thing where I would say to John now and then,
'Look at these bags under my eyes,' she explains, shrugging. Still,
when Dr. Sherman, who occasionally works with Dana at Cornell,
noticed her eyes were puffy above her surgical mask and approached
her one day about having the operation (and offered his services
gratis), she began to consider it seriously - and put her fears
and biases about cosmetic surgery in perspective. "I thought about
the whole need-versus-want thing. I mean, I don't really need this,"
she says. "But I weighed the risks and benefits, and there aren't
a lot of risks: It's not an invasive procedure. I'm young, I'm healthy.
There's minimal bruising - I won't have to miss work." She pauses.
"It's kind of like having a mole on your face. It's not a big deal,
but if it bugs you and it's a minor thing to take it off - why not?"
When I ask her if she's anxious about the surgery, she shakes
her head firmly and says, "I'm calm and excited to see the results.
That's all."
"I just hope I don't lose you," John sniffs theatrically. Dana
laughs and rolls her eyes. "Shut up."
The Operation
Friday, October 25
Dana, wearing a pink surgical gown, is lying on the able when
I enter the operating room in Dr. Sherman's office; though
she's smiling, her former calm has dissolved. "I'm so nervous!"
she cries. As the anesthesiologist inserts an IV into the back of
her hand, Dana, who has only had anesthesia once before, confesses
that, for her, the experience of being sedated is a funny mix of
busman's holiday and science experiment. "All day long I give people
these medicines and I wonder, What the hell do they feel?" she says.
The anesthesiologist pumps the first part of a mix of drugs - analgesics
and anxiolytic-into the IV, and Dana tries to gauge her reactions
clinically: "I feel it: It's a calming effect. Thoughts are separating."
She is quiet for a moment, then says, slowly, "Wow. Wild. Unbelievable."
When Dr. Sherman, dressed for surgery in green scrubs, green
rubber clogs, and a red calico beanie, sees that Dana is sedated
(he calls it "the margarita effect"), he and a scrub nurse place
corneal shields - metal disks like oversize contact lenses - on
her eyes to protect them. Dr. Sherman injects local anesthetic into
Dana's lower lids and turns on the Three Tenors.
Using a smooth metal hook, the nurse lifts Dana's right lower
lid away from her face to expose the conjunctiva. Dr. Sherman
takes up his laser - a pen-like tool connected by a long, flexible
metal arm to a large generator - and begins making cuts in the tissue.
(As promised, the laser's incisions are eerily bloodless.) Using
tweezers, Dr. Sherman begins pulling out pieces of lumpy, pale-yellow
fat that look - there is no nicer way to put it - like chicken scraps;
he then runs the laser's beam back and forth over the fat until
it detaches, sealing the blood vessels at the same time. (This part
of the procedure causes a small amount of smoking and sparking and
since the smoke - essentially vaporized tissue - could conduct viruses,
another nurse holds the hose of a smoke retractor near Dana's eyes.)
Dr. Sherman removes nine corn-kernel-sized balls of fat from under
the right eye, and then he repeats the procedure on the left, taking
out roughly the same amount. Just as I'm beginning to be able to
uncurl my toes, Dr. Sherman removes the corneal shields,
pushes back his stool, and declares, "We're done." (Since the conjunctive
heals quickly, Dana does not require stitches; the entire procedure
has taken about twenty-five minutes.) Dr. Sherman points to the
areas under Dana's eyes, which are notably flatter, and, beaming,
says, "Look at the difference in the contour. See where it goes
down now? You can see the outline of her muscle. You couldn't see
that before. Great, huh? We always end in time for this" - he raises
his hands to indicate the Three Tenors' rousing finale and shakes
his head, as though genuinely baffled by his luck. "We have fun
here. I can't believe I get paid to do this."
The Follow-Up
Friday, November 1
One week after the operation, I visit Dana at Cornell, where she's
taking a break between surgeries. Her hair is tucked under a mesh
net, and, even so, she looks beautiful. There is a faint yellowish
bruising on the skin below her eyes, and while her lower lids are
still swollen enough to cover the bottoms of her irises, she looks
exactly like herself - only maybe a bit more alert and well-rested
than she did before. She says she still feels mild tightness and
tenderness around her eyes and that her vision is slightly blurry.
(Dr. Sherman has reassured her this will disappear as soon
as her eye muscles fully recuperate.) In general, though, Dana is
pleased with the results - overwhelmingly so. "The swelling went
down a day later; I was back at work on Monday. I started exercising
again four days after the operation." A few people at work noticed
the bruising, she says, but, generally - and happily - the results
are apparent only to her. "I don't see the bags anymore, which is
just kind of cool," she says, smiling. "It's something that I know
is different. And I'm glad it's nothing more dramatic than that."
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