Cosmetic Surgery Secrets
Bill Adams, Reinvents Himself

(Editor's note: A little nip here and a little tuck there hardly describes the tremendous surge in male cosmetic surgery. The latest figures indicate that one-fourth of all cosmetic surgical procedures are now done on men. As he approaches 60 in a year where American men will spend $9.5 billion to look better, area writer Bill Adams chronicles his personal experiences in his efforts to look and feel better.)

At first, there appeared to be a typographical error in the invitation. It began: "You are invited to join a few special friends at a cocktail party celebrating Bill Adams' 40th birthday."

Fortieth? Some guests surely remembered attending my fortieth birthday party nearly 20 years ago -- the one I celebrated by buying myself a new car.

Because of the attempted humor or the implied intrigue, they all came to my party back in August -- one of the happiest birthdays I've ever celebrated because I again gave myself something very special: a facelift.

Of course I admit it! After all, when a surgeon removes years from your face, who's going to believe it when you tell them your just well rested?

Now, with the procedures completed and because I have been a professional for more than 40 years, I've been asked to write about the experience. And, believe me, it's difficult not to be a little tongue in cheek when you're writing a first-person story about a middle-aged man having cosmetic surgery--especially when my cheeks and chin were about six inches south of where they were at that "first" fortieth birthday party. Actually, that was about the same time I first considered having a nip and tuck here or there. One of my journalism students had submitted a story about the "new field" of cosmetic surgery and the increasing numbers of people (predominantly female) who were turning to surgery to look and hopefully, feel better about themselves.

Back then, the number of males opting for cosmetic surgery was minimal--usually for hair transplants. In fact, as late as two years ago, statistics published by the American Academy of Cosmetic Surgery show that hair transplants constituted more than 34 percent of all male cosmetic surgery procedures. However, only 1.4 percent of all males having cosmetic surgery had facelifts, and a facelift is what I needed.

How did I go about it? Seriously. Carefully. Thoughtfully.

After all, this is major surgery that not only changes the way you look, but also the way others feel about your and the way you feel about yourself--permanently!

Before you decide what procedures you want to have done (if you really want to do them at all) and who you want to do them, you should become deeply introspective.

In my case, I wanted to get into better physical condition, have whiter, healthier teeth; get rid of my gray hair and say goodbye to the wrinkled, saggy, flabby skin on my face and neck. In other words, I wanted to look again the way I once spent 40 years dreading to look: 40.

So I joined a health club, worked with a personal trainer once a week and lost 20 pounds in one month. During that same time, I also went to my dentist and had my teeth whitened. What I didn't accomplish as easily, however, was finding the right cosmetic surgeon--the most important step in the process. I researched magazines, books, pamphlets and brochures for suggestions. Some made sense. Some didn't

For example, talk to former patients about how they fared with certain doctors. (How can you find someone who was recommended doctor that would say anything negative?)

Look through "before-and-after" picture albums in their offices. (What doctor intelligent enough to get a medical degree would be dumb enough to out anything but flattering "afters" in their albums?)

The doctor should be board certified. Aren't they all? Well, there are a number of self-styled boards that don't assure the same standards as those imposed by the American Board of Cosmetic Surgery (ABCS), the nation's largest interdisciplinary medical organization "exclusively devoting its educational efforts to cosmetic surgery."

With this in mind, I began my search. One prominent doctor in Central Florida was too arrogant and aloof. Another got bad reports from a former patient ("I would pay what I paid him to undo what he did to me!"). Another was more concerned about costs than with explanation of procedures. Another wanted to do so much that I would have been unrecognizable after the surgery. (I didn't want to look like Kevin Costner. I wanted to look like I looked 15-20 years ago-- with shorter ears!)

Then one day in June, a friend remarked that he'd heard about a doctor in Gainesville who had done work on a friend and she was thrilled with the results.

His name? "Graper, I think."

I called the Graper Facial Institute the next morning. A pleasant women name Ginny answered the telephone, and a number of my questions.

"Yes, Dr. Graper is board certified. In fact, he is currently Chairman of the Examining Committee of the American Board of Cosmetic Surgery."

And, I soon discovered, Dr. Charles Graper, DDS, MD, FACS, went to the University of Florida (where he was a varsity diver), Emory University School of Dentistry, Hahnemann University College of Medicine and held residencies at the University of Pennsylvania and Orlando Regional Medical Center.

The father of two grown sons, he is also a licensed dentist, is certified by the American Board of Medical Examiners, is board certified on both Cosmetic Surgery and Maxillofacial Surgery and a Diplomate of the American Board of Cosmetic Surgery. And, he's a national lecturer.

Okay!

I made an appointment at the Graper Facial Institute, and told Dr. Graper (who also has an office in Lake City) what I wanted. He told me what I needed.

He believed that I should have some "rejuvenative" surgery to accent my chin/neckline which was essentially obliterated by sagging, excess skin. Also, I had numerous lines around my eyes and mouth which he felt could be reduced with laser skin resurfacing. In addition, there was considerable amount of herniated fat in my lower eyelids.

Did I have any questions?

Oh yes!

Will it hurt? ("The biggest fear of most patients is pain. Our ability, because of advanced training in pain management, allows us to control pain in an effective, safe and predicable manner.")

How long will it take? ("In your case, the procedures will be done in three sittings the laser procedure will take about 45 minutes. The eyelids will take about an hour and the lower face and neckline will take approximately four hours.")

How much will it cost? ("Talk with Ginny. I don't get involved in those things.")

Do I have to stay in a hospital? ("Most of this type of surgery is done as an outpatient. We have an operating room in our offices to facilitate patient care.")

How different will I look when I've recuperated? ("We do not want to make you look like a different person. We want you to look natural and unoperated, yet rejuvenated and rested")

How long will it take to heal? ("The complete healing process takes from three to four weeks, but you will be totally functional after three or four days.")

When can you begin? ("The shorter procedures can be done next week and the longer within the next two weeks.")

Will it hurt? ("Hey we covered that already!")

We decided he would eliminate the age lines around my eyes and mouth with a laser procedure the following Tuesday morning at 9 o'clock. I was there 30 minutes early.

Dr. Graper showed me the laser machine, explained how it works and talked about the "perioral and periorbital skin resurfacing" I was about to have. Periorbital and perioral are fancy terms for the skin around the eyes (orbital) and mouth (oral). This procedure reduces wrinkles--mostly caused by sun exposure, smiling, and squinting-without scalpels or stitches.

Then, I sat in a comfortable, lounge-type chair and his assistant checked my blood pressure and I was given a shot of strong tranquilizer to relax me. A few injections of a local anesthetic were inserted in the areas around the eyes and mouth. He began using the "Nova-Pulse" laser to remove the other layers of skin and I felt no pain or discomfort.

In a few minutes, I was given a McDonald's chocolate yogurt milk shake (for energy and to prevent nausea) and driven to University Centre Hotel (which offers special arrangements for Graper Institute patients) and Dr. Graper came by around eight o'clock to check my progress. He was pleased. So was I!

The next day, I went home to Ocala and was amazed to see how quickly the redness from the laser work disappeared. Within three days, the discoloration was gone. I had kept the treated areas coated in a topical antibiotic, as instructed, and the discomfort--if any--was minimal.

I was ready for the next step: removal of those wrinkly bags that had been developing under my eyes for the past 20 years. I didn't want to have a "Happy Face" or "basset hound" look and I didn't want any tell-tale scars around my eyelids. Neither did Dr. Graper.

He explained what was coming up on Friday: transconjuctival blepharoplasty, a fancy term referring to a procedure performed behind the eyelids to preserve a natural look. (Before this and any further procedures, I was required to have simple lab procedures--including blood and urine tests.)

Dr. Graper had gone jogging that morning while I was having my lab work, but when I arrived at 9:30, he was relaxed and "ready to rock and roll," as he put it.

I was, at least, ready. Following Ginny's instructions, I'd had no food or drink since the last evening. I had on loose-fitting clothes. My friend Peg Westmoreland was there to drive me back to the hotel. Someone had been assigned to pick up a milk shake at McDonald's.

I was connected to a blood pressure monitor and then to an IV tube in my right arm, which administered antibiotics and sedatives. Then, Dr. Graper dropped some numbing eye drops into both eyes and injected local anesthetics around the areas. Next, he inserted plastic shields in front of both eyeballs. We talked with each other throughout the procedure, and there was absolutely no pain.

I admit, however, that I do not remember when Dr. Graper peeled down my eyelids, some how clamped them in place and surgically removed the fatty tissue inside.

Within 45 minutes, I was sitting up, my eyes were open and I was thirsty for my milk shake, at least until he showed me the two metal trays of yellow fatty tissue he had removed from inside my eyelids. There was still no pain.

After a check-up the next day, the eye surgery seemed to have gone so well that the face-lift was scheduled for the following Monday at nine.

By this time, I had developed so much respect for (and confidence in) Dr. Graper and his staff that I was not the least bit apprehensive. In fact, I was experiencing an unusual form of euphoria.

I checked into the hotel Sunday evening and Dr. Graper came by and joined me for dinner. This was an opportunity to ask some final questions and for him to explain, in lay terms, what he would be doing the next morning.

He compared a facelift to hernia repair-- a skin tightening and tightening of the tissue under the skin where that have become lax, reversing the skin laxity by tightening and supporting with sutures. Dr. Graper has become nationally known for doing this with a special result: his patients look normal and unoperated yet refreshed and rejuvenated. (No "happy faces." No basset hounds.)

Driving to the Graper Institute the next morning, I didn't experience the dread one might expect, but sincerely looking forward to accomplishing a long-time goal, a goal pooh-poohed by some friends and denounced by a majority of my family.

This was something I wanted to do for myself, and it was almost 10 o'clock and time to do it.

The initial procedures in the operating room began similarly to those I'd experienced during the eyelid surgery. Hooking up the IV. Attaching the blood pressure monitor. Snapping a few "before" pictures. And, drawing little maps all over my face and neck with a special felt-tip pen which would serve as a guide for the surgery.

Yep! Things were a little different that morning. There were two assistants, dressed in teal scrubs, and they were--like Dr. Graper and his associate Dr. Tony Spina--were enthusiastic. And supportive. And warm and friendly, but no more little jokes.

As the first drops of the valium derivative began taking effect, I realized that this was serious stuff.

I could sense that local anesthetics were being injected into my face, but there was no pain.

Dr. Graper continued to talk as he began the little incision beneath my chin through which he would liposuction the fat from under my chin and neck. In this twilight-type sleep, I felt no pain. I don't remember the liposuction, but I do remember when he began the incisions into my scalp area, in front of, and then behind, the ear. I don't remember when these incisions were explored and the tissue planes were identified. The tissue planes were then rearranged to support the lax skin, as I was told later. I remember, slightly, when the stitching began, as the incisions were sutured. I remember Dr. Graper saying that if he didn't like the way I looked, he'd take them out and start over. I'm not sure if he did or not. Then, after four hours, he was finished.

When I was taken back to the hotel, I went to sleep on 12 pillows (so that I would stay at a 45 degree angle) with two one-pound bags of frozen peas as ice packs. (Dr. Graper believes the little round peas are less intrusive than the corners of ice cubes), and slept until seven that evening.

The phone rang. It was Dr. Graper. He and his wife were downstairs in the Centre Court Restaurant inviting me to come downstairs and have dinner.

Dinner? Downstairs? I've just had my entire face cut, stretched, pulled, lipoed, stitched, and stapled and I'm being invited to dinner.

Fifteen minutes later, while the Grapers enjoyed steak and stuffed shrimp, I had a glass of wine, cottage cheese, garlic mashed potatoes and chocolate pudding.

After dinner, the Grapers came up to my suite and he gave me something to help me sleep. Before I dozed off, I called room service and ordered breakfast for 7:30 the next morning. Scrambled eggs. Grits. Juice. Yogurt. Coffee.

When the breakfast waiter knocked on my door, I got up, opened the door and noticed a startled look on his face as he placed the tray on the table and left. I went straight to the bathroom to look in the mirror. My face was swollen so much that I could hardly see my eyes.

Forgetting breakfast, I went straight to the telephone and called Dr. Graper. Although he had told me that I would have extreme edema (swelling) for a few days, I had not expected this.

On the phone, I was assured that my system was reacting naturally to the recent invasion (appropriate term, since I resembled a Martian) and that all systems were go. He was actually pleased, I think, that I looked like a Halloween pumpkin.

I took my peas to bed and watched "Good Morning America" and everything else Cox Cable offer post-operative cosmetic surgery patients--anything to avoid the mirror-until that evening when Dr. Graper came by, carefully examined my face and neck and remarked that he was extremely pleased.

On Wednesday, I drove home to Ocala. The swelling was subsiding dramatically. When I checked my phone messages, there was one from my friends Suzanne and Tony Liuzzo inviting me to join about 100 other guests at their "Westwind" horse farm for a Fourth of July party the next day. I accepted.

How did people respond? Most friends wanted to know if I'd lost weight. Others thought I looked rested. Others didn't say anything at all, but just took a second look. Nobody asked me if I'd had a face lift.

But when they realized what I had done and found that I was more than comfortable talking about it, almost everyone (after asking "Did it hurt?") wanted to know how much it costs.

Well, different doctors in different locales charge different rates for different procedures. My cosmetic surgery cost about the same as good, mid-sized, one-owner used car.

And that's not a bad deal when you consider my mileage and realize that I feel like a Ferrari.