A Frown Turned Upside Down
 
One Woman's Adventure in Plastic Surgery

By Elizabeth Weiss McGolerick / Photography by Anastasia Chernyavsky

The Mind's Reflection

And who is Ann Boyer? Originally from Britain, she is a 59-year-old educational consultant who lives and works in McLean. She is also a devoted patient of Dr. Magassy, one of the region's most highly-regarded plastic surgeons.

On the first of November, Boyer indulged in an $11,000 birthday gift from her husband. Her elected surgeries included liposuction of the arms, a facelift, an endobrow midface lift, and a neck lift. As daunting as her adventure may seem, this would not be Boyer's first time under Dr. Magassy's precise knife. "My first procedure was in February 2004. I had my breasts lifted and lower eyelids done," she says. One year later she had liposuction to the tummy, hips, and thighs. "It changed my life completely."

Boyer says she's not one of those serial surgery people. "I think there comes a time when you have to say, 'That's enough'," she says. "I knew what I wanted. It was really in order of importance for me. I lost a lot of weight at one point quite quickly and I had really saggy breasts. Very uncomfortable."

Boyer wasn't looking to conform to an ideal or to stand out from a crowd, she says. She simply wanted to feel better about herself. "I'm very tall and I'm never going to be stick thin and I don't want to be," she says, describing the level of confidence her surgeries have given her. "I know I'm nicely in proportion now. I want to wear what I want and know that I look nice. That's really what it is."

Boyer had her lower eyelids done because "everyone kept telling me I had bags under my eyes, and that I looked tired." And then she decided to undergo facial surgery, because "when I catch myself in a photograph, if I'm not smiling the corners of my mouth go down. People mentioned that I looked so sad and I hate that."

Under the Knife

Simon & Garfunkel wafts through the O.R. It's 9:00 a.m. on a gloriously mild November morning when a not-at-all nervous Boyer enters Dr. Magassy's surgery center for the third time. For the next five hours, to the tunes of Bob Denver and Frank Sinatra, and with a scrubs-garbed reporter in observance, Boyer gets sliced, injected, suctioned, scraped, compressed, sewn, stapled, and bandaged.

Very few instructions are given during the marathon surgery. Each person knows their role before, during, and after the procedure. An intervenous anesthetic puts Boyer under and the journey begins with liposuction of the arms. A new combination of laser and ultrasound techniques "melt away the superficial fat as well as the deep layer [of fat]," Magassy explains. This breaking up of tiers allows for easier suctioning during the procedure. Together, the laser and ultrasound also shrink the excess skin. Astonishingly, the desired smooth, tightened surface is already visible as recovery nurses work efficiently and with great care to clean and wrap Boyer's arms after the procedure.

Facing Change

The bulk of surgery time—more than four hours—is dedicated to Boyer's endobrow midface lift, face lift, and neck lift. Board certified as a general surgeon as well as a plastic surgeon, Magassy says, "I actually pioneered [the endobrow midface lift] here in the D.C. [area]. I've done a little over 1,200 so far."

After injecting local anesthesia into Boyer's scalp, brow, temples, cheeks, and under her eyes, several small incisions are made in her hairline. Magassy's intricate endoscopic techniques—meaning minimal-incision surgery done while using a tiny fiberoptic lens for visualization—allow him to separate the skin of Boyer's face from the skull, muscle, fat, and capillaries, and slide it up and back. This procedure lifts the face vertically rather than pulling the skin to the sides. "The endobrow midface brings out the artistic qualities [of cosmetic surgery]," Magassy says. "You can truly see what the difference is—the hollows are filled in and the whole face is pulled up. Very dramatic results."

During the surgery, Magassy sears capillaries to reduce blood loss, removes the frown muscles between Boyer's eyes, separates the periosteum from the skull (making a scraping sound no kinder than fork tines on a plate), and inserts dissolvable implants in the cheek to pull the face up.

Before Boyer's neck lift, Magassy administers local anesthesia around her chin and ears. He liposuctions her neck and removes extra skin and parts of her lower earlobes, tightening the understructure as well as the exterior. Boyer's profile is magically altered as Magassy's quick, exact stitches are set in place.

The difference in Boyer's face from the start of surgery to the finish is quite distinct. Her cheeks are higher, her forehead smooth, the corners of her mouth turned up, her neck an easy curve. There is no stretching of the skin or strained features. She comes out of surgery well-wrapped and looking a little rough, but Boyer's procedures have already changed her dramatically.

Handled with Care

For Magassy's bigger surgeries—and Boyer's makes the grade—RN Connie Worley visits patients the following day at their home, checks their dressings, reviews instructions, and removes draining tubes. Worley likes to call herself the "Reassurance Agent." She is the right-hand woman for Magassy's patients, interviewing them before surgery and seeing them through recovery. "If a patient is going to develop a complication, it happens in the first 24 hours," Worley says. The home visits are unique to Magassy's practice and a terrific perk for patients, eliminating the painful step of visiting the doctor's office a day after surgery.

Recovering the Self

"I feel like an Egyptian mummy," Boyer says, five days after her surgeries. "My neck is incredibly tight and quite uncomfortable but I'm not complaining. I'm so grateful to Magassy. This is going to give me a new lease on life."

Magassy keeps close tabs on Boyer over the next few weeks, removing the staples from her hairline and behind her ears, giving her a compression garment for her arms to replace the bandages, and even re-piercing her ears since the original holes were sliced away during surgery.

"They never know how painful [recovery] is going to be because everyone's different," Boyer says. One month after the surgery, all the bruising on her face had disappeared, some slight swelling remains on her chin and neck, and she is still experiencing a burning sensation in her arms. "The experience has not been without pain and some days have been easier than others," she says, "but I believe I have made an excellent recovery and it's been more than worth it. I am delighted with the changes I see. Very subtle and natural. I have a more youthful neckline suddenly. I can actually see better now that my brows have been lifted."

Boyer's advice for potential plastic surgery candidates? "The most important thing is having confidence in your plastic surgeon and knowing that person is going to make you look the way you want to look. You hear about places that give special prices and sales—you get what you pay for. I've read about disasters but, if you look into it, you'll find [the patients] didn't do their homework. You've got to go to someone who is board certified and very experienced. Even if they're not as experienced as Magassy, you want somebody who has a good reputation. It all sounds obvious, but it's amazing what people don't do."

Magassy's Nurse Anesthetist Debbie Richardson echoes Boyer and encourages patients to investigate their plastic surgeon. "Ask a lot of questions, make sure they have a staff that have been working together for some time, and look for a doctor who does a lot of the procedure that you want to have done."

(April 2007)