The Rewards & Perils of Plastic Surgery

Not too many years ago, the right to shuck oversized noses and overripe faces was considered a prerogative of the rich – those who had the time, money, and inclination to cater to their vanities. Ordinary folks with imperfect features were expected to compensate for their bad luck by developing talent, wit, and charm. To consider changing that luck by cosmetic plastic surgery was thought to be an insult to nature. It smacked of narcissism.

The middle class has since wised up. Those who got a raw deal from Mother Nature or Father Time are getting even. They are remodeling their figures along with the kitchen, getting their noses straightened as matter-of-factly as their teeth. In the past ten years, the number of plastic surgeons practicing in Dallas has doubled, and some are now booked up for as long as six months in advance. Last year they tampered with the identities of an estimated 6,000 people in the city, implanting gallons of silicone into deflated breasts, putting the knife to bulbous noses, shaving gravity’s dirty tricks from heads and tails.

Their patients are not preening neurotics. “The people coming in for cosmetic surgery today aren’t doing it out of vanity,” says Dr. Donald R. Klein, secretary of the American Society of Aesthetic Plastic Surgery. “They’re middle-income, working-class people, and their reasons for wanting surgery are valid, both socially and economically.” Klein, who has practiced in Dallas 16 years, says that an increasingly common type of patient is the 40-to-50-year-old woman who has been dumped by her husband and is suddenly faced with having to pay her own bills. “She comes in for a face lift because she wants to look her best when she tries to re-enter the job market. She knows she’ll be competing with much younger women. Her age, unfortunately, is a real economic disadvantage.”

That youth and beauty translate into dollars and cents is unquestionable. Attractive people, studies show, are assumed to be more sincere, sensitive, interesting, and intelligent than their less fortunate brethren. Employment agencies report that attractive people are easier to place and get higher salaries. Once on the job, the pretty person’s work is evaluated more favorably than that of the unblessed, according to University of Maryland researchers; another study showed attractive waitresses get double the tips of unattractive ones.

What makes it all even more undemocratic is that, in “the melting pot,” the concept of beauty is one of the most narrowly defined. It has been homogenized, pasteurized, and predigested into factory-line uniformity: The American Beauty has a slender build, a thin, straight nose, high cheekbones, strong chin, and, most important, permanent-press skin. Those who don’t conform to this standard are considered cold, boring, and untrustworthy, says the University of Minnesota’s Dr. Ellen Berscheid, a leading psychologist in the field.

Even children under 12 don’t get to ride free. One 6-year-old boy with ears like radar receivers came to a Dallas surgeon’s office with his mother. She told the doctor, “We love him just the way he is, but….” Her fears were well-grounded. He is likely to be ridiculed by his classmates, and sociologists say he’ll get lower grades from his teacher.

If this drives the homely person nuts, a University of Connecticut study shows that he’ll get less treatment in a mental hospital than the pretty crazies, and he’ll be locked up longer. If it drives him to crime, he’ll get a longer sentence from the jury, and he is less likely to get paroled early for good behavior.

That such incredible value is placed on appearance – packaging determined by unseen and uncontrolled genetic hanky-panky – is unfair, unreasonable, disgraceful, and downright disgusting. But it’s part of human nature. The ideal solution would be to change that nature, but that would put a lot of plastic surgeons out to pasture, and it might take a couple of centuries. Those unwilling to wait can purchase a new appearance for the price of a used car.

The selling of plastic beauty – prompted by refined medical techniques, wider media coverage, and the public testimony of the remodeled – is booming nationwide, but the market varies with locale. “You see more rhinoplastic surgery [nose jobs] in the East since there’s a greater ethnic mix there,” says Dr. Klein. “Here, where the weather is warm most of the year, women are more concerned about their bodies. A lot of them get breast augmentation so they’ll look better in halter tops and swimsuits. The dry climate and sun age the skin more quickly, too, so we do a lot of face lifts and eyelid lifts.”

While wrinkles have always been gen-derless, it’s only recently that men have become willing to admit that they want to look younger; in the past, the prevailing attitude was that men who showed concern about their looks also preferred ruffled underwear. One Dallas surgeon estimates that a few years ago he saw five men for every hundred women; now 40 percent of his patients are men. Even the most macho are realizing that their success, both at work and at play, often depends on how well they project an image of vigor, health, and youth.

The best candidate for cosmetic surgery, says Dr. Klein, has “a healthy, stable personality. It’s a person who wants to look better, but doesn’t have unrealistic goals.” He’ll also need the mental stamina of a guru and the stubbornness of a jackass. In a word, determination.

Those who have been through cosmetic remodeling say it wasn’t the surgery itself or the recovery period that was most traumatic; it was getting there. Most go through a similar sequence of events. They have been self-conscious about their looks for years before they consider the possibility of surgical change. The first obstacle comes when they discuss their feelings with friends and relatives.

“When I’d mention my nose,” says one woman, “my friends would say, ’Oh, don’t be silly. You look just fine.’ “Some may mean it; most are just being tactful. Your mother will point out that your nose isn’t as big as Barbra Streisand’s.

Some drop out at this point. The rest worry that when they go to see a surgeon, he will tell them they look fine. (More often than not, this doesn’t happen.) The problems continue after the surgery is scheduled. When friends find out that the patient is really serious, they try to save him from a dramatic mistake by pointing out the case of the man on “Sixty Minutes” who had had a nose job. The nose fell off, and he spent $25,000 to have it redone, but he still looked like he had been dragged face down across the Rocky Mountains. “Every time I heard something like that, I’d call my doctor and he’d reassure me and I would forget about it,” says one woman.

The last obstacle – and for all the patients we interviewed, the most psychologically devastating – was filling in their names at the bottom of the surgeon’s release form. The release varies among surgeons, but generally it states the risks involved in the surgery, and the results the patient can and cannot expect. The form will tell what the surgeon will guarantee, and what he will not, including any post-operative repair that may be needed. Some releases go into several pages of detail; others are short.

“The release doesn’t really say anything that you didn’t already know,” says one patient. “But it scared me to death. Suddenly you fully realize that it’s going to be a permanent change in the way you look.”

The feelings of fear and guilt intensify at this point. For some, the fears have religious overtones; the patient may imagine she’ll be punished by the Creator for tinkering with His product. He’ll make her nose fall off, just like the guy on “Sixty Minutes.’’ Other patients become overwhelmed with guilt. “It made me start thinking about all those people out there who are really deformed – the ones who are born with no legs or arms. I thought, God, here I am with absolutely nothing wrong with me except this little hump on my nose, and I think I’ve got it bad.” For most people, the fears end when they get to the operating room.

Plastic surgery does have endless possibilities, but it also has shortcomings. The horror stories in the field are dreadful, and they are real. They are also, fortunately, rare, and becoming more so. Dr. Harlan Pollock, past president of the Dallas Society of Plastic Surgeons, puts it this way: “It is surgery, not a beauty parlor treatment. There is a risk of complications. But it’s not experimental; we’re using time-proven procedures. In the hands of a trained plastic surgeon, the risk of serious complications is small.” Cosmetic plastic surgery is not magic, but it can make you look better. If you resemble Shelley Winters, no plastic surgeon can transform you into Farrah Faw-cett; he can make you look like a younger Shelley Winters. It’s a repair job, an improvement, not a miracle or a fountain of youth.

Beauty and the Breast

Despite the anti-glamour ravings of feminists, and even Vogue’s stamp of approval, flat is not where it’s at when it comes to women’s chests. Simply stated, breasts are important to women because they’re important to men. In Dallas, breast augmentation is one of the two most frequently requested types of cosmetic surgery (equaled only by face lifts). The majority of these patients are married women in their thirties, but the operation can be performed at almost any age after full development.

Pam McDearmon, a 19-year-old Dallas model, had breast augmentation surgery last August for career reasons. “I’m short for a model (5’4″, 96 pounds, now 36-23-34), so I felt like I had to have some kind of advantage to compete with taller models. I don’t have the long legs or the stature to do high fashion or runway modeling, so mostly I do lingerie and swimsuits.”

Pam’s mother had previously had successful silicone implants, but an acquaintance had problems with infection after her breast surgery. “It did scare me when I thought about the risks,” said Pam. “But I was determined. I wasn’t really small, but I didn’t have enough at the top. Mostly I needed it to pull up my bust.”

Enlargement of breasts is a relatively new technique. The first operations were done in the early Sixties by injection of purified silicone. Silicone injections were, as the headlines read, “thrust into the forefront of medical breakthroughs” with the transformation of one Carol Doda from a 36-inch San Francisco go-go dancer into a 44-inch topless superstar. Not much later, implants replaced injections when it was discovered that the silicone sometimes “traveled” in the breast and into other parts of the body, causing serious complications.

The implant is a silicone rubber envelope filled with silicone gel, which is inserted into a pocket between the natural breast and the chest wall. The incision for insertion can be made underneath the breast, in the armpit, or along the lower edge of the nipple. The cost ranges from $1,000 to $2,000.

Pam had her surgery in the morning and was home for lunch (some surgeons prefer a hospital stay). “The nurse came in and told me she was giving me a Valium to relax me before the operation. That’s the last thing I remember before I woke up in the recovery room. I never had any pain at all. The first couple of days there was a slight heavy feeling, a tingling, but it never hurt.”

While her husband was disappointed at first, Pam liked the results. “My husband said, “Is that all?’ He thought I should’ve gotten more for the money [$1,400]. But I didn’t want to come out of it and fall on my face – I didn’t want to be greedy. Then, after a couple of weeks, he totally changed his outlook. He’d tell me to wear a bra and to button up my blouses. And he’d say things about how terrible it was for girls to run around without bras. Before, he was just like any man. He’d always stare at girls with big breasts. It’s weird.”

Within a few months following surgery, Pam was selected for a nude layout in a national men’s magazine. “I don’t think they could tell that I had the implants. There wasn’t a scar or anything. The layout more than paid for the operation, and I’ve had a lot of other modeling jobs since then. Some of them I probably would’ve gotten before, but I definitely think it helps.” She’s also become a popular T-shirt model; in addition to a T-shirt brochure, she was selected to appear in a ten-minute “Today Show” segment on the T-shirt industry.

Disadvantages? “1 was turned down for one assignment because they said I was too big. I couldn’t believe it! Then there’s the reaction I get from men, especially if I have on something low-cut. Like when I go into a store with a halter top on and some guy will start talking to me, but he’s staring at my breasts the whole time. I just cross my arm across my chest, and he usually gets the message. But I don’t regret having it done at all. I’d still do it.”

Face and Eyelid Lifts

Phyllis Diller described the results of her face lift this way: “You look in the mirror each morning and get the first message of the day. Now I don’t have to decode it.”

Wrinkled women and men are getting their morning messages decoded in droves, and they’re doing it before the message is totally jumbled. “Younger and younger people are coming in for face lifts,” says Dr. Frank Dunton. president of the Dallas Society of Plastic Surgeons. “I think it’s good. There’s no reason for a woman to wait until she’s 60 to have a face lift if she needs it at 40 and it can help her look and feel younger.”

Dunton has lifted more than 3,000 faces in the past 17 years, which means – considering the average face lift will remove five years – that he is personally responsible for cutting away 15,000 years from the faces of Dallas. Statistics regarding the number of miles the unwanted skin might cover were not available.

Most face lifts are done on patients between the ages of 40 and 60, but patients with skin types that age more quickly can have face lifts in their early thirties. People over 60 are getting face lifts more frequently than in the past, ’it used to be that a woman in her sixties or seventies not only looked old, she felt old,” says Dr. Donald Klein. “Now, because of medical advances in a lot of areas, and since people are taking better care of themselves physically, a woman at 60 feels young and vibrant, but still looks her age. There’s no reason she shouldn’t get a face lift so she can look younger, too.”

Eyelid lifts can be done in conjunction with face lifts, or they can be performed before a full face lift is needed. Sometimes eyelid surgery is done on teenagers to correct hereditary eyebags – puffy pouches under the eye that can make a child look haggard at 14.

When a surgeon feels a patient’s skin has not aged enough for face or eyelid surgery to make a noticeable improvement, he’ll generally recommend that the patient wait a few years. He will take into consideration a patient’s career: While he’s likely to agree to an eyelid lift for a model or actor at 25, he may advise a salesclerk the same age to hang on a couple of years.

A full face lift will average $2,000 to $3,000. The eyelid lift goes for about $1,200.

One Dallas elementary school teacher had her face lift at the age of 34. “I first started thinking about having a face lift when I was 25,” says Mrs. Jones. “My ex-husband is a doctor, and he and I used to joke about it, but I was already getting wrinkled at that age. I’m fair complex-ioned, but I stayed out in the sun all the time. I just didn’t take care of my skin at all. “

A few years ago, the Joneses were divorced, whereupon he promptly married a 21-year-old nurse. “At first, I had thought I would put off the face lift until I was 40. Then I started thinking I would have it at 35. Finally, last year, I decided to just do it. I already looked 40.”

She was careful in her selection of a surgeon, first getting the names of three plastic surgeons recommended by friends who were doctors. She scheduled consultations with all three, then selected the one she wanted to do the surgery. “I knew after I started talking to him that he was the one I wanted to do it.

I had thought I would just get the eye lift first, and see how that turned out before I got a face lift. We talked it over and decided to go ahead with the whole works – eyelid lift, face lift, and chemosurgery [chemical skin peeling].

“He went over the entire procedure with me. It never scared me because I had total confidence in him. The only part i was worried about was that I didn’t want a general anesthetic, and I really didn’t want to stay in the hospital. When I told him that, he was delighted. He had been wanting to do a face lift on an out-patient basis and thought I’d be perfect for it.” She scheduled surgery during the first week of summer vacation, and sent her children off to visit their father. Her surgery – the face and eyelid lifts were done at the same time – took five hours.

In the face lift, the surgeon makes an incision behind the hairline at the temple, then down around the front of the ear-lobes and back up behind the ears toward the nape. He separates the facial skin and part of the neck skin from the underlying muscle and tissue, then pulls the skin up and back toward the ears. He cuts off the excess skin, then stitches up the incision. The eyelid lift is done by making incisions above the eye, in the crease of the eyelid, and in the lash line below the eye. He does the upper eyelid first, removing extra skin and fat, then closing the incision. The same procedure is followed on the lower lids.

“I was awake during the operation, but I didn’t feel anything because of the local anesthetic,”’ recalls Mrs. Jones. “There’s a bright light shining in your face, and the surgeon is behind your head, so you can’t see what he’s doing. But I would hear him say, ’Okay, now turn your head to the right,’ and I’d say, ’Is that far enough?’ After he was finished with the surgery, I just got up and went home.”

In the first few days following surgery, her face was swollen and her eyelids were red. but she had no bruises. (Most patients will show bruises, however.) “I never, during or after surgery, felt any pain. When my kids got home two weeks later, they were a little surprised at how I looked, but by then the stitches were out and a lot of the swelling had gone down.”

The painful part of the treatment for Mrs. Jones was the chemosurgery, used to eliminate the fine lines and wrinkles that can’t be removed through lifts. In chemical peeling, a strong acid, usually phenol, is applied to the skin, burning off the upper layer of skin and the connective tissue under it. In the healing process, the burned skin is replaced by new. smoother skin. More than any type of cosmetic treatment, chemosurgery has been the villain in horror stories of surgery resulting in permanent and extensive scarring of the face. In most cases of disfigurement, the treatment was done by unqualified laypeople at “wrinkle farms” that sprouted up around the country in the 1960’s, and quickly disappeared. There are built-in hazards in chemosur-gery, and some plastic surgeons refuse to do it. Phenol is a systemic poison that can be absorbed by the skin, and there’s no accurate way to gauge the acid’s penetration. There’s also the risk of possible blotching or scarring if the patient’s skin reacts unfavorably. But on carefully selected patients, the surgeon can get remarkably good results.

“I went back for chemosurgery about a month after my face lift,” says Mrs. Jones. “When he put the acid on my face, it felt like it was on fire. It burned for the next twelve hours. I was heavily medicated, so that helped some. After the first day it didn’t hurt, but it looked absolutely horrible. It scabbed over. I turned into a hermit – I didn’t leave the house for the next three weeks.”

Three months after the chemosurgery, Mrs. Jones had the third part of the treatment: a visit to a Neiman-Marcus cosmetician who specializes in skin care for face-lift patients. “They were trying to guess how old I was. They said 27 or 28. They show you how to apply make-up and give you a beauty regimen for skin care. Now, no matter where I am or what I’m doing, I take the time to take care of my skin.”

When Mrs. Jones returned to school last fall, the other faculty members wondered what she had been up to. “Some of them would come up and say, ’You look great – what have you done?’ Then they’d look me up and down and say, ’I know what it is – you changed your hair.’ I had changed my hair, but nobody guessed I’d had a face lift. After I had mine, my mother-in-law had a face lift, and then her sister had one.”

For Mrs. Jones, the results were worth the pain and effort. ” If I had it to do over again, I would definitely do it. And I’ll have another one when I need it. I think it’s important to look your best, not for anybody else, but for yourself.”

Buy a Nose

Some plastic surgeons have developed what they believe is “the perfect nose,” a one-size-fits-all feature. One surgeon in Dallas is so well known for the conformity of the noses he creates that they’ve become a trademark, as in “She has blue eyes and a Doctor Clone nose.” A woman acquainted with several Doctor Clone noses describes them as “small and slightly tilted up. They look good on people with average-sized faces and features, but on bigger people, they look out of place.”

The skilled plastic surgeon realizes that a nose should blend with the other facial features. Even height is a factor; short people can wear tilted noses, but a tall person already has people looking up his nostrils, so he should do without.

More than any other type of cosmetic plastic surgery, a nose job can vastly improve a patient’s looks in a short time. An hour on the operating table can cost from $1,000 (for chiseling away a minor hump) to $1,800 (for a bridge-to-nostrils overhaul).

Jane Smith, a 26-year-old Dallas secretary, had been self-conscious about her nose for half her life before she chucked it. “I guess I first started worrying about it in junior high,” says Miss Smith. “My nose was never really that big – maybe most people wouldn’t have worried about it. But I’d try to keep people from seeing my profile. If I thought someone was looking at me from the side, I’d turn my head. Even when I was driving, if I saw a car coming up next to me, I’d put my hand up to my face, as if 1 had something in my eye, so that they couldn’t see my nose.”

Miss Smith felt that she’d been dealt a bad hand, but didn’t think the problem was noticeable enough to justify cosmetic surgery. Then last summer, she went to an ear specialist for an infection and noticed some photographs of cosmetic surgery patients on the wall. As it turned out, the physician also specialized in plastic surgery.

“I probably would’ve never gone to a plastic surgeon, but since I was already there, I told him I’d never really liked my nose, and asked him if something could be done. He walked over to me and looked and said, ’Well, I think we can take some of the length off here, and some of the width out here.’ I can’t tell you how happy I was. At last, somebody was being honest with me. My friends had always told me my nose wasn’t big, that it looked just fine the way it was.”

Miss Smith went through a period of uncertainty before she had the surgery. She read articles on nose jobs, and talked to people who had had them. Her friends were of little help. “They’d call up and tell me about all these grotesque things that happened to somebody. Then I’d call up my doctor and ask him about it, and he’d reassure me again.” Herfamily was not overwhelmingly supportive, either. “My mother was hesitant about it, but she never really came out and said it was crazy. My sisters thought it was, well, interesting.”

She canceled her first appointment for surgery. “I just chickened out. I told them I wanted to think about it some more.” She went through with it two weeks later and slept through the hour-and-a-half operation. “I didn’t feel anything. I was sick from the anesthetic, but I knew that would happen. I never felt any pain, though.”

The day after surgery, Miss Smith got the first look at her new face. “I almost fainted,” she says. “It was a total shock. The doctor had told me what to expect, and so had other people who had done it. but I don’t think anything can prepare you. My eyes were purple and almost swollen shut. My nose was swollen, too. It looked like plastic.

” I went back to work the next Monday afternoon. Most of the people in the office knew I was having it done, so they weren’t surprised. Sometimes I thought people who didn’t know would kind of stare, but no one ever came out and asked me if I’d done it. The first time my family saw it, it was still swollen so they didn’t think it looked that much different. The next time, most of the swelling was gone and they thought it really was an improvement.”

Miss Smith, a year after the surgery, has forgotten the insecurities about her nose. “It’s not like there’s been a big change in my life or my personality, but I do think it helped considerably. It’s mostly little things that have changed. Before, I always wore my hair down around my face to hide my nose. Now I experiment more. I wear it pulled back, and I can wear it up. I used to make comments and jokes about my nose, but I don’t do that any more. And I don’t worry about people looking at me from the side.

“My only real regret about it is that I didn’t get it done ten years ago.”

Body Sculpting

The term “body sculpting” sounds as if it holds great promise for those of us who would like to be flat where we are curved, and curved where we are flat. Unfortunately, body sculpting is one of the most difficult types of cosmetic surgery to perform, and it gives the least satisfactory results.

Reconstruction of heavy thighs, buttocks, hips, stomachs, and arms, even when lumped together in the category of body sculpting, accounts for less than 10 percent of the cosmetic surgery done in Dallas. Some surgeons prefer not to do this type of surgery at all. Others will perform the surgery only in cases of severe figure irregularities that don’t respond to diet or exercise. These patients are generally normally sized, but they have one area of the body that is grossly out of proportion; for instance, the patient may have a slender waist and arms, but huge hips.

“One of the most difficult types of cosmetic surgery is slenderizing flabby arms,” says Dr. Frank Dunton. “It’s hard to get satisfactory results since you can’t hide the scars.”

Trimming fat arms generally requires two operations, one for each arm. An incision is made down the inside of the arm, then the surgeon removes excess fat and skin, and the incision is closed. It is usually done under general anesthesia, and it requires a hospital stay of two days. The arm remains bandaged for about two weeks, and the patient is not allowed to lift it. Then the stitches are taken out and the scar covered with tape splints. In a month, the other arm is trimmed.

The procedures for reducing thighs, hips, and buttocks are much the same, though they differ in the time required for surgery and healing. All leave evident scars, though some are more visible than others.

The tummy tuck, or abdominal lipec-tomy, is the most frequently requested type of body sculpting. Usually the patient is a woman whose stomach has been stretched by pregnancies.

The women who have had this surgery are some of the happiest with the results,” says Dr. Dunton. But it’s not a minor procedure, and the patient could be hospitalized for up to two weeks. The procedure is much the same as for other reductions: An incision is made, either horizontally or vertically, on the stomach; excess fat and skin are removed; the incision is closed. There’s discomfort in sitting and walking, and the patient must wear stomach supports for several weeks after surgery. There’s a possibility of infection or hemorrhage, and a risk that fat droplets in the blood could enter the lungs or brain, causing serious pulmonary and brain complications.

Costs for body sculpting vary widely, but fall in this general range: stomach, $2,000 to $4,000; hips, buttocks, or arms, $1,500; thighs, $2,000.

Picking a Surgeon

Any medical doctor can legally perform cosmetic plastic surgery. Some may even be able to do it well. Don’t count on it. Taking unnecessary chances when a permanent change in your appearance is involved can be life-endangering.

Surgeons specializing in plastic surgery have at least six additional years of training in the field. Those certified by the American Board of Plastic Surgery have also passed extensive oral and written examinations in the specialty. These are the minimum qualifications you should look for in a surgeon. (Board certification can be verified by the county medical society.)

Since cosmetic surgery is a creative process, skills can vary widely even among board-certified plastic surgeons. “I know a couple of plastic surgeons in town,” says one Dallas physician, “’that I wouldn’t trust to work on my dog.” One Dallas teacher who had had a successful face lift recommended her surgeon to a friend, who had already scheduled the operation with another plastic surgeon. “She decided to go ahead with her surgeon,” says the teacher. “It turned out really bad. She’s been back to have it worked on again, but she still looks worse now than she did before the surgery.”

You can increase your odds of avoiding a botch by consulting several surgeons before making a decision. These can be recommended by your family doctor, by friends who have had a successful operation, or by the county medical society. (Doctors listed under “plastic surgery” in the telephone book are not all board-certified. The phone company doesnt check qualifications.)

During the consultation, the reputable surgeon will let the patient explain his problem; he will not suggest surgery the patient doesn’t want. One Dallas man went to a local plastic surgeon several years ago to have a medical problem (deviated septum) corrected. “I told him I didn’t want the shape of my nose changed at all,” says the man. “In fact, I told him if it was going to change, I didn’t want the surgery.” Not only did he come out with a differently shaped nose, but within a month the bridge of his nose began to split down the middle. He had to go to another surgeon to have it redone.

No plastic surgeon can guarantee perfect results, but if he has had consistently successful results in other patients, the odds are good that he can give you the same. You should ask to see “before” and “after” pictures of his patients who have had similar operations. It’s not unreasonable to ask him to arrange a talk with a former patient.

A good surgeon will not try to discourage you if the operation can makeyou look better, but he will explain in detail the surgical procedure and all therisks. He will tell you if your goal is unrealistic; he won’t promise to make youlook 20 if you’re 60, and he won’t guarantee to save your marriage or make youa star.


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