She was referring to Dr. Haworth, her plastic surgeon. Claire and all her girlfriends always referred to their plastic surgeons by their first names. It was never doctor so-and-so. It made it all seem very clubby, and judging by the indentations between my brows, not a club I could afford.

Botox, this is your big week

Beauty is only skin deep, but dematologists can erase little flaws in time for a red-carpet stroll.

By Gina Piccalo
Times Staff Writer

Here in Beverly Hills, amid the gurgling fountains of wealth and luxury, the world’s most famous women come in disguise, during off hours, by private elevator, using false names, to fight the good fight against, the one thing that money can’t buy: time.

In the weeks before the Oscars, the entertainment industry’s biggest night of the year, it’s the dermatologists and plastic surgeons they seek – anxious to look younger, slimmer, more beautiful than usual. That red-carpet walk is much more than a fashion show. It can mean better roles, more money or a career kick-start.

“You get a lot of people who are conscious about how they will appear in photographs,” says plastic surgeon Dr. Randal Haworth. “They say, I don’t want any bruising.’ They’re even giving me a hard time coming into the room 20 minutes late.”

“They don’t just roll off the truck famous and beautiful,” says Beverly Hills cosmetic dermatologist Dr. Harold Lancer, whose clients include Oscar nominee Diane Lane, Cher, Nia Vardalos and Goldie Hawn. “It’s a process. I’m sort of specialist in fine-tuning the process.”

Lancer occupies the penthouse floor of a nondescript building on Wilshire Boulevard a few block from Rodeo Drive. Inside his office, hallways are crowded with filing cabinets and wall-sized painting of 1920s party scenes. Art deco mirrors hang in nearly every examination room. Lancer won’t relocate to a larger space, he says, because the high-profile clients like the building’s vacant lobby. “They have the whole top floor,” Lancer says. “It’s sort of isolated.”

On Friday morning about a week ago, he hustled from room to room, injecting and sloughing and burning away all evidence of age on the faces of women in their 30s and 40s. On this day there were no A listers hiding out in exam rooms, and few patients planned to attend the awards. But they all came for the same treatments that Lancer has performed on Oscar nominees and actresses every week and for months.

“When a show is approaching or an interview or a film release or a pilot season, they will speed up the schedule,” Lancer says. “With the Oscars, chances are they’re in ‘chronic mode.'”

For Santa Monica plastic surgeon Dr. R. Patrick Abergel, that means an enormous demand for Botox, the $350 shot of botulinum toxin that paralyzes facial muscles, thus eliminating frown lines. “March for me is the busiest month of the year,” he says. “we’re probably going to do more Botox [in one week] than we’ll do in a month.”

But Lancer warns actors not to overdo it. “It looks ridiculous if you’re nominated an you receive an award and you have no facial expression,” he says.

Even worse, for some, is wearing one’s age to the awards ceremony. Women have been bringing their evening gowns to Abergel, pointing to the areas exposed and having him laser away sun damage on their cleavage and removing back and upper arm fat. “With a very small needle, we just reabsorb all the fat from the arms,” he says. “It heals within a week to 10 days.” This “mini-sculpt” costs $5,000. The same procedure can remove jowls, says Abergel.

Others are paying $500 to $1,000 per shot for injections of collagen or its derivatives – Cosmoderm, Restylane, Perlane – to plump cheeks or fill laugh lines. “Like air in a tire,” Lancer says. While those procedures last a few months, Abergel uses a permanent lip-plumping substance, polytetrafluoroethylene, the same plastic used to make Gore-Tex. Granted, this one is more costly: $4,500 for both lips.

For more stubborn wrinkles, like those Haworth calls “marionette lines,” there’s the bone substitute called Radiance. It builds up the skeleton around the mouth, plumping sagging skin. Then there’s the lower eyelid “pinch,” which removes winkles below the eye “with one little stitch,” says Haworth, and heals in three days.

For Skin with a youthful glow, starlets favor microdernabrasion, a $600 process that sloughs off dead skin and with it fine lines from the face, neck, shoulders and cleavage, followed by a $500 infrard laser toning that burns off sun damage and encourages collagen production. Another option is a series of $1,000 “photo facials,” blasts of a broad spectrum of light that dissolve spider veins and age spots.

“For many, many years the look in Hollywood was pulled,” says Abergel, referring to full face lifts, as opposed to today’s less invasive procedures. “The new trend now is to look…very natural.”

Back in Beverly Hills, Lancer leaned over Annie Avery, a 40 year old yoga instructor from the San Fernando Valley. She isn’t attending the Oscars but scheduled he appointment early to beat the rush. Tiny scarlet jewels of blood appeared on her top lip as he injected $500 worth of Cosmoderm, a human derived collagen. “I have a pretty high tolerance,” said Avery, wiping a few tears from her eyes.

Down the hall, the lithe 35 year old Jennifer Campbell, a former Miss Hawaiian Tropic and “Baywatch” co-star, perched on the examination table. She came to talk about facial blemishes and ended up consulting with Lancer’s technician – who tattoos the equivalent of lipstick, eyeliner and eyebrow pencil. It’d be nice not to worry about your eyebrows falling off in the water,” Campbell says. “For women, it’s very tough in L.A. You’re competing with girls in their 20s.”

Lancer moved on to Paris Henman, a Malibu mom with blemishes left over from pregnancy. He explained the importance of sun block. “If you forget for one week in the Caribbean, it will be undone,” he told her.

Next, Lancer passed a wand over the face of young blond woman in a $200 microdermabrasion treatment. With each pass, the skin was buffed with tiny crystals, leaving her skin as smooth as an infant’s.

“This particle polishing is what we do for entertainment people,” Lancer says. “I tell patients it’s like detailing your car.”

And when image is everything, even car metaphors seem fitting.

Some doctors complain about “lipo junkies,” who never run out of body parts to fret over. Randal Haworth, M.D., a cosmetic surgeon in Los Angeles, knows many, including a twentysomething TV actress who, at 5’7: and about 120 punts, was thin to begin with. At first, Dr. Haworth removed a little fat from her…

Tucked between Anastasia, the reigning “queen of brows,” and Classy Collections, 436 North Bedford Drive houses some of the most sought sought-after plastic surgeons and dermatologists in the country, where the elite retreat to tuck and tweak. Professional and most importantly private, the doctors deliver state of the art surgical care to those in need of little boost. Take the brothers in Suite 304, doctors Bob and Simon Ourian, at Epione Aesthetic Clinic. Simon pioneered the technique of Laser Lip Enhancement (LLE), a noninvasive laser treatment using injections of autologous fat, and the Coolaser, a noninvasive facelift that eliminates post treatment care. In suite 202, Dr. Renato Calabria recommends the new Vertical Facelift, a procedure that reshapes the facial tissues vertically, nearly eliminating any visible scars. Or downstairs, in Suite 105, dermatologist Dr. Debra Luftman rolls back the clock with a bevy of treatments such as Glycolic Acid Light Peels and Fotofacial laser treatments, using Derma K and Erbium laser. A visit to 436 Bedford Drive isn’t complete without stopping by Dr. Randal Haworth’s office. He specializes in just about everything beauty-particularly faces, noses, and breast. When clients say, “This man is an artist!” they mean it. Dr. Haworth is also well known in the art world for his charcoal sketches and has had several gallery shows – a true synthesis of art and science. —LAYLA REVIS

Britney Spears, 21 What: Reportedly has had breast implants The Story: In 1999, the then-17-year-old singer seemed to bust out overnight. New York’s Daily News reported that Spears had implant. Her reps at the time didn’t deny the claim. An Expert Says: “It’s very probable that she had augmentation,” Beverly Hills plastic surgeon Randal D. Haworth tells Us. Her Side: The pop star has attributed her fuller bust to “a major growth spurt” and later said, “Like I’m really going to get breast implants at 17?”

Lara Flynn Boyle Dr. Randal Haworth of L.A.: “She appears to have had work on her lips.” Her rep’s response: “We’ve never discussed it.”

Question: Do you believe in plastic surgery? You bet. I had my lips,ears, eyelids and titties done when I was 36, and maybe I’ll have some more when I’m around 85. I slightly regret having my titties done as my body has not reacted very well, so I’ll probably need to have them done again. This is nothing against my plastic surgeon, though, Dr. Randal Haworth – he’s the greatest.

By Pearl Britto Many people think having plastic surgery is an act of vanity or something they should be ashamed to admit they want. We all want to look our best, and we spend hours sitting in hair salons, getting our nails done, exercising at gyms, maintaining healthy diets, and standing in front of a mirror applying makeup and great pains to maintain flawless hygiene. Even a new wardrobe can be fulfilling to our aesthetic senses. Plastic Surgery, on a more serious level, is similar to all of these things. Plastic Surgery used to be associated primarily with famous Hollywood celebrities an jet setters. But as personal improvement through plastic surgery is increasingly becoming a reality for people throughout the world, the celebrities only connotation no longer applies. As a plastic surgery consultant, I have worked with several of the top surgeons in Beverly Hills and have seen patients from many walks of life, including high profile celebrities, professionals, housewives, and even college students. Desire for self-improvement transcends all occupational and geographical boundaries, and I believe that wanting to alter the features you were born with is nothing to be ashamed of. Most people feel their best when they look their best. However, no one should undergo a surgical procedure to please someone else. If someone tries to make you feel that you need surgery to look better in their eyes, save you time and money and consider changing your friends or partner instead! How Do You Begin? One of the most important decisions in considering plastic surgery is choosing a qualified, board certified surgeon. In this day and age, the process can be very confusing. An excellent referral source is the official web site of the American Society of Plastic Surgeons, and choosing a surgeon who has mastered the particular procedure you are interested in is important. For instance, Beverly Hills plastic surgeon Randal Digby Haworth, M.D. , is one of the most highly regarded plastic surgeons in the area of breast augmentation. Dr. Haworth has earned a reputation for being an expert by his meticulous work and keen eye for perfection in this area. You will want to consider the surgeon’s expertise and find a surgeon whose reputation matches your needs. A common concern I have seen with patients is the inability to ask questions of the surgeon. This situation has made e-mail a new comfortable place for people to research and ask questions without feeling pressured or overwhelmed. A patient should never be afraid to ask their doctor, or his/her staff, any questions that pertain to potential surgery regardless of how silly the question may seem. Trust and comfort are important when you consider any operation. You should never leave an office feeling as if you have been sold a sugical procedure, or that you just closed a deal. You are not a car, this is your body and you must live and be happy with the changes you make to it. Choosing Your Breast Implants Beyond the media hype of which celebrity did what, a great deal of many sucessful practices are made up of everyday people. I have observed that the popularity of certain procedures seems to be dependent upon the geographical location. For example, in Los Angeles, breast augmentation, breast lift, and breast reduction are very common, Breast implants come in two varieties – silicone and saline. In the United States, however, the saline filled breast implant is essentially the only option available to a first-time patient. There are exceptions to this rule. The FDA has specified that silicone implants may be utilized in the following circumstances: If a patient already has implants that happen to be encapsulated (hard); if someone requires a breast lift, reduction, or reconstruction at the same time as needing an implant’ or if someone has very thin breast tissue. As with any surgery, it is important that patients choosing silicone implants understand all potential risks involved. Unlike saline, silicone will not deflate if it ruptures, so it can be a long time before you are even aware there is a problem. Silicone, in my option, looks and feels more natural to the touch in a large number of patients. Because of this, some patients prefer silicone. I always advise women to make sure they have their implants examined on a regular basis to ensure there is no leakage. Saline implants can also feel natural when done correctly, and the question of placing the implant under or over the muscle is also an important decision and one that should be explained by the doctor at the time of consultation. Breast Size Breast size is a personal choice, and patients should not focus on the volume number, or ccs of the implant. This can be a confusing issue with women. I try to emphasize that all body sizes are different, and much like choosing a haircut that may look perfect on your friend (most can relate to this), it could be a different issue on you. There are three factors that a surgeon must consider when producing your final bust size: Your chest wall circumference; your natural breast cup size; and finally, the actual size of the implant. To illustrate this point, for instance, a 6’6″ tall woman with size A cup breast may need a 500 cc implant to achieve a mid-C cup, whereas a 4’6″ woman with A cup will require only 225 cc to get the same end cup results. This is why I feel it is difficult to compare what you need for an implant size based upon what your friend has. All the many variables must be considered. Is Bigger Better? I have seen many women who believe bigger is better, and although I don’t personally believe your breast should rest upon your collarbone, some women feel that is a good look for them. Again it is all about preference. This is another important issue to discuss with your surgeon. All in all, it is safe to say that there is no one perfect implant size to fit all types of women. If a woman is unsure of what size may look the best, I recommend they buy a Miracle Bra or the popular Water Bra and wear it under their clothes. Once you are comfortable with a size, I then suggest you wear it to your consultation to show the surgeon exactly what you fancy. What you think a B, C, or D cup is could differ from actual reality. Costs Involved Recovery Time and Restrictions Recovery time for a primary breast augmentation is generally one week, and the patient can usually resume exercise three to four weeks after surgery. Some doctors will give the okay even sooner. But having been a patient myself, I personally feel more comfortable taking the extra time for safety. That’s my opinion and not a medical rule. Recovery time for breast reductions without implants usually takes one week, and the time varies for the patient to resume exercise. It is recommended to resume slowly as the patient’s condition improves and they feel better. The pain and recovery for a breast reduction is usually longer than a breast augmentation, and there is usually more trauma with a reduction surgery. All breast augmentation patients are restricted from driving for five to seven days. It is recommended that they are not to lift anything heavier than a glass of water for at least one week. Again, I believe it is better to be safe than sorry and would suggest that patients wait at least two weeks before lifting, When Should You Have Breast Implants? A great many women consider having breast implants after they have had their children, because they want to recapture the natural, firm breasts they once had before children. In these cases, the implants tend to be smaller and may go undetected. I have also consulted with patients in their 50s who are physically fit, but since gravity has no mercy on breasts, they choose surgery for obtaining firmer looking breasts. In fact, some women who already have a substantial amount of breast tissue op for a breast lift without the implant. Each patient’s body will react differently to implants. Plastic Surgery is not the answer to happiness. However, if taking that step can improve self confidence and help a person feel better about the way they look, it can make a big difference for alot of people. In the end, remember, you want others to see and appreciate you, not just the size and shape of your breasts. For more information on how to find a Board Certified Plastic Surgeon in your area, or check to see if your surgeon is board certified, you could contact the ASPS (American Society of Plastic Surgery) at: 847-228-9900, or find them on the web at: www.plasticsurgery.org Pearl Britto is a reporter and freelance consultant on plastic surgery techniques and procedures. As a layperson, she has spent the last 13 years working in various managerial and public relations positions with board certified orthopedic and plastic surgeons in the Beverly Hills area. Her experience as a plastic surgery consultant has led her to be featured in countless media projects and interviews; and, for a fun and creative break between consultations, Pearl enjoys managing the personal web site of star 98.7 Los Angeles radio on air personality Jamie White (www.JamieWhite.com ). Pearl Britto can be reached at [email protected]