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Saving Face

[whitespace] Richard Noodleman Laser Lite: Richard Noodleman is one of a growing legion of dermatologists who performs quickie laser surgery for the busy professional. His office contains a makeup counter, where staffers make patients look presentable for work afterward.

Christopher Gardner

Nothing like a face lift to rejuvenate a sagging career, but who has the time? Silicon Valley execs turn to the 'Weekend Neck Lift' and other drive-thru surgical procedures and don't miss a day of work.

By Cecily Barnes

ASIDE FROM HIS THICK, tree-trunk neck, Gary had always considered himself a fit and attractive man. But as he hit the half-century mark, he noticed the tree trunk had begun to sag noticeably--so much so that he decided something had to be done about the fatty tissue and loose skin below his chin.

He began to research the medical procedure involved in getting a new face and didn't like what he found out. The face lift involved general anesthesia, two major incisions several inches long from the front of the ears to the scalp, and a recovery period of up to three weeks. As the marketing director of a busy aerospace company in San Francisco, he simply didn't have the time.

"I could've made the time but I preferred not to. It's not my idea of the best way to spend my vacation time," Gary says. "Also, it just sounded too complicated--there was a lot of cutting and pulling of the skin."

He sat on the idea for two years, debating how big a sacrifice a new neck was worth. Then Gary saw Campbell physician Richard Noodleman's ad for the "Weekend Neck Lift." Now here was something that sounded doable. It involved only one small incision below the chin, and it carried a short two- to three-day recovery time. He would not need to be put under general anesthesia, and the procedure would take just three hours. Gary scheduled his neck lift for the first day in October, a Thursday.

Under a local anesthetic, Gary felt nothing as Dr. Noodleman made a three-centimeter incision below his chin, sucked out fat and tightened the skin and the muscle with a laser. His recovery was barely noticeable, just a few days of soreness. "It took only a few hours and I drove myself home afterwards," he says. "I think I worked out at the gym three days later, and went back to work."

Ten days after the procedure, Gary flew to Asia for a three-week business trip. "It didn't slow me down at all," he says.

When he returned, co-workers thought he'd shed a few pounds during his travels. Nobody knew.

Workplace Envy

GARY IS PART of a new breed of high-powered professionals who have the money and desire for plastic surgery, but who don't have the time. Dr. Noodleman and his partner, Dr. David Harris, fit into the corresponding movement of doctors who are stepping in to fill the market demand with abbreviated, one-stop cosmetic surgery procedures.

Dr. Dean Kane, who heads up Mercy Medical Center's plastic surgery department and was formerly president of the Maryland State Plastic Surgery Society, has observed this trend in plastic surgery centers everywhere. The reason? Plastic surgeons have an increasingly younger and busier clientele.

"They have increased discretionary income but decreased discretionary time. If they have to choose between two procedures, they'd rather have the quicker one," Kane explains. "And with younger patients, they actually need less radical surgery."

Dr. Kane attributes the drop in age among plastic surgery patients to aggressive marketing by doctors who are flocking to the field.

"A lot of medicine now is being managed by HMOs and the pay is getting worse. Doctors can no longer make a good income treating disease," Kane says. "Physicians are looking for other avenues to supplement their incomes."

With doctors wooing customers through advertisements, and an increasing social acceptance of plastic surgery, younger and younger people are turning up.

Then there's pressure in the workplace. In an economy that increasingly covets the adaptability and energy associated with youth, the pressure is on to stay young-looking on the job. In her book Venus Envy, Elizabeth Haiken cites studies that show prettier, younger-looking people make more in the corporate world than their uglier brethren. (One study suggests attractive people make 5 percent more money than average, while the ugly make 7 percent less.)

Whether people are consciously aware of this or not, Kane believes they respond to it.

"People are challenged both socially and professionally to look their best; otherwise a younger person will take their job," Kane says.

Since younger patients have fewer wrinkles to straighten, doctors can perform magic and leave the patient with very little recovery time. The cuts are fewer and shallower, and sometimes a knife is not used at all.

Noodleman & staff
Christopher Gardner

Face the Crowd: Dr. Richard Noodleman, center, is surrounded by his staff, some of whom have had procedures done in his office and believe it helps them better understand their clients' needs.

Nip and Tuck

INSTEAD OF THE surgically involved face lift, Noodleman offers the "Weekend Neck Lift," which costs approximately $5,000 to $6,000. Instead of traditional liposuction, which mandates general anesthesia and weeks of recovery, Noodleman and Harris perform tumescent liposuction ($2,500 to $10,000), which uses a smaller suction device and can be done with local anesthesia. Clients often use their new thin thighs to walk out of this procedure.

And then there's BOTOX ($400-$600), whereby tiny needles inject fluid into the face to flatten "dynamic facial muscles" used to make expressions. No lined forehead, no look of worry or surprise. Most procedures promise to have clients back at work Monday morning.

This depends, however, on the enormity of the problem being fixed. Cindy, who works as an executive assistant at Oracle, sought her chin lift after losing an extreme amount of weight. "I had a Ronald Reagan turkey chin," she says. While Cindy was quite pleased with the result of her procedure, she needed two full weeks before she felt ready for public display.

Cindy, however, was the exception. Others report jumping right back into their routine, something next to impossible after an intensive plastic surgery operation.

"We're not always the cheapest way to do it," Noodleman says, "but people are buying not just the service but the ability to get back into their regular routine more quickly."

Got Work?

HARRIS AND NOODLEMAN'S picturesque, 7,500-square-foot office has the feel of a lovely spa, complete with deep-sinking couches, light rose hues and complimentary tea and snacks. The patients have just written quadruple- digit checks for elective surgery, after all. Why not also elect to be pampered and catered to?

Clients spend their time sifting through a video library and sipping tea while they wait, which is never for very long.

A receptionist stationed at the front desk radios the appropriate patient-care coordinator as each client walks through the door. With afternoon traffic and appointments still on the datebook, neither patient nor doctor has much time to lose.

"We use Motorola talkabouts, little hand-held two-way radios," explains Arlene Noodleman, who acts as the administrator for her husband's practice in addition to being a preventive-medicine physician herself. "When the patient comes in, if the coordinator isn't at her desk, we'll let her know that her patient is there. We really try to keep the wait under 10 minutes."

The patient-care coordinators arrive like little angels, wearing pink-and-white hospital garb, perky hairdos and attentive, understanding smiles.

They are sweet, approachable, discreet, understanding and incredibly accessible. Most coordinators offer another invaluable attribute. They are models, as Noodleman puts it, of the good work he does.

"It's a benefit of working here," Noodleman says matter-of-factly. "Once you've been here a year, we offer a bit of a discount. It's also helpful to have had [cosmetic surgery] done, because then they can talk about it more intelligently and be living examples of the good work we do."

Between them, Noodleman and Harris employ six patient-care coordinators: Kathy, Jo Anne, Charlotte, Laura, Hannah and Jayne. Of those six, three have been peeled, lifted or otherwise improved.

They are resident experts on the doctors' work, and they are at their patient's service.

Other amenities add to the pleasant environment. For example, during the procedure itself, patients can view a movie on the television mounted on the ceiling or listen to their favorite CD.

"We have a movie library but we also tell them to bring in their own favorite movie," Arlene Noodleman says.

When they walk out of the procedure, patients carry a complimentary tote bag, booties to keep their feet warm and a spray bottle for their face if they've had some sort of peel or laser work. The next day, a bright bouquet of flowers, courtesy of the Age Defying Dermatology center, arrives at their door, an encouragement to get well soon. In ideal circumstances, patients should feel uncertain about whether they've gone on a vacation or undergone a surgical procedure. Younger patients can almost be tricked into thinking they've had an enjoyable experience, because their procedures are generally less severe.

Secret Surgery

WHEN THE TIME COMES to return to work, the Age Defying Dermatology center doesn't abandon its clients. They are encouraged to drop in for 20 minutes with one of the staff aestheticians at the camouflage makeup island to cover up the telltale red marks and bruises. Flesh-colored powders and creams are applied to veil any signs that this weekend was different from any other.

"We want people to look at our patients and say, 'Gee, you look great,' but not be sure why. We want them to look rejuvenated, like they've been on vacation," Arlene Noodleman says.

Arlene Noodleman is another good example of her husband's work, a fact revealed by the patches of red on her face from a recent laser peel. (Some of the makeup must have rubbed off.) While her husband finishes his rounds, Arlene and I sit in a small intake room and talk.

"I have had all the procedures myself," she says, checking her skin's healing progress with her fingertips.

"I don't know if you can tell, but I just had laser resurfacing done two weeks ago. I'm still healing a little bit."

She takes her hand from her face and slides it down the outside of her thigh.

"And I've had lipo," she continues. "I'm 47 years old. Nobody thinks I'm that old."

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From the April 1-7, 1999 issue of Metro.

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