When your friend tells you to get plastic surgery

(No. 127) Why a neck lift is so appealing to one man, and so unappealing to another.

How can we deal with our necks? Illustration by Stephen

The other day I received an unexpected email from my old college roommate, Paul Ramsour. He was encouraging me to get a neck lift from the same Nashville  surgeon who had taken the knife to Paul’s own wobbly skin. I guess he’d seen my neck in social media videos, and assumed I was horrified by it. I’m not. I wish my neck were more youthful, but I find that my jogging habit has helped calm it down a bit.

Then Paul told me how he ended up having plastic surgery. Because this is such a contentious topic these days, I thought I’d share Paul’s story with Stephen’s People. Paul, who is 65, writes:

Dear Stephen,

My neck surgery was a success. But my medical history has not always been easy. I’m now 65, and my 40s and 50s were somewhat grim with lots of doctor visits. In 1994-1995 I was brought back from the brink of immune collapse, due to HIV, with a mere 240 T4 helper lymphocytes, by way of a Phase 3 Clinical Trial that showed remarkable results within six months. I am deeply grateful to the medical folk at Vanderbilt University Medical Center, in Nashville, who took such good care of me then, and later. I’ve had all sorts of other interventions having nothing to do with that pesky virus that have made my life better at every turn. All that treatment has left me optimistic about the coming decades. I am mostly well and I’m feeling pretty, pretty good. 

Paul Ramsour with a new neck.

As I got older, I developed a serious double chin sag with definite gobbler leanings. Other than that, I was pretty well preserved, for someone in their seventh decade. A very dear friend who saw my photos on a college reunion website once suggested that I had been mainlining antioxidants. Well no. But I’d long since given up sun exposure and nights of sweaty second-hand smoke among bar crowds. What I might credit for decent preservation until I hit my early sixties are good genetics and a pretty good diet. I’ve weighed about the same amount since I was in my early twenties. I received good skin and pretty good hair from my German and Swiss forebears. The weight isn’t arranged the same as it ever was and the hair has followed the path of my eponymous pioneer folk—Weishaar. Sure, I’ve minded the effects of aging -- who wouldn’t? -- but as I aged I felt I still looked pretty good, and even got modeling work in my late 40s. 

Since I was spared the worst effects of the 80’s plague by a Phase Three clinical trial and decades of publicly funded exorbitantly priced antiretroviral cocktails, now I just sit and wait and watch the inexorable forces of Time and Gravity wash over my flesh. Until my neck surgery, the wrinkles at the base of my ears reminded me fondly of my father.

However, after I hit the age of sixty, I began to notice in my consciously infrequent, furtive glances into a mirror an uncomfortable resemblance to my long dead mother. That’s right Nora Ephron, I felt bad about my neck. It was gravity and heredity and longevity concatenating to give me an unmistakable turkey gobbler neck.  What really made my neck impossible to evade was the simple presence of wind and its effect on my flesh. When one is outdoors the only part of the body that should be ruffled or blown about is hair. But when that ill-fitting blobby neck of mine got to blowin’ in the wind, I was horrified and completely grossed out. I can endure most of the unavoidable concessions and limitations of older age. But not that one.

Yikes!  

My partner, who is a beautiful brown skinned handsome Chicago native, had been doctoring up his hair and beard for years. When we first met nearly thirty years ago, he cagily avoided telling me his age. I figured it out soon enough by oblique cultural referents, specifically Motown music. He too fretted about his neck, for his own genetic reasons. As many older men do, he grew facial hair to draw attention away from what he felt was a crinkly sagging neck. The dye jobs grew too annoying. Beard and mustache intervention for a fellow with dark hair are more imperative and frequent  due to the heavy contrast between brown/black primary color and insinuating silver, smoke or white. 

I thought he was nuts the way he obsessed over his wrinkly neck. He visited the offices of three surgeons and chose the one he thought best. He saved the money and set the date. I still thought he was off his rocker, but I didn’t try to talk him out of it. He spends frugally and I was glad that he was devoting the fruits of some of his labor to himself, as self care. 

He carefully arranged for almost three weeks away from his job through a clever combination of vacation time and the Thanksgiving long weekend. This is a closeted gay man who’s only NOT out to one person—himself. If you met my gentle, smiling, kind boyfriend you would pretty well know right out of the gate that he’s a friend of Dorothy. The idea was that he could return to work and the watchful residents of the 75 apartments he tended would be none the wiser -- about his neck, or his sexuality. 

On the appointed day, I took him to the surgeon’s office. While I waited endless hours I leafed through the binders of before and after photos. I was genuinely impressed and quite taken with the this surgeon’s gift. Not one of the people looked pinched or weird in any way. They all looked noticeably better, less weathered and saggy, but still themselves. The folks who had obviously smoked still showed the traces but they looked much better. They all looked like themselves, except that the wreckage of living through decades of normal wear looked better on their skin. The surgeon, Dr. Michael Boggess, is a true saint of medicine who combines the inspiration of both art and science to produce better lives for his patients.

The neck is a metaphor for nourishment, voice, breath — and peril. Illustration by Stephen

Eddie was woozy and bound up when he returned to my care. I could tell immediately that it was an amazing success. He stayed with me a couple nights and his recovery was quick. The results were very positive. So I took $10,000 out of my savings and had it done myself. By all accounts I live on modest means, and you might think $10,000 is extravagant. But I don’t have habits of clothes, travel, or drugs and alcohol. The only things I spend on in a fairly unrestrained way are food and tools. It’s only money, after all. 

I’m glad I did it and it and have no regrets. The little crescents of wrinkles next to my earlobes are gone. That floppy flap of neck skin is pulled up and will never return. I’m proud of all my many scars, both surgical and accidental, but unless I show you the ones from this surgery, you will never notice. 

So Stephen, I offer you my surgeon’s name, and my home as a place where you can recover from neck surgery.  You’ll never regret it, and by the time we show up for our 50th Grinnell College Reunion, in 2029, you and I will be the guys with the best faces and the most hair on our heads. Perhaps a shallow aim, but sweet all the same.

— By Paul Ramsour

Note from Stephen: Despite my affection for Paul, and his kind offer of a recuperation room in Nashville if I were to get my neck “fixed,” I have declined the invitation. For a couple of reasons. One, I am paranoid about anyone touching my neck, and always have been. A psychic once told me it was because in a past life I was a medieval knight, and got my head chopped off in a battle. Whatever the reason, my neck is special. Two, I have found that my running and weight lifting program has reduced my wattle (and my facial fat), so there’s that. And three, I believe in aging. I am pro-aging. I don’t have the need (yet, I’m aware this could all change) to “reverse” anything. So I’m gonna sit tight. If, at our college reunion, Paul wins the “most well preserved old person award,” I will applaud, and snort, knowing that could have been me.

---

From the Department of Fiction

I wrote and illustrated a novel about some young people in the future who go for an epic wander to find the truth about what’s beyond the wall. It’s called The Lost City of Desire, and you can read the chapters at Everlands. Subscribe for weekly chapter updates and other posts about the writing life.