Lid

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KEEPING A LID ON THAT LID
By Judy Dunn

     Cosmetic eyelid surgery, known as blepharoplasty or eyelidplasty, occasionally turns out far from what the patient expected. That is what happened in my case. My story is about the dire consequences of having chosen the wrong person to do my eyelid surgery and eyebrow lift; about having expectations that I would look much better rather than worse, after these surgical procedures.

    I was 45 and living in Caracas when my right eyelid started its descent. I realized, unhappily, that the eyelid was dutifully carrying out the instructions of a genetic code.  It would be an exaggeration to say that at that time, my drooping right eyelid was unsightly; however, I felt sure that it had begun a relentless decline, and that one day I would have to put an end to its rebelliousness, by having it corrected surgically. Every day—and countless times a day—throughout my forties, I scrutinized my right eyelid to see how much more it drooped than on the previous day. My left eyelid apparently was programmed differently; was subject to a different set of laws, because there was no evidence of the kind of demoralizing activity that my right eyelid was engaged in.

     I kept hoping that somehow my right eyelid would reverse its course. I invented exercises which consisted of raising my eyebrows rapidly as high as they would go, as this pulled the drooping eyelid up.  As a part of me refused to acknowledge that the process of eyelid decline was irreversible, I continued with the exercises hoping that I had discovered a way to at least arrest the process.

       I complained endlessly to my husband about my drooping right eyelid, and then soon after, about my left eyebrow which had begun to sag. His response was always, “There’s nothing wrong with your eyelid or your eyebrow.” Was I crazy or was he? I wondered. My children thought there was nothing wrong with my right eyelid; they did think, however, that there was something wrong with my left eyelid. It seemed to me at the time, that there was a family conspiracy to invalidate my perceptions.

     Whenever I looked in the mirror, I felt stricken when I saw my errant, droopy right eyelid and my rapidly collapsing left eyebrow. My right eyebrow, inexplicably, was located at an acceptable level, however. I became depressed, because the rest of my face was doing quite well I thought. The baggage or fatty deposit under my right eye was very small, insignificant really, and there was no baggage under my left eye.  This reinforced my conviction that my eyelids and eyebrows had conspired to engage in an asymmetrical plan of action designed to ruin me.  I became increasingly convinced that each was following a different agenda. My right eyelid and left eyebrow, and my left eyelid and right eyebrow seemed totally unrelated, almost as if they were not occupants of the same face.

     I had been a practicing psychoanalytic psychotherapist when I lived in Caracas. My patients, when in crisis, and even when not in crisis, tended to somatize many of the emotional issue they were struggling with. They complained of sore throats, chronic headaches, colitis, lower back pain, chest pain and double vision; they suffered from insomnia, heartburn, mysterious rashes, and stiff necks. As for me, I wouldn’t have minded a rash now and then, a few sleepless nights or occasional lower back pain, but I couldn’t cope with an implacable drooping eyelid and collapsing eyebrow.

     I had a very competent eye doctor in Caracas to whom I periodically whined about my right eyelid and left eyebrow problem. Every time I complained about this, he used to say, “I can fix the eyelid and eyebrow for you in 15 minutes.” I resisted the offer; what I had in mind for my right eyelid and left eyebrow was a painstaking job that would be done in New York City and that would take at least two hours. Furthermore, I wanted to have this done by a plastic surgeon, not an eye doctor.

     I had two friends in Caracas whose eyelids drooped, and whose eyebrows sagged. Also, they had plenty of excess baggage under their eyes.  One of them who had money to throw out, went to a renowned plastic surgeon in Brazil to have her eyelids corrected, her eyebrows lifted, and baggage removed from under her eyes. All this was done successfully by the Brazilian plastic surgeon. Unfortunately, her other baggage—expensive leather suitcases-- were removed also at the airport in Rio de Janeiro. Her baggage was never found, but the baggage under her eyes returned in just one year.

     My other friend who was 55 and prematurely wrinkled, decided to have an entire facelift in Caracas. It was a flawless job, the work of a Venezuelan master craftsman. The skin on her face and neck was silky smooth looking; her face looked as if it were carved out of marble; she looked like a fabulous 70 after the facelift! I decided not to bring my right eyelid and left eyebrow to her plastic surgeon, because I was afraid he might talk me into having my entire face lifted, in which case I was sure I’d end up looking 70. The thought had occurred to me that looking 70 may have been her plastic surgeon’s “signature” or logotype. No, New York City was where I was going to have my eyelid and eyebrow corrected.

      Was obsessing about my drooping right eyelid and left eyebrow inappropriate for a psychotherapist?  I wasn’t sure. Countless comments from patients such as “You always look so tired, doctor,” and “You look so depressed,” finally resolved the psychotherapists-shouldn’t-be-preoccupied - with-their-appearance conflict I was experiencing. These comments made me wonder what fantasies patients were having about my emotional health. Looking tired all the time to a patient whose mother died when he or she was three years old, could be very threatening; my appearance may have portended abandonment, the way he or she interpreted the mother’s death. Looking tired all the time could be construed by a patient who has a history of having to please others and a need to be entertaining, as a lack of interest on my part, as being bored. Similarly, my looking depressed might make a person who feels guilty about everything feel that he or she hurt me in some way; this would exacerbate the patient’s guilt feelings. I convinced myself that I would be correcting my drooping eyelid and sagging eyebrow not just for myself, but for my patients’ well-being, also.

     I should have explored patients’ comments about my sleep-deprived appearance and their fantasies about it. Valuable opportunities to explore their fantasies and the conflicts and issues surrounding them were subordinated to my right eyelid and left eyebrow. What I thought was a profound concern for my patients’ well-being, was, I finally admitted to myself, a rationalization: I hated the way I looked!  I did not think I looked attractive anymore.

    My eyes, which I had always thought were the most striking part of my face, had lost their primacy there.  When men looked at me in the street, our eyes locked only briefly; once they spotted the drooping right eyelid and sagging left eyebrow, their glance went elsewhere.

    I went to New York to have cosmetic eyelid surgery while I could still see  out of my right eye; by then, the drooping eyelid was encroaching significantly on my eye’s turf and was beginning to impair my vision;  also, I was sure that   my rapidly descending left eyebrow had begun an  irreversible course. I had to act quickly. Unfortunately, I didn’t know of any plastic surgeons in the New York area, so I called an eye doctor in New York I had consulted 20 years before for a minor problem. I told him about my drooping eyelid and sagging eyebrow, and asked him for the name of a good plastic surgeon. Why did I want a plastic surgeon just for an eyelid and eyebrow?  he wanted to know. “I can recommend an eye doctor who does cosmetic eyelid surgery at a small hospital in Jersey City, New Jersey. He’s Chief of cosmetic eyelid surgery there; he’s a true artist.” 

        I was so impatient to get that wayward lid and eyebrow back to where they belonged, that I decided I’d have to abandon the idea of having the surgery performed in New York. Jersey City, New Jersey. So let it be in Jersey City, as long as the man could restore some dignity to my eyelid and eyebrow. What could go wrong? I reasoned. Chief of Cosmetic Eyelid Surgery sounded very impressive to me. My husband looked perplexed when I told him the surgery would be performed by an eye doctor in Jersey City.

     “Why an eye doctor in Jersey City?” “Well, he’s chief of cosmetic eyelid surgery at this Jersey City hospital. “What hospital, my husband persisted.”

     “I forgot to ask,” I said.

     Two days later I was sitting in the eyelid surgeon’s office in Jersey City, wondering why I had gotten an appointment so quickly. Why didn’t I have to wait a few months or at least a few weeks for an appointment? Was it because there wasn’t much of a market for cosmetic eyelid and eyebrow surgery in Jersey City?

     The eyelid surgeon’s name was a sound made up of a particularly unattractive grouping of letters. If his name could be tasted, as if in some unusual deviation of sensory function such as in synesthesia, it would have a mealy texture, I thought. It had instantly created an image in my mind of a bleached-out looking man with hair the color of   seaweed that was plastered artfully to his scalp.  I imagined his eyes to be the indeterminate color of a stagnant pond of water. It took a few moments for me to adjust to the appearance of the real man, so remote was it from the image of the man I had created. He was in his early 50’s, tall, with an attractive face and very soft-looking brown hair. He was a hairsbreadth away from being handsome; however; I couldn’t figure out then why handsomeness eluded him.

     He was pleasant in a rather detached way. Nevertheless, I was concerned that I wasn’t getting a good feeling about him. Basically, he was charmless, and had noxious breath, the expulsion of which made me turn my head away.

     He examined my eyes and told me I needed new lenses. When I had the prescription filled and wore the glasses in the street for the first time, the sidewalk seemed to levitate and come within inches of my face. I had become dizzy, had kept tripping over my feet, and finally zigzagged to the ground. I wondered briefly if this incorrect eyeglass prescription augured darkly for my eyelid surgery. I quickly decided it was a mistake made by the optician.

     The cosmetic eyelid surgeon took pictures of my face from different angles. Unfortunately, the prints were ready before I had worked up the courage to look at them. I looked so freakish that I thought it would be an act of kindness to myself, an act of mercy, not to postpone the surgery. On the photographs, my collapsed left eyebrow, as if  it were being pushed up  by an express current of air, appeared to soar exaltedly; my right eyebrow shared a lower level indignity with my right eyelid. More than anything else, I resembled a Picasso painting on those photos, because of the dislocation of my features—an eyelid here, an eyebrow there; a lopsided mouth veering from its centrality in my face, but incongruously providing some structural balance to the whole. The face on those photos cried out for some drastic cosmetic measures to save it from itself. Maybe the surgeon was indirectly trying to tell me that he did complete facelifts, also!

     He didn’t even wait for the shock to subside. He said, “As long as you’re going to have the right eyelid done, you should have the left one done, also. And I’ll create a set of eyebrows that are complimentary.” He went on, barely pausing to take a breath. “I’ll do away with the fatty deposits that you have under both eyes, also.” He tried to convince me that I had a fatty deposit under my left eye, as well as under my right eye.

     “It will cost you twice as much if you don’t have your eyelids and eyebrows done at the same time,” he said. Was this indeed a bargain? I couldn’t make any sense out of what he was saying, but I stopped trying to understand what he meant, as soon as he pushed those hideous photos closer to me; the sight of them made both of my eyelids twitch uncontrollably. I felt stricken, powerless, and heard myself ask in a voice that sounded as if it were borrowed from a toddler, “What is your fee for doing everything at the same time?”

     “$3,500.” Absolutely no contrition in his voice; nothing to soften the blow. The man was all business. “Make an appointment with my secretary for surgery,” he said.

     I took another compulsive glance at the photos of me spread out on his desk, and said wretchedly, “Okay.”

      I asked his secretary to show me some before- and after-surgery photos of patients on whom the surgeon had performed cosmetic eyelid surgery. “Pictures?” She seemed surprised by my request, but went to a filing cabinet and began to search through its disordered contents. She pulled out two before- and after- photos, one of a man, and one of a woman. The before-photos of the woman showed eyelids that were grossly misshapen, because of the puffiness and multiple folds of skin on her eyelids. The woman looked as if she had been crying steadily for six months. The man looked as if he had been sleeping for 50 years with his eyes open; his eyelids looked as if they had been sentenced to death. There was some improvement on the after-photos of both people, but something still didn’t look right, only I couldn’t identify what it was. My spirit drooped like my eyelid. I asked the secretary to show me more pictures.

     “Most of them are in our L.A. office,” she said crisply.

     “Like in Los Angeles?” She nodded distractedly.

         The surgeon was bi-coastal; this was heady news for me! My confidence soared; he probably did the eyelids and eyebrows of the Hollywood crowd. I felt immeasurably better; no need to feel uncertain about this man. Yet I couldn’t sustain that surge of confidence I’d had when his secretary first told me about the L.A. office. Conflict erupted and swept all my uncertainty right back into its roiling core. I really didn’t like the surgeon. I didn’t feel comfortable with him. Once again I wondered why, if he was such a good cosmetic eyelid surgeon, I didn’t have to wait to get an appointment with him. Was his surgery agenda bone-bare, because he had just started practicing and therefore referrals weren’t pouring in? Was there really an L.A. office? But in spite of the doubts I had about the surgeon, the searing memory of how I looked on the photos he had taken, summarily excised those doubts, just as the extraneous folds of skin surrounding my eyes would soon be excised.

     The operation was scheduled for 7:30 a.m. two days later in that small hospital in Jersey City whose name I still didn’t know. My husband said, “You can still cancel the surgery, if you’re not getting good vibes from the doctor;   your eyes haven’t stopped twitching since you agreed to have him do the surgery.”

      Wearily, I said, “ You should see how ugly I look on those pre-op photos.”

     The operation was scheduled for 7:30 a.m. in that small Jersey City hospital whose name I still didn’t  know. At 7:10 a.m. I was sitting in a chair in the hallway off the operating room gasping from my rollicking angst. I had been given an injection to sedate me before surgery; however, instead of feeling relaxed, looking dreamily at nothing, and thinking about how nice I was going to look, my heart hammered arhythmically. Heat undulated throughout my body, and I had difficulty breathing. I was sure I would never make it to the operating room; I’d be D.O.A.

      Just before being wheeled into the operating room, I was given another injection that made me feel as if a wad of   cotton that had been steeped in glue filled my mouth. Still, I tried to get a message through to the surgeon. “Not

 Sedated…not….relaxed,” somehow pushed thickly through the gluey cotton.

     Hiding behind a green surgical mask and gown, the surgeon said, “We’re going to give you some oxygen; it will make you feel better.” I think I was more grateful that he was wearing a mask and I wasn’t being assailed by his fetid breath, than I was when the oxygen started flowing through the tubes in my nose, and breathing became easier.

     At last I felt a soothing, warm kind of drowsiness. It didn’t last though, because sharp bursts of panic invaded the beginning calm. Each time I was about to drift off to sleep, panic heralded its arrival by way of galloping palpitations and feelings of terror.

     “I’m experiencing panic,” I said. “Who doesn’t?” was the surgeon’s glib reply. “Concentrate on the oxygen. As they say, just go with the flow.” Panic gripped and then released its grip over and over for two hours. At times the panic struck with the force of a whiplash. I wanted to stop the operation, to pull the intravenous needle out of my arm, but the thought of something viscous, hanging by a thread from one of my eyelids stopped me.

     “Could you put on some music?” I thought that music might stop the panic. A nurse turned on the radio, and the exuberance of the Rhapsody in Blue suddenly burst into the operating room; it was a strange counterpoint to the insistent rushes of panic that still stabbed me. Finally the words, “We’re finished” reached me. The panic stopped; I was no longer its captive.”

     I had probably slept a bit, because I never had any awareness if the surgeon was working on the baggage that I didn’t have under my left eye; on my drooping right eyelid; on the baggage that I did have under my right eye. Then I heard the doctor say, “Come back to my office in a week.”

          At home I avoided looking in the mirror, because I was afraid that in his zeal, the surgeon may have lowered the right eyelid more. Finally, on the third day home, I looked in the mirror and saw a very bruised woman with the hardened eyes and heavily eye-shadowed eyelids and lower lids of a hooker staring back at me. I smiled; was another career staring me in the face? Was it really possible for me to put down the tools I’d used for so many years to explore a patient’s psyche, and take to the streets and street corners with a new bag of tricks?

    One week later, I was back in the eyelid surgeon’s Jersey City office; he inspected his handiwork. With a shaking hand I pointed out to him that my right eyelid drooped even more over my right eye than it did before surgery, and that there was now a flap of skin which draped itself over my left eye. “I was crying as I shouted, “And why is my left eyelid drooping now? And what have you done to my eyebrows? When I raise them, my right eyebrow is an inch lower than it was, and my left eyebrow almost collides with my hairline.

     His response was, “But how do you like the smooth area under your eyes? No more fatty deposits, eh?

     I wasn’t crying anymore, just shouting. “Don’t you see that my right eyelid is drooping more than before surgery? And now my left eyelid is drooping, also. What were you doing in that operating room for two hours, figuring out how to cheat on your income taxes?”

     “Now don’t get hysterical on me,” he crowed. “Don’t you remember that your right eyelid practically used to cover your lower eyelashes? I raised it considerably.”

     “Oh, of course I remember,” I said, giving him the momentary satisfaction of joining him in his delusional state.

       Then I shrieked, “Doctor, you are aware, of course, that you completely dislocated my eyebrows, aren’t you? Who do you think you are, Picasso?”

 He smiled fatuously, as though I had conferred a compliment on him.

       He answered with, “You don’t seem happy that I created an aesthetic balance between your eyebrows.”

     “The only aesthetic balance between my eyebrows is the bridge of my nose,” I said coldly.

     Desperate, frustrated by his devious  defensiveness, I tried once again to bring up the subject of the two drooping eyelids. “Do you agree that both my right and left eyelids droop now?”

     “I don’t know” was his reply. “Make an appointment with my secretary for four weeks from today.”

     I knew that four weeks, six weeks, six months from then, both eyelids would look the same, both hapless victims of his inexcusable ineptitude. It was just before I walked out of his office that I noticed his left eyelid for the first time. It drooped; an unattractive diagonal fold of skin covered a sizeable portion of his left eye. I felt as if ice water had suddenly been splashed on my face. He had used his left drooping eyelid as a model for both of my eyelids! I’m not saying that he did it consciously, but it was very apparent to me that at a deeper level, he wanted both of my eyelids to look like his left one.

     “Do you think I should sue him?” I raged when I came home.

     “I think you should forget the whole thing,” my husband said soberly.

     “But look at my eyelids and eyebrows,” I howled. “I’ll sue him.”

    “You’ll be wasting money; it would be better if you tried to forget the whole thing.” I was angry at my husband for not being outraged; for not wanting to denounce the eyelid surgeon to the American Opthalmological Association.

     “How can I let him get away with it?” I shouted.

     “By forgetting the whole thing,” he said.

        I wrote a letter to the surgeon accusing him of flagrant incompetence; I also said I considered him to be clinically crazy. When I finished the letter, I suddenly broke into gales of liberating laughter that soared and resonated well beyond the boundless terrain of hysteria. What if he had transplanted my right eyebrow to the bottom of my chin, I was thinking.

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Send questions or comments to Judy Dunn at dunnjm@eckerd.edu