“Sharon Osbourne, fantastic . . . Joan Rivers, too much . . . Michael Jackson, no comment . . .” Dr Z. Paul Lorenc is rattling off his verdicts on certain celebrities but his judgments don’t concern their talents or their latest records. The New York plastic surgeon is criticising their browlifts, facelifts, nose jobs, nips and tucks and, unlike most of his colleagues who take a diplomatic line, Dr Lorenc (pronounced Lawrence) wields his scalpel in public.
“I believe that Paul McCartney, instead of looking young, looks simply startled,” Dr Lorenc says of the former Beatle, another one of the targets in his new book A Little Work: Behind the Doors of a Park Avenue Plastic Surgeon. “He looks like he possibly had some surgery in the past. His face is very recognisable but if you look at the progression, it is not necessarily a natural one. Look at the position of the earlobes, for instance, they’re too low, it’s a giveaway sign. And I think his brow is too high, making him look surprised.
“Meg Ryan, in my opinion, looks like she has had an implant in her upper lip. It’s clear there is a very large immobile object in there, the lip has lost it’s natural curvature. And Joan Rivers, she is the person people tell me they don’t want to look like. But I love Joan Rivers,” he says, “because she has the candour to admit, yes, she had a facelift. It might not necessarily be the sense of aesthetics that I or somebody else might have — but it works for her.”
While dishing the dirt on celebrities and their penchant for plastic surgery makes for titillating conversation, why is Dr Lorenc doing this? Isn’t he committing professional suicide? Dr Lorenc says his intent is to expose myths that trivialise the profession. Celebrities are just a vehicle, he insists, the shortest route to the public consciousness. He uses them, along with multiple case histories from his practice, to warn those dreaming about carving up their faces, that plastic surgery, despite the fantasies you see played out on Nip/Tuck (Channel 4), Extreme Makeover (Living TV), and Cosmetic Surgery Live (Five), has risks, and worse, results you have to live with.
“Somebody had to say it, to tell public the reality of plastic surgery. Right now it is glamorised, trivialised, talked about like getting a haircut. But it’s surgery, there are consequences.” In Dr Lorenc’s book he gives blow by sickening blow detail of each operation. “I think the public needs a reality check.”
We hear cases, Dr Lorenc continues, of plastic surgery that has gone wrong. For example Denise Hendry, wife of the former Scottish football captain Colin Hendry, who had a heart attack after liposuction, and Olivia Goldsmith, the author of The First Wives Club, who died this year after a reaction to anaesthesia during facelift — but the public, he says, chooses to ignore them. The belief is that they were unlucky, it would never happen to me.
Dr Lorenc, 49, trained at New York University Medical Centre and has run his private practice for more than 16 years. Business clearly is good — a facelift or rhinoplasty runs up to $8,500 (£4,575), breast implants up to $8,000 (£4,306) and liposuction up to $7,500 (£4,037) — his office has a Picasso on the wall and a Giacometti lamp on the desk. He has worked on the late Katharine Hepburn, the musician Gregg Allman, and various Saudi princes and Hollywood actors. And yes, plenty of Brits.
“I operate on about 50 to 60 British patients a year,” he says. “One came from London for total body liposuction. But it’s mostly facelifts they want.” And are they as obsessed about lines and wrinkles as New Yorkers? Dr Lorenc nods. “I think it’s more the personality of the patient rather than where they live.”
Last year the American Association of Plastic Surgeons recorded 8.7 million cosmetic procedures (up from 6.6 million the year before). But of this figure only 1.68 million were surgical operations — the rest were Botox, chemical peels and so on. In the UK there are about 75,000 procedures each year according to BUPA, of which 25,000 are surgical. The most popular operations are breast augmentation, breast reduction, face/neck lift and liposuction.
“The demand is there because the media has put aesthetic surgery out there,” he says. “Everybody is talking about it. When I started work, the average patient was a wealthy woman in her sixties. I’ve seen the average age drop 20 years. Also, what we can do with lasers, endoscopic surgery, Botox and fillers, has changed the profession. Sixteen years ago it was scalpel and sutures; now I do so many different things.”
But the biggest influence, he believes, has been the explosion in celebrity culture and worship. In the 21st century, Britney, Brad, Posh and Becks have become surrogate royals. We look at them and see our own bodies as deeply flawed by comparison. So we run to the surgeon to redress the balance.
Dr Lorenc likes to tell one particular joke: “How can you tell when a celebrity has had plastic surgery? When he or she denies it.” He says he chuckles when he hears a star credit yoga or some miracle cream for their unlined face when in reality it’s thanks to a browlift or Botox. While he understands the pressure among the famous of New York, Hollywood and London to look young and sexy, he is confounded by how much work they have done, sometimes becoming caricatures of their former selves.
Michael Jackson, he says, “is used by patients as a point of reference of an overly operated-on nose”. And, he points out, Jackson told the journalist Martin Bashir that he had had only two nasal operations in his life.
Roseanne, he says, who has come clean about a nose job, breast reduction and liposuction, is an example of someone who had benefited from plastic surgery. “Cher looks fantastic, and Sharon Osbourne (stomach stapled, a facelift, tummy tuck and a boob job) is a perfect example of a natural post-surgical look that I think plastic surgeons should promote.”
Interestingly, while he considers Sophia Loren the epitome of perfection — “If she had surgery it was good surgery, she looks like herself” — in his own practice women most often mention Raquel Welch as someone who has aged beautifully. “They also mention J-Lo for body parts, mostly her bottom, and, if they are having a tummy tuck, they mention Britney’s stomach button.” Not that Dr Lorenc gives them what they want. “Everyone is different in terms of anatomy and elasticity. For me to say, ‘Oh yes, I can give you J-Lo’s butt’ is a lie.”
Moreover, Dr Lorenc was appalled by the episode of I Want a Famous Face, which went out on MTV, in which a young girl underwent a surgical metamorphosis to approximate Kate Winslet. “If somebody said, turn me into Winslet, I would show them the door. If Kate came in and said I want to look like me, I would say: ‘Great, hop right on the operating table’.”
Dr Lorenc is concerned that too many people today think that plastic surgery procedures are swift and painless and the results immediate. He blames television. Recently the British Association of Aesthetic Plastic Surgeons issued a statement critical of shows such as Cosmetic Surgery Live and I Want a Famous Face, claiming that they prey on vulnerable people and misrepresent the reality of surgery.
“I couldn’t agree with the British surgeons more,” he says. “These shows are extremely deceptive. They trivialise surgery so patients don’t think of it as surgery with scarring, complications and pain. They think of it as going to the dentist — and it’s not.”
But doth the doctor protest too much? The fallout from these shows will probably be a huge rise in business for the profession. According to a survey commissioned by Living TV, two thirds of Britons want to change their looks with cosmetic surgery.
Dr Lorenc does concede that TV will boost demand — but it is the myths it will promote that comcern him. “We will have new technologies in the future and plastic surgery will be less traumatic but there will always be pain, possible complications, recovery. And plastic surgery still won’t change your life. It can enhance your looks but it won’t fix a bad marriage or the fact that your children hate you. And I worry we live in a time where people really believe it can.”
A Little Work: Behind the Doors of a Park Avenue Plastic Surgeon can be ordered from Amazon.com and costs $16.47 (£8.90) plus p&p.
Myth-information
“You can get a nose job in your lunch hour.” Not remotely possible. 
