The Fold (15 page)

“Joyce.” An older woman wearing a white nurse’s uniform stood at a door that led down another hallway.

Joyce quickly stood up. Gomo followed. The nurse held up her hand and addressed Gomo. “You can wait here, Mrs. Jones. The doctor will come out to see you after he is done with Joyce.”

Gomo looked confused but nodded at the authority in the nurse’s voice and sat back down. Joyce clutched
the clipboard to her chest and followed the nurse into the hallway.

“Right this way,” the nurse said and took Joyce’s clipboard before leading her down the hall to an examining room. “I’m just going to take your height and weight and then your blood pressure.”

“Should I take my shoes off?” Joyce asked before stepping on the scale.

“Only if you want to,” the nurse said.

Joyce thought for a second and then stepped on the scale with her shoes on. The nurse checked Joyce’s weight and then filled out a form. Next she had Joyce stand against a wall for her height. Finally, Joyce was allowed to sit while the nurse took her blood pressure. Joyce tried not to stare at the nurse’s face, wondering if everyone in the office got work done for free. Maybe it was like the deal that Gina got at the department store. Joyce marveled at the thought of getting plastic surgery at an employee discount of twenty percent off.

“Time to take the picture,” the nurse said, taking the stethoscope out of her ears.

“Do I need to change?” Joyce asked.

“No, just stay right where you are,” the nurse said and pulled out a digital camera from a cabinet. She aimed it at Joyce’s face and snapped. A quick flash went
off, blinding Joyce. When her vision cleared, the nurse was standing over a laptop computer set up on a small table with wheels. Joyce tried to peer around the nurse, but she finished too quickly.

“The doctor should be right with you.”

“Okay,” Joyce said nervously.

The nurse smiled and then closed the door behind her as she left.

Joyce looked around the office. On one wall, there was a poster-sized diagram of all the parts of a face. Blue android eyes stared back at Joyce. On the counter next to the sink, there were the usual glass containers of tongue depressants and cotton balls, next to a box of Kleenex and rubber gloves. Except for the computer, it was not so different from her pediatrician’s office.

There was a knock at the door. “May I come in?”

“Yes,” Joyce said.

A heavily bearded man in his late fifties entered the room. He held a clipboard in one hand and stretched out his right hand for a handshake.

“Hi, Joyce, I’m Dr. Reiner,” he said and had a seat in the opposite swiveling chair. “Nice to meet a family member of one of our favorite clients.”

“Hi,” Joyce said shyly and shook his hand.

Dr. Reiner leaned over and set his clipboard down
on the counter. He sat back in his chair and crossed one leg over the other. “So, Joyce,” he said, “what brings you to my office?”

“Uhm, oh, I thought my aunt had already spoken with you.” Joyce pointed at her eyes. “The eyelid surgery.”

Dr. Reiner nodded. “Yes, your aunt did express her desire for you to undergo blepharoplasty.”

Joyce tried to say that silently in her head. She was too nervous to ask him to repeat it.

“However, what your aunt wants and what you want might be two separate things.”

Joyce nodded. “Well, I think I would like to get the folds.”

Dr. Reiner swiveled around and reached for his clipboard. He flipped through a few pages before handing the clipboard over to Joyce. There was a series of before and after photos of Asian eyes that had undergone the surgery. Dr. Reiner pushed off from the floor and he and his chair rolled over to the large poster of the face. He pointed to the upper eyelid on the face.

“Let me go over the procedure and then we can talk about the complications and risks involved.”

Joyce cringed at the words
risks
and
complications
.

“There are a number of ways to achieve a more defined pretarsal crease. While Asian eyes do have folds, the muscle is just attached to the eyelid at such a low point, it is hard to see it. Your eyes are not going to be necessarily bigger with the surgery,” he said, widening his eyes as far as possible. “But what we will do is reattach the muscle higher so the pretarsal crease will be more substantial and give a fuller, possibly rounder, look to the eyes.”

Joyce nodded.

“Now, since you are a teenager, there are certain considerations that you must take into account.” He paused for a second, studying the poster before pushing himself off and rolling over to where Joyce was sitting. “You are still growing,” he said with serious concern narrowing his eyes. He pointed to his head and then his heart. “Mentally, emotionally, not to mention that your face and body might still be changing.”

Joyce blushed and prayed that he wouldn’t ask when she started her period.

Dr. Reiner thoughtfully held his bearded chin. “Many teenagers come to my office with requests for breast augmentation and liposuction and blepharoplasty. And when I see these young adults, I wonder if nothing but a good dose of self-confidence, exercise and a lesson at the
makeup counter might not be all they really need. Do you understand what I’m saying, Joyce?”

Joyce nodded. “So you might not agree to do the surgery?”

Dr. Reiner sighed. “It’s not that I won’t do the surgery, but I do encourage my young clients to seriously contemplate why they might want to alter their appearance. They have to know with as much certainty as possible that this is what they want. There are risks involved, as with any kind of surgery. Complications such as infection or a reaction to the anesthesia are possible. Double or blurred vision, asymmetrical healing or scarring are other complicating factors to consider. And the very real possibility that there might not be pixie dust at the end of a hard road to recovery. Not everyone has the same reaction after cosmetic surgery. For some people it’s worth it. For others, the results might not be what they expected, or their life doesn’t change in the way they want it to. I try and encourage as much thinking and questioning as possible before making the final decision.”

“Does it hurt a lot?” Joyce asked in a tiny voice.

Dr. Reiner put his hands up and looked like he was trying to gauge how to catch a football that had just been tossed into the air. “Well, that is a hard question
to answer only because people have various levels of tolerance for pain.”

“But there is pain.”

“Well, yes. Anytime you cut and sew your skin, there will be pain. It’s just a matter of how you mentally take on that challenge and also how your body heals. Luckily, the plus side of being a teenager in regard to surgery is the repair rate, which is much faster for young cells like yours.”

“Great,” Joyce said, without much joy. The part about cutting and sewing was still on her mind. “How much cutting do you have to do?” Joyce could still picture the surgery photos that she had found on the Internet. Her stomach jumped at the image.

“That depends on what procedure you choose to undergo to achieve the crease that you want. Some opt to cut and secure the fold to the tarsal plate, which is the most effective way of making sure the folds do not disappear. Others opt for a laser cut, which has a faster rate of healing. And others, with young skin such as yours, might only need a few stitches to hold the skin back, but there is also a higher possibility that the fold might not stay in place.”

Joyce mulled over all the information. “What hurts the least?”

Dr. Reiner smiled. “I take it you have a low level of tolerance for pain.”

Joyce grimaced and nodded.

“Well, I would recommend, based on your age and lack of complicating conditions, to try the stitches. Always best to go with the least invasive treatment and see if that works.”

“Otherwise, what do you have to do?” Joyce asked.

“We can always go back and operate again.”

“Are you going to put me to sleep?”

Dr. Reiner was looking down at his clipboard, filling in some information. “Sleep?”

“Put me under. So I don’t feel anything.”

“Oh. No. We’ll just use local anesthesia.”

“You mean I’ll be awake for the whole thing?”

“Yes, Joyce. Is that a problem?” Dr. Reiner put down his clipboard and looked very concerned.

“No.” Joyce waved her hands. “No. I mean. Can’t you just make me go to sleep and then I won’t have to worry about anything?”

“There are more risks involved when we fully anesthetize someone. And for a procedure like this, I wouldn’t recommend taking any more risks than is necessary.”

“Okay,” Joyce said weakly.

Dr. Reiner opened up a drawer under the sink counter. He pulled out a hand mirror, which he handed over to Joyce, small tweezers and a bottle filled with some clear liquid. He set all the equipment on the counter and then rolled the small table with the laptop computer over to Joyce.

Dr. Reiner pointed to the sheet with the eyes. “If you’ll notice the difference in appearance in each set of eyes. Some choose to have a larger, more defined crease. Where the crease begins and how you want it to taper or not taper off is a very personal decision. I can do any of the creases that you see there on the sheet.”

Joyce scanned through all the eyes but didn’t really see a difference. Dr. Reiner pointed to one set of eyes.

“This person wanted her crease to be as understated and natural looking as possible. See how narrow the crease is compared to the eyes in this photo. And the ends of this one taper down as opposed to flaring out.”

“Oh,” Joyce said, finally noticing the difference. “How do you know what looks best on me?”

Dr. Reiner sat up in his chair and reached over for the small table with the laptop. He turned the laptop slightly
toward him and punched in a few commands. Magically, Joyce’s face appeared on the screen. Dr. Reiner zoomed in on Joyce’s eyes. He turned to Joyce.

“It depends on how you want your eyes to look,” Dr. Reiner said. He fiddled with the keys and moved the cursor over to Joyce’s eyelids. Slowly the image changed so that Joyce could see her eyes opening slightly and a narrow crease appearing where there had been none before. Joyce raised her fingertips to her eyelid as though the same crease was engraving itself into her skin. Dr. Reiner glanced at her and smiled. Joyce pretended she had a bug bite on the side of her face.

“Now, we could make your creases more substantial,” he said and manipulated the image some more until Joyce had two very distinguishable lines above her eyes. Joyce gasped. That was really weird looking.

“I would recommend trying for something more subtle, but it depends on your taste.”

Joyce stared at the foreign eyes on her face. “Yeah,” she said, “I think subtle would be better for me.” Joyce thought about the Korean mothers’ grapevine going into overdrive when they saw her with huge san-gah-pu-rhees on her face. At least if the line was more natural, people might not notice right away and then they might think the folds had always been there.

Dr. Reiner decreased the size of the crease and let Joyce have a look.

Joyce studied the eyes staring back at her. She stared down at the sheet with all the eyes. The various pairs seemed to be saying pick me, pick me. Moving the sheet of eyes closer then farther then closer to her face, Joyce tried to distinguish the differences between the creases, but ended up feeling overwhelmed. She could feel Dr. Reiner waiting and yet she didn’t want to rush and pick just any old pair of eyes. This was worse than trying on clothes at the department store. If only Gina were here.

Dr. Reiner wheeled forward. “Let me suggest trying something for a trial basis. We can glue back part of your eyelids to create the effect of the defined pretarsal crease and then you can see if you would like to go bigger or smaller.”

“You can do that?” Joyce said.

Dr. Reiner picked up the small bottle. “Very common in Asian countries for women who do not choose or can’t afford the permanent route to glue or tape their eyelids back. It’s not unlike women here gluing on fake eyelashes.”

“Cool,” Joyce said. After a second she added, “There isn’t any pain involved?”

Dr. Reiner smiled as he put on his rubber gloves. “No, Joyce.”

Dr. Reiner applied a thin layer of glue on one eye and carefully used his tweezers to lift up a portion of the skin on her upper eyelid until Joyce could see a crease forming in the mirror she held up to her face.

“That is so amazing,” Joyce said when he was done. She turned from side to side to check out the results. Only one eyelid was up but Joyce could see what a difference it was making. Dr. Reiner held a small ruler to her eye and noted the exact measurement.

“Let’s do the other one,” Dr. Reiner said and Joyce moved the mirror to one side so that he could do the other eyelid.

Joyce couldn’t stop staring at herself in the mirror.

“Wow! This is crazy! I didn’t really think a small change would make this big a difference in the way I looked.”

Dr. Reiner dropped all his equipment into the sink and threw away his gloves. “The glue should keep your eyelids in place for a day or so. Use warm water and soap if you want to dissolve the glue. And I wouldn’t recommend vigorously rubbing your eyes.”

“Okay,” Joyce said, still reveling in her new appearance. She felt like she was looking at someone she knew but didn’t
know. Someone familiar and yet different. Who did she look like?

“Joyce,” Dr. Reiner said. “Joyce.”

Joyce looked up from the mirror.

“So you like what you see?”

Joyce grinned so wide, she worried her creases might pop off. She dialed back the wattage of her smile. “Thank you, Dr. Reiner!”

Dr. Reiner picked up his clipboard. “I’ll make a note of the size crease you have and when you come back in for the surgery, we can talk about whether you want to keep it to that size or go bigger or smaller.”

“So the next time I see you, I’m going to make this permanent?”

“Only if you decide that is the right decision for you.” Dr. Reiner shook Joyce’s hand. “It was nice to have met you, Joyce. Why don’t you come out after you’ve had another minute to look at the handout of the different sets of eyes. I’ll just check in with your aunt.”