Before the Nuptials - Nips and Tucks

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With the average U.S. wedding costing around $22,000, more wedding party participants want to look their best for those wedding pictures which may be passed on to future generation. Cosmetic and plastic surgeons tell who is coming in for a nip and tuck before the big day.

When R. L.'s wedding day rolled around last May 7th, her nose, which she had hated for so long, had been at last fully repaired so she could stare into the many cameras present on the big day with confidence, if not a huge measure of sass.

"With my old nose, I knew I would hate every wedding picture taken that day," R.L. told (She asked her full name be withheld.)

R.L., now 30, suffered a botched rhinoplasty (nose job) when she was 16, followed by another surgery years later to try and repair the damage. But it did not work.

She did some research and started looking for a surgeon who specializes in cosmetic surgery revisions.

"My nose was an absolute atrocity," says R.L., who works in marketing in New York City and just married a graphic artist. She shopped physicians for the pre-wedding revision surgery by reading doctors' websites for information about their training and background and then ventured out for face-to-face interviews of three. One in particular impressed her with price, training, patient testimonials and a warm beside manner.

"I knew I had to get it right this time," R.L. says. "When I went in for surgery, my nose was twisted, and the left side was collapsed so badly, I could not breathe through it. In the past, when a picture was taken, I made sure the photographer was far off or that only my good side was pictured. Once my nose was finally straightened, I couldn't believe I had been walking around so long, looking that badly."

R.L. is not the only bride looking for a surgeon to perform a nip, a tuck or more before taking that walk down the aisle. Cosmetic surgeons and others report seeing many more wedding party members seeking procedures before the nuptials.

"Cosmetic surgery procedures for brides-to-be, mothers of the brides and others in the wedding are up 300% over this time last year," says Cho Phillips, executive director of, a Northern California website devoted to engagement, marriage and other family issues. "First-time brides tend to have liposuction and breast augmentation in preparation for their big day."

Yet another wedding consultant says pre-nuptial cosmetic surgery is so common, most couples should think about carving out a budget for facial makeovers.

Arlene Howard, 64, a Beverly Hills public relations practitioner, had the striking good looks of a model in her early 20s. Now, she has an October 10th wedding date at the Bel Air Hotel in Beverly Hills. So for a segment of tv's "Dr. 90210," Arlene underwent a facial peel that took 25 years off the calendar – after a two-month recovery time -- and made her, in the words of her husband-to-be, "a trophy bride."

"I wanted my outward appearance to catch up with my self-image," Arlene says. "It will now be the wedding I've always wanted." Compliments have been so encouraging, Arlene says she will also have a tummy tuck before the wedding.

Says Robert Freund, M.D., a Manhattan plastic surgeon, "As the field of cosmetic and plastic surgery receives more attention in the media, cosmetic surgical procedures become more widely accepted. Plus, the medical technology is getting better and that allows plastic surgeons to offer more sophisticated rejuvenations, with quicker healing time and less post-operative bruising."

It was another uncomely schnoze that drove Tara, J. a 29-year-old magazine writer in New York State, to see about repairing the damage caused by a surfboard that broke her nose years ago. Her rhinoplasty was done in February to prepare for an October (2003) wedding.

"I think everybody noticed my new nose at the wedding," she says.

"Because all eyes will be on the bride at the wedding, the perfect time to start a new skincare routine is at the engagement," says Keith LaFerriere, M.D., president of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) which reports the two most popular procedures for brides-to-be and their mothers are Botox and chemical peels.

"If a bride goes in for Botox or chemical peels, she should have it done weeks in advance because swelling and redness can occur," says Dr. LaFerriere who is also a clinical associate professor at the University of Missouri, Columbia.

According to Leo McCafferty, M.D. a Pittsburgh plastic surgeon and immediate past chair of the public education committee of the American Society for Aesthetic Plastic Surgeons, (ASAPS) the mother of the bride is more likely to get a pre-wedding nip or tuck.

"Most often, the mothers of brides and grooms are seeking facelifts or eyelifts, sometimes, up to a year before the wedding," Dr. McCafferty says.

That was what drove Mary Anne R. of Brooklyn, New York, to see a plastic surgeon before her daughter's wedding in May 2004. Except, in her case, Mary Anne wanted less to be more attractive.

"I've always been very large chested and learned I was a candidate for breast reduction after reading about typical symptoms such women have," says Mary Anne. "For instance, I was having pain in my shoulders and down into my arms from my bras which, in some respects, were almost like wearing harnesses. I really wanted to go to the wedding in a strapless dress, but that was impossible before the surgery. I would have popped right out!"

Mary Anne underwent a breast reduction in November 2003, and says she had completely healed and "looked great" by the wedding date in March, 2004.

"At the ceremony, I received many compliments in my strapless dress and everybody told me how wonderful I looked," she says. "Plus, my husband is my biggest fan of my new look."

Jennie H., of Union Town, Pennsylvania, actually didn't think too much about cosmetic surgery until a close friend at her health club pointed out how tired she looked.

"I took a look in the mirror, and said, 'My god! She's right! I don't look good." Although it was only six weeks before the wedding, Winnie had upper and lower blepharoplasty (eye lids and eye bags) performed on May 7th, 2004, and was healed in time for her daughter's July 26th wedding.

"At the wedding, virtually everybody noticed and complimented me on how young I looked," Jennie says.

Michael C. Bruck, M.D., director of plastic surgery at New York's Juva Skin & Laser Center in New York City finds the most common pre-wedding cosmetic surgery mistake is waiting too long to see the surgeon about major procedures on the face, eyes and abdomen.

"The other busy time for special occasion requests is before high school and college reunions," Dr. Bruck says. "For some reason, those people come in much farther in advance of the event. Maybe they want to look extra good for old flames."

About one quarter of patients, who visit doctors for pre-wedding consultations – but did not go ahead with the procedure – come back after the wedding for the operation, he says.

"Once a patient starts thinking about a particular cosmetic procedure, it seems to stick in her mind," says Dr. Bruck who reports using a lot of Restylane, a filler that gets rid of blemishes, acne scars and some minor lines and wrinkles.

However, all is not lost if you do find yourself short on time. For instance, David J. Goldberg, M.D., dermatologist and director of The Skin Laser & Surgery Specialists of New York & New Jersey, says some wedding ceremony patients come to him a scant week before the ceremony.

"For younger brides, physicians can offer smoother skin through laser dermatology and some filler agents to fill out lips," Dr. Goldberg says. "Hylaform is good because it produces quick results and is a natural substance, so no skin or allergy tests are required. Those tests take time."

Blushing brides find microdermabrasion helps makeup go on smoother. There is usually no bruising because the needles used to inject some fillers are as thin as one human hair.

A current trend is giving cosmetic surgery as a gift. So, six months before opening her other gifts, Sheryl H., a 30-year-old medical transcriptionist in Springfield, Missouri, opened an envelope containing a gift for six dermabrasion treatments. "I had little dark areas of complexion on my face but dermabrasion made my skin lighter, smoother and fresher," she says. "The treatments make your face feel wind burned but your skin glows more afterwards."

Mothers of brides in a hurry often ask for fast relief of crow's feet, wrinkles and worry lines. Dr. Goldberg says Hylaform usually fills that bill, too.

But whatever procedure is used, girls – and their moms – just wanna look good.

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Brent Frank