Durangoans, who, according to conventional wisdom, are indifferent to sartorial elegance, could have a sensitive side, nevertheless.
They turn to cosmetic surgery often enough to help support three plastic surgeons in town.
“I had my eyes done in 2008,” said a 62-year-old woman who'll be known as Meredith. “Three years later, there's no sagging. I'm very pleased.”
Despite her satisfaction, Meredith didn't want to see her real name in print. Ditto a 61-year-old woman who had a tummy tuck.
The tendency to avoid the spotlight is typical in elective surgery, say Dr. Denis Winder of Durango Plastic Surgery and Dr. Ryan Naffziger at Animas Plastic Surgery.
The office of Dr. Ronald Ritz, a plastic surgeon in Durango, didn't respond to a telephone call.
Plastic surgeons are certified by the American Board of Plastic Surgery, recognition given by the successful completion of a five-year residency following medical school. They do three years of general surgery and two years of plastic surgery.
Naffziger and Winder do reconstructive surgery, but cosmetic surgery is their bread-and-butter. Winder said that before the current recession, 90 percent of his business was elective surgery, Naffiger's business is two-thirds cosmetic, one-third reconstructive.
An online consumer's guide shows the total cost of plastic surgery – hospital, surgery (including surgeon's fee), anesthesia and medications – ranges from $3,000 and $4,000 to $11,000 to $13,000. The prices are only estimates because cost fluctuates according to the individual, the guide says.
An assistant at Naffziger's office said cost of surgery is discussed only face to face. Too many variables such as insurance or whether surgery is done in the doctor's office or at a hospital make generalizations pointless, she said.
Surgical modification of the eyelid, such as Meredith had done, is called blepharoplasty. The procedure can be done when sagging lids impair vision or for vanity's sake.
Rejuvenated eyelids can erase years of wear and tear, improving appearance and restoring self-image, but blepharoplasty isn't the elective surgery most in demand.
Breast augmentation or reduction is still number one – as it is across the country – Winder and Naffziger said.
Breast surgery is followed in popularity by liposuction, the removal of fat by suction, and abdomnoplasty – the tummy tuck – in which the surgeon removes fat and skin and tightens loose muscle.
“It's all about self-image,” Winder said. “But a woman who has breast surgery often says, ‘I don't want it to be noticeable.'”
The injection of neurotoxins – marketed under such trade names as Botox – smooths wrinkles. But the procedure should be done by a medical practitioner or designated assistant, Winder said.
Patients hail from the Four Corners and the Front Range as well as Durango. People who spend the summer or winter in Durango can have surgery and recuperate where they're unlikely to see familiar people.
“My philosophy is to make my patient look nice but not grotesque,” Winder said.
Meredith had eyelid surgery to smooth out creases.
“My vision wasn't impaired,” Meredith said. “I just wanted to look younger.”
She went into surgery under general anesthesia at 8:30 a.m. and was out before noon. She wore butterfly bandages for a couple of days to stabilize the incisions and took pain pills and then an across-the-counter analgesic.
Meredith did research before choosing a surgeon. She asked friends familiar with the process for recommendations, and she assessed the risks.
Just the right amount of fat must be removed from the eyelid, she learned. Too much, and you can't close your eyes.
Literature from plastic surgeons says that although it's uncommon, bleeding, infection, scarring or blindness can result from blepharoplasty, Meredith said.
“My husband was a little hesitant,” Meredith said. “But I was confident.”
Meredith said someone who didn't know her well recently guessed her age at 50.
“I look better than ever before because the surgery took off 10 to 15 years,” she said. “I think I look like my photographs of years ago.”
Far more women than men have cosmetic surgery, Naffziger and Winder said. But the opportunity to shed pounds or smooth wrinkles is catching on with men, who frequently want enhanced pectoral or calf muscles.
Winder and Naffziger said new technology, improved safety of anesthesia, less down time after surgery and more affordable prices have increased the popularity of elective surgery.
“You can have surgery for less than the cost of a week's vacation,” Naffziger said.
Patients tend to confide their secret only to family and close friends, the surgeons said.
Women in post-childbearing age often want their abdomen and breasts restructured, Naffziger said.
“It's the mommy makeover,” Naffziger said.
The 61-year-old woman, whom we'll call Francine, had a tummy tuck in 1999 after the birth of a child when she was past her 40th birthday.
“I was self-conscious because I put on weight and had three little rolls of fat on my midriff that just wouldn't go away,” Francine said. “I exercised, but my surgeon said exercise alone probably wasn't going to do it.”
Francine restricted her activities for about three weeks after surgery. She wore a catheter for about a week to drain liquid from the incisions into a small bag worn on the body.
While she had some post-surgery discomfort, she didn't take any heavy pain medication, Francine said.
The surgery did wonders for her self-confidence, Francine said.
“I think I could wear a bikini – although I haven't,” she said. “But I use a sunsuit when I go to the recreation center pool with my grandson.”