My 40s were looking to be the best decade yet. We had welcomed our first child, a little blonde cherub, a few months after the milestone birthday. I didn’t experience any postpartum depression, and I was back in my size two pants within weeks. I was loving life as a new mom, and aside from the constant exhaustion and vomit-covered clothing I sported daily, I felt like mom life was better than I could have ever imagined. Then one day, as I was getting dressed, I felt this weird bump at the top of my right breast. “It’s probably just one of those clogged milk ducts,” my best friend assured me a few days later.
“You don’t think it’s breast cancer, do you?” I asked her as we drank wine while watching The Golden Girls.
“Sarah, it is not breast cancer.”
Just to be safe, I made a doctor’s appointment—and well, spoiler alert, it was indeed breast cancer. What happened next was a whirlwind. Tests, waiting for results, more tests, more waiting, surgery, and more waiting. Finally, I got some good news. The cancer had not spread and the doctors felt confident that the double mastectomy had removed it all. The type of breast cancer I had was highly estrogen receptor positive, so I would have to take a pill for 5 to 10 years, to keep the estrogen at bay. Okay, I could do that.
“Also, we want to give you a monthly shot to put you into menopause,” my doctor said. What? I was 41. I was way too young for menopause. And what about the side effects?
“There most likely will be some side effects—hot flashes and bone pain being two of the most common,” my oncologist explained. I guess I could handle those. It was a tad overwhelming to be immediately put into menopause, but I had younger friends who were breast cancer survivors who’d been dealt the same fate, and they had fared well. I was lucky to be alive.
It was about a year into treatment when I noticed my eyesight deteriorating. The medication was keeping the cancer at bay, but it wasn’t without a price. I went to the eye doctor, who said I had early signs of cataracts as well as some fluid behind my eyes that needed monitoring. I got progressive lenses and dry-eye drops and made an appointment with a specialist. No biggie.
A few months later, I went for a bone-density scan and the results weren’t good. The lack of estrogen had started to take its toll on my bones, and I was pre-osteoporotic. I would need to make sure I was taking lots of vitamin D and calcium. Sure, no problem.
And then the final straw hit. I caught my reflection in the car mirror one day and didn’t recognize myself. My skin had literally started to fall down my face. In the two years I had been on the treatment, my skin had lost so much elasticity; I was even getting the dreaded turkey wattle.
I decided I would not become my grandmother overnight. I got facials, upped my skin-care regimen, and began dabbling in Botox and even a little filler. I did skin tightening treatments—the ones that hurt so much, if you had secrets you would definitely give them up. I even did one so gimmicky and useless that the clinic I went to discontinued it a month later. Nothing was helping, and I was feeling worse about how I looked. I avoided mirrors because when I would see myself and my saggy skin, I felt really defeated. I made an appointment to speak with a plastic surgeon. I didn’t ever think I would be thinking about plastic surgery at 46. But then again, I never thought I would be in my 40s with the estrogen level of an 80-year-old.
The doctor I met with, despite having lots of great reviews and a fancy office, made me feel terrible. “Did you lose a ton of weight recently? I have never seen someone your age with so much excess skin. This is a tough case. I will have to treat you like a weight-loss patient.”
He also told me that to achieve the results I wanted would be more complicated than I had anticipated. I was hoping he could just go in and remove the neck skin and be done with it. But alas, it doesn’t work like that. A facelift would be required as well.
He went on to explain all the possible complications, including the chance that the operation might not work, then handed me a fancy envelope with his estimate enclosed before exiting the room with a quick wave.
Yeah, this wasn’t the doctor for me. I found a few other doctors who specialized only in facial surgery, and while I was impressed with them, something didn’t feel quite right.
I ultimately found my doctor in Dr. Philip Solomon. He’s a certified facial plastic surgeon with an office just a few miles from my home in Toronto. I told him what I was hoping to achieve, and he explained to me very carefully why a neck lift is often performed in concert with a facelift.
“Lifting just the neck would leave an unnatural appearance along your jawline where skin overhung the jaw. The neck would be tight, but the jawline and jowl area would be heav. Lifting the face and neck provide the most natural result,” Dr. Solomon described.
He also helped me to understand the changes I was seeing in my face and the role the sudden onset of menopause was playing. “As one approaches menopause, estrogen drops—and this leads to a significant change in skin collagen, which drops with aging. Often, patients who have cancer or diseases that affect hormone levels may notice accelerated signs of aging,” Dr. Solomon said.
During the consultation, he laughed and chatted with me, answered all my questions, and reassured me that there is no right or wrong time to address these issues. “We no longer go by age but rather assess the case and see if surgery at this point in time is warranted. Some of our happiest patients are in their 40s to early 50s,” he said.
The day of my procedure (an extended deep plane facelift, which includes the neck), I was a little nervous but also very excited.
When I woke up from the three-and-a-half-hour procedure, I felt better than I had in a long time. In fact, I even did a little dance on my way out of the clinic. I was swollen and had drains taped to me, but I was giddy.
The first few days after the surgery, I stayed in a hotel; I didn’t want my young kids (ages 3 and 6) to see their mom with drains, wrapped in bandages, and unshowered. I had very little pain and managed to get by with just regular Tylenol. For me, the most challenging aspect was that I am a stomach sleeper and after a facelift you need to sleep elevated and on your back. Needless to say, I slept maybe an hour those first few days as I adjusted to this new sleeping routine. On day four, the drains were removed and I could shower and was ready to be reunited with my kids. I had some bruising and swelling, which got a bit worse on days five and six, but I kept my head wrapped in a compression garment, which my kids accepted as something Mama had to wear to help with her “face boo-boo.” By week two, I was back to picking up my kids from school and running errands, with the scars virtually invisible. When I wore my hair down, I looked a little swollen but nothing anyone would remark upon.
My husband was really great through all of this. He didn’t think I needed cosmetic surgery, something he would remind me of daily by telling me how beautiful I was. But he supported and honored my decision to go through with it, making sure I had everything I needed to help with my recovery (especially my favorite seltzers, soups, and sweet treats). And when he saw me for the first time without the bandages on, my face super puffy and yellow from bruising, he gave me a big hug, reassuring me it was all going to work out. And he was right. Once the six-week mark came around, I’d almost forgotten I’d had anything done, since the majority of my swelling was gone and a lot of the feeling in my face had returned.
Cancer took a lot from me, including my ability to carry another baby, but I feel like through this process I got a little bit of who I was back. It’s been almost three months since my facelift and neck lift, and I don’t think I have felt more like myself in a very long time. I don’t look much different, and not one person has noticed I had anything done, but I feel more at peace with myself—and if getting plastic surgery helped to get me here, then it was absolutely worth it.
