1. How many people who've had full facelifts are walking around in Auckland?
A lot more than you'd think. I would say that there are 20-odd surgeons with busy private practices and 400 to 500 facelifts done in Auckland every year.
2. Is there a typical candidate for a facelift?
The vast majority are white European females. It's very socio-economic. The facelift that we do on a routine basis costs about $16,500; it's an expensive luxury. But you can go along to [another surgeon] and probably pay $40,000 to $45,000 for essentially the same operation. Life events tend to precipitate it: separation, divorce, job changes, menopause. That's not to say that we don't see people who are a lot younger, but menopause is really the point that the big, deep insecurities bite home. Your face begins to age, everything gets a bit droopy, your husband runs off with his secretary, you lose your job, the kids have gone to university. It's not unusual to have all that crashing down at that age. It's brutal. The surgery doesn't cure any of it, but at least it might make you feel better. We also see senior executives coming to have surgery done because they feel they will cope better in the workplace. The youth pressure is very real.
3. Do male senior executives come in too?
Not so much.
4. As a cosmetic surgeon do you ever feel that you are instrumental in this youth pressure?
No, I think I'm contributing to people's welfare and happiness. If you do good facelifts it makes a huge change to people's lives and how they're perceived by themselves and others. There's no question about that. And I don't think it's the male plastic surgeons who are applying the pressure - sure we advertise, but we're not the image-makers. The image-makers are television, women's magazines. I think the pressure is actually female.
5. Do you ever talk people out of a procedure that they request?
Yes. With augmentations, I tend to be moderate in my views and I think big breasts produce big problems. I refuse to do liposuction on people who are significantly overweight. And I think unless people's expectations of facial surgery are realistic you shouldn't be doing it. You become attuned to recognise people who are fantasists and sometimes you can sense when someone believes having their face remodelled will convert them into a 19-year-old. If people go into facial surgery expecting it to do things for their self esteem, they'll often be gratified. But it doesn't fix marriages, it doesn't fix interpersonal conflict at work or personality problems.
6. When you're out socially, do you find yourself privately noting what people could do surgically to improve themselves?
Absolutely not. Never. Yes everybody asks [my opinion] but I tell them to ring my secretary and make an appointment. Dinner party consultations are not where I want to be.
7. What's your earliest memory?
The first is being carsick in my grandfather's car. The second is being in a train at the Edinburgh station. What I remember is the smell of the coal. I was 2 or 3 when we left Scotland and went to the south of England. My father was a chest physician and my mother was a nurse. We moved again to the States when I was 7. I arrived in North Carolina with a very received BBC sort of accent. This was the deep south, the south of Martin Luther King and black activism. It was all brewing, though I wasn't aware of it. Retrospectively you can see you were living in a segregated society - the schools, the bus. We had a woman called Lizzie Goldsmith who was our housemaid. Then I came to New Zealand when I was 8 or 9 sounding like Tennessee Williams which really made me feel like a Martian. People with American accents were pretty uncommon in Dunedin in 1960.
8. Were you interested in physical beauty from a young age?
No. The motivation of plastic surgery wasn't beautification. I find the idea of creating physical perfection totally nauseating and unobtainable for the vast number of people. The motivation was physical reconstruction. I was always interested in biology. At high school age I read pretty much the content of the Dunedin Public Library - Nature, Scientific American, various other magazines. There were some exciting stories that came out - the discovery of DNA, Banting and Best and their work with diabetes, the Mayo brothers. And I became interested in plastic surgery, reading about people like McIndoe and Gillies who were guys from Dunedin who really developed the whole specialty. In my 30s I spent five years in Canada, Britain, Saudi Arabia, and when I came back here there wasn't really any choice but to go into private practice and that meant most of what I was doing was cosmetic. So cosmetic surgery wasn't really my deliberate choice, that was the way it worked out.
9. Are you married?
No, I've been married. I have two sons who I'm very close to, a stepdaughter and six grandkids. I have a [5ha] property out east that I share with five alpacas. Why? I just thought it was a nice idea. I'd always been attracted to their looks as animals and they're very good lawnmowers. They're highly intelligent, very biddable, very curious. They kind of follow you around.
10. What would you be if you were not a plastic surgeon?
I seriously considered doing architecture. I liked form, I liked shape, I liked building things.
11. How do you relax at home after you've been at work cutting somebody's face open?
I don't find that particularly stressful, so I don't need to recover from it. But I swim a bit, I race yachts with my best mate Julian who I've known since we were 18. Being a surgeon also allowed me to own and drive in a motor racing team. We won four years out of five at the Nurburgring in Germany. Driving at that kind of speed is alright until the corners come up and then you've got to get the timing right. With high adrenalin activity, if you're going to get scared, you get scared afterwards. I supposed it is a bit like surgery in a way.
12. Have you had any cosmetic surgery yourself?
Yeah, I had a prominent ear done. It stuck out and I always tried to hide it, I'd sort of turn my head. I didn't have it done until I was about 50 but it made a huge difference to the way I felt about myself, it was quite astonishing. I don't know if it affected the way other people saw me, I don't think it did. People aren't very attuned to the changes in other people's appearance. How often have you changed your hairstyle and found no one notices? Often when people have a facelift and return to work people just think they look relaxed and have been to Fiji or something. And one week ago they virtually had their face off.