Even though my hairdressers makeshift salon doesnt have the sumptuous accouterments of a bona fide shop of beauty, an oversized mirror stares back at me as Lance meticulously cuts my hair, then mousses it and gooses it, attempting to conceal the thinner patches. Ive looked better, I think to myself while I listen to Lance whine melodramatically about his own personal beauty crisis: Hes worrying about the potential side effects of his medical regime for HIV.
The worst one is when, after years of taking protease inhibitors, your face caves in, he complains. Can you imagine, honey?
Lance lives in fear of lipodystrophy, a condition that results when ongoing drug therapies cause fat to be distributed abnormally. Lipodystrophy affects the face, legs, stomach and neck. In some instances, there is an excess of fat; in others, so much fat is lost that the empty tissue sags.
Later that evening, I plant myself in front of the mirror to study my face. I have been HIV-positive for 15 years, medicated for six with a cocktail of 22 pills, including Fortavase and Combivir. In slow motion, I turn my face to the left, then to the right, inching in closer to the glass, then pulling away. What are you doing, Daddy? asks my 8-year-old daughter, Tia, who doesnt yet know my HIV status. Since I adopted her as an infant, Ive felt it was my job to protect her, so shes unaccustomed to seeing me in such a state. But before I can come up with an explanation for my inquisitive kid, I hear Gloria Swanson as Norma Desmond whisper in my ear: We had faces then. Then. Faces then.
Oh, my God, I realize with a shock. Ive got it. Ive got lipodystrophy. It looks as though my cheeks have been scooped out with a spoon. Were Lances histrionics a subtle way to let me know my glamour days are numbered?
I am an actor. Its my livelihood, my lifes work. And if youre an actor flailing about in Hollywood, even if youre called upon to play a homeless wino on Skid Row, youre expected to be beautiful. And while the majority of my actors life has been onstage rather than on celluloid, my face has paid more than a few months rent. Losing my face could cost me my career.
I have to do something. Ive seen a procedure advertised in the gay press, complete with dramatic before and after pictures, that promised to repair the damage. So vain, I think to myself. So shallow. So L.A.
I rip the ad out of the newspaper and secrete it under some papers on my desk.
A few weeks later, Im sitting in the snazzy waiting room of the doctors office, flipping through the pages of a magazine that features nationally respected political activist David Mixner on the cover. Inside, Mixner discusses the beginnings of AIDS and its relentless reverberations, which he began fighting some 20 years ago, before people with AIDS had such luxuries as sagging skin, buffalo humps and distended bellies brought about by the long-term use of protease inhibitors.
Reading about Mixner, I think back to Sean, an edgy musician whose career was beginning to heat up, the first person I actually knew who had contracted what had then been mislabeled as the mysterious gay cancer. I remember visiting him, watching him maniacally pace around his unkempt bed that was situated in the middle of his tiny one-room apartment. Am I going to die? he asked, not wanting an answer. How soon? There was a smell emanating from the bed that separated us. I sleep and sweat, sweat and sleep, he said. There were purple spots dotting his arms that would later be identified as one of the diseases earlier disfiguring manifestations: Kaposis sarcoma. What Sean would have given for a longer life with a falling face.
A voice interrupts my reverie: Michael?
I am ushered into a consultation with an office manager, who subsequently spells out the details. The transformation will be accomplished by making multiple injections of silicone directly into the areas where my face has hollowed. The results will not be immediately apparent, he warns; in fact, there are three visits spread out over a couple of months. Its not like a botox treatmenta to get you ready for the Academy Awards, he kids.
I ask whether I should expect downtime, and how much. The next day, there will be swelling and possibly bruising, he informs me. He lowers his voice to a whisper: You can tell people you had your wisdom teeth removed, he advises confidentially. God knows you wouldnt tell anyone your face was caving in from HIV medication. Thats just not pretty.
I am moved into a different room, where, after a few moments, the doctor sweeps in, sits down and wheels his chair up close. He whips on a pair of plastic gloves, sticks several fingers in my mouth and tugs at the area where there used to be fat. Bring in a picture of what you used to look like, he suggests. It helps.
The doctor explains the process of injecting silicone, a substance, he explains, that has been used to correct facial defects for approximately 40 years. Hell use a new, highly purified, medical-grade silicone, Silikon 1000. He points on my face as if its a piece of canvas. Ill fill this in and extend it here.
Okay, I say. I just dont want to look like Siegfried. Or Roy.
We havent had one single complaint, he gushes. Ill bring in my high school yearbook photo, I think to myself.
What would my dead friends say? What about David, who was blanketed with big dark-purple lesions on his entire body, including almost every inch of his photogenic face? Or Billy, who was partially paralyzed and entirely blind by the time he died? Or Victor, who spent his final days on fire with fever while suffering from relentless diarrhea? Or Jim, who ended his life babbling incoherently as a result of dementia? Or Larry, who was confined to a wheelchair because of some mysterious muscle deterioration? What would they, none of whom celebrated a 40th birthday, have to say about this need I have to repair my flaccid face? I feel indescribably shallow.
My friend Robert Chesley, the acclaimed queer playwright, spent his final days parading around San Franciscos Castro district, defiantly shirtless, proudly displaying the lesions that decorated his body. Taking it one slogan further than Were here, were queer, get used to it, Bob said, Im here, Im queer, Ive got AIDS, get over it. It was a message he was sending to the straights who might be gawking but also to his gay brothers who wished AIDS would go away. If there had been a quick fix for Bobs AIDS lesions, I wonder, would he have considered it, relinquishing the power he obviously found in embracing the demon? I feel like such a pussy.
One might have assumed that the plague years had taught us something about the transitory superficiality of beauty. As we sat at the bedsides of our dying friends, some of them virtually unrecognizable, how many of us realized that it wasnt their physical beauty that made them lovable, but their spirits, their courage and wit? Ironically, however, as protease inhibitors have mostly banished the uglier manifestations of AIDS for the lucky ones (the white, insured and living in America), the gay mans hallmark obsession with physical perfection has intensified. Not only do we not want to look sick; we aspire to look fabulous. Courtesy of steroids and weight training, gay men have traded that emaciated AIDS look of the 80s for determinedly buffed bods that became the AIDS look of the 90s and persisted through the turn of the century. (That fab look can also carry a dangerous implicit message: He cant be HIV-positive if he looks that good.) Understandably in this beauty-conscious climate, when faces started to fall, there was panic.
After signing in for my first procedure, I am escorted to the room where the magic will take place. Within a few minutes, the maestro appears, even more upbeat than Id remembered. Suddenly he holds a magnifying mirror up to my face and begins making marks with a black pen. Then he launches into a rap about the sand entering the oyster making a pearl. This is undoubtedly an analogy, entirely lost on me, which has something to do with the silicone; Im wondering if Ill be able to figure out a way to change the age on my drivers license.
Fabian, the doctors assistant, performs his tasks with the high-voltage fluidity of a Vegas showgirl on opening night. Together, they numb my face. So far, its less invasive than a visit to the dentist. I am left alone for eight minutes while my face freezes. For whatever reason, I begin to cry, feeling silly and pathetic. But most of all, and this is a recurring motif, I feel alone, missing my dead brothers, awash in memories of their faces, their laughs, their immortal humanness. These cathartic episodes never last more than a few minutes, and Ive fully recovered when the good doctor returns for my prickings.
Although I feel nothing, the doctor makes injection after injection with determined dexterity while Fabian dutifully assists. Within a few minutes, it is over.
I had arranged for my daughter to spend the weekend with trusted members of our extended family. While I dont like deceiving Tia, I decide not to burden her with too much information. But part of me wonders if Im avoiding an opportunity to spell out Daddys delicate condition.
My devoted friend Jim takes me downtown to the Omni Hotel to recover -- a night of reminiscences and room service. After we find our suite, I madly search the halls for the ice machine, and after faithfully taking my herbal remedies to ward off bruising, I flop onto the bed and apply ice packs to my face.
When the swelling calms down, there is a marked difference in my appearance. My face is full and robust-looking; my skin stretches smoothly over the silicone. I already feel considerably less defaced by AIDS, and Im only a third of the way into the procedure. There are two more treatments coming up.
Now that I know what to expect, phase two seems less dramatic. With a different assistant in tow (Fabian was probably at an audition), the doctor performs the ritual: face freezing first, artful injections next, two minutes of ice, and its over. By the time of the third and final visit, its clear that all I need is some fine-tuning and my face will be restored. As the doctor maps out his strategy for my last battery of prickings, I hear myself say, Is there anything you can do about that splotchy discoloration on my neck?
The doctor summons the laser specialist to give me the pitch. Part of me is tempted to make an appointment on the spot. But another part of me wonders, When will it stop?
A month later, my improved face has not resulted in a dream date, a lucrative modeling job or a resolution about that insurmountable battle with my boisterous self-esteem demons. But I do look better. The surgery has eliminated a disquieting self-consciousness in public and serves my undeniable need to feel attractive. Still, Ive so far avoided the urge to indulge in any further facial tinkering. And as a warning to myself, I have taped a life-size photo of Michael Jackson to my bathroom mirror.
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