(Note from Dr. David Magilke: In my practice I’ve noticed that prospective patients are very curious about the actual experience of any surgery or procedure they’re considering undergoing. My patient Deborah Sayler (that’s her real name) has agreed to share her experience on my blog. We performed a facelift on Deborah in our surgical suite on June 7, 2010. This series of five blog entries, which will run this week and next, describes Deborah’s decision-making process, her surgical experience, and her recovery. The pieces were written by journalist Margie Boulé.)

“Why did I do it? Because I knew it would only get worse.”

Deborah Sayler, a professional in her fifties, works in the high tech field. She has one piece of jewelry she cherishes.

“It’s my 18-carat-gold Omega necklace, for which I have numerous beautiful slides I put on it, so I can color-coordinate my jewelry with my outfits. I would put on my suit in the morning, and hardly a day went by when I did not wear that necklace.”

Three years ago, Deborah put the necklace in her jewery chest and left it there.

“The women on the maternal side of my family are blessed with what I affectionately refer to as the Brahma Bull neck,” Deborah says. And when she looked in the mirror, there it was, hanging from her chin. “I said to myself, this has got to go.”

For three years, Deborah saw no one until she’d put tightening creams on her neck. “They’re like anti-gravity creams,” Deborah says. And they were costly. And they only worked for a few hours, she says.

“I tried a myriad of things, to make it look not quite so bad.” Nothing really worked.

Deborah had gained weight in the last few years; weight loss didn’t do a thing to get rid of the sagging skin beneath her chin. Deborah began to think about finding a plastic surgeon to tighten the skin on her neck.

She didn’t think it was her imagination; people she saw on the street weren’t as friendly when she caught their eye. Men no longer smiled at her.

And she knew, having spent her career in the high tech field with people much younger than she, that a youthful appearance would help.

Last December Deborah was laid off. She didn’t think her appearance had anything to do with the job loss, but she knew it could interfere with her hunt for a new job. “It’s not that I lack the skill. It’s just when you reach a certain age, companies don’t want to hire you, in my experience. They especially don’t, when they see you with this neck. You may have the best resume and the finest background in the world. But if you look like I did, they don’t want to hire you.

“So I went in search of a plastic surgeon. Why did I do it? Because I knew it would only get worse.”

Deborah decided to research local physicians, pick a few, and get quotes from them. “I went online, looking for plastic surgeons in the Portland metro area.”

The first surgeon Deborah visited “was a wonderful guy. He was very straight-forward. In essence, he told me yes, I could use a plastic surgeon. But I would best be served by a plastic surgeon who was also an ear, nose and throat specialist.” The doctor recommended Dr. David Magilke.

Deborah got a quote from the first physician, since she liked him so much. “He did something else I applaud him for. He didn’t try to tell me I needed more than what I was asking for.”

Deborah visited a second doctor she’d found online. “There are just some doctors you click with, and others you don’t,” she says. “I did not have a warm, comfortable feeling about this man. His staff was nice enough. He had very posh offices and offered a myriad of services. But I just did not feel comfortable. I filed away his quote.

“By the way, his office called me within 30 days, which felt like a sales call. I think this is one profession where there should be no sales jobs.”

Deborah booked a consultation with Dr. Magilke and “I just immediately liked him. He’s engaging, warm, and friendly. He might feel uncomfortable with me saying that, he might not want to blow his own horn, but people need to know.”

She talked with Dr. Magilke about what she wanted done. “He agreed with me, that I didn’t think I needed anything else” but a neck lift.

Dr. Magilke showed Deborah “this large library of before-and-after pictures” of other patients. “One in particular was a woman the same age as me,” who also had a sagging neck. In her “after” pictures, “she looked absolutely wonderful.”

Deborah had taken three years to decide whether she would have this surgery. “This was not a decision I made lightly. But the worse it got, the more convinced I was that I was finally going to do it…And I knew as soon as I walked out (of Dr. Magilke’s office) that if I could come up with the money, I would have David do the surgery, based on my talk with him, the environment, the staff, the whole package.”

The cost of the surgery was significant to Deborah. But she’d recently received an inheritance that was near the cost of the surgical procedure. “It almost felt like it was meant to be.” She booked the surgery. She was comfortable. She never had doubts, she says.

“About a week before the surgery I started getting an excited feeling,” she says. “I never really had serious trepidations. I was not anxious. I was a little nervous, because you’re voluntarily saying, ‘Please cut into my body, because I don’t like how my neck looks.’ That was part of the soul-searching I went through.”

Deborah got a list of products and medications she’d need for her recovery, and made arrangements for friends to stay with her and care for her for a few nights after surgery. “I personally suggest you have someone stay with you at least through the dinner meal on the third day,” she says. I found that the first two nights I absolutely needed someone to stay with me and help.”

The night before surgery she took a shower, as instructed. “Standing in the shower I wasn’t second-guessing myself, but saying to myself: ‘Okay Deborah, you’ve made this decision. Is it the right thing for you?’ And the other Deborah said, ‘Oh for crying out loud, men and women have been having plastic surgery for years. This was a well-founded and well-thought-out decision. Get over yourself,’ ” she laughs.

Deborah knew she was making an investment of trust in Dr. Magilke. But she’d also done her own preparation. “I did research on his credentials, his training. I’d covered what I call the tactical aspect of things.”

She was ready.