My jawline has dropped a wee bit, the skin under my chin sags a smidgen, and a wrinkle or two now reside on my face although I am still in my 30s.

Mostly, I walk away from the mirror when I start to fixate on these flaws, and I focus on the present. My two boys usually want to know why I am staring at myself, and I don't really want to get into it with them anyway.

I find plastic-surgery makeover shows especially painful to watch. It is disheartening to listen to some folks go on about how important the perfect body is to them.

Once, while channel surfing, I came upon an interview with an attractive young woman who explained how a "butt lift" was going to transform her life.

Another couple confided to the television audience that they "needed" complete body makeovers to present their best selves to each other on their wedding day.

Professionally, I write about cosmetic surgery and dermatology for medical publications. Some days I find it difficult to interview expert surgeons who discuss the procedures in detail with me.

For example, for a mid-face lift, there might be talk of excising of the skin, dissection of the face and underlying muscles, and insertion of sutures and a substructure formation.

Transcribing the interview is no fun, either. I stop the tape and walk to the mirror to examine my face and poke and prod at my skin and analyze my bone structure.

Will I someday change my mind and succumb to surgery in an attempt to regain my youthful features? If I do, I won't be alone. Cosmetic surgery is not just for movie stars anymore.

According to the American Society of Plastic Surgeons, more than 9.2 million cosmetic procedures were performed in 2004 on patients looking to "rejuvenate or enhance their natural appearance through plastic surgery."

In a high-risk obstetrician's office (where most of the patients are 35 and older), I saw business cards for a local cosmetic-surgery practice stacked on the lobby desk.

I have learned many things from the doctors I have interviewed. Two lessons remain foremost in my mind: No surgery - cosmetic or otherwise - is without risk, and managing patient expectations is essential.

There are limits to what can be done, no matter how excellent the surgeon. If a patient's expectations run too high, dissatisfaction will result.

In other words, if you are unhappy with some aspect of your life, a face lift or a butt implant isn't going to fix what ails you. That's work that has to be done on the inside - by you and you only. The result can be life-changing.

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