insist on the fairytale.

Introduction

The Hammer and the Nail

One of my greatest life lessons is from my dad: “When you’re a hammer, everything looks like a nail.”

I don’t think there’s anything in life that it can’t apply to, but I was surprised recently when I saw a sensationally beautiful woman with over-injected lips and vascular compromise from an injector literally hammering filler into her lips. It broke my heart. Just because you can hold a syringe and push it doesn’t mean you should. A face is not a nail. Every face is not the same. Not even close.

There is nothing “simple” about injecting, and it has nothing to do with the product—it’s the hands holding it. The intricacies of the anatomy of the face are quite complex and deserve intense respect.

I am a board-certified facial plastic surgeon with a passion for beauty in all forms, inside and out. I love human faces and my dog’s tail. I was born and raised in Mississippi, spent my entire childhood trying to get to New York or LA, and most of my adult life wishing I was home.

I have a passion for truth—beauty parlor, bathroom-type truth. I think we are at our best inspiring and sharing with other women the things reserved for the beauty parlor, or the bathroom when there is a long line, and I am adding my office to that list. I believe real beauty is being brave, bold, and having the courage to follow your heart. I value honesty most of all and cherish the trust so many give to me.

I see every detail on every face, the shadows and the light, and this is my gift. I can operate, inject, or laser to redirect shadows, remove extra skin, or smooth skin texture—but the real magic is seeing the light of happiness shine from inside when someone looks like they did five or ten years ago. This is the feeling I wake up for.

I wrote this because I strongly resent the secrecy that seems to surround plastic surgery, or anything for that matter. I am determined to create transparency so that the honesty and openness essential to this field can shine. No smoke. Only mirrors here.

Chapter 1

The Bathroom Truth

There are so many ways to define beauty. I don’t believe it is in the eye of the beholder, but in the hearts and memories of each of us. It is what gives us joy.

For me, beauty is more about restoring than transforming. Restoring a historical stairwell or a sagging neck doesn’t change the appreciation of the beauty intrinsically waiting to shine. Whether it is an interior designer (like my momma) who finds the perfect carpet to truly crown a stairwell, or a surgeon restoring youth, form, or function, they each inspire an appreciation that is beautiful.

But here is the bathroom truth: while a woman would likely help another woman figure out how to get a new couch, she may tell her a facelift is not okay. The missing part in this is the woman behind the face—whose heart breaks when she sees her mother in the mirror. She doesn’t look how she feels.

I don’t necessarily expect anyone to understand how a stairwell and a facelift relate, except perhaps those who feel this way. There’s an unparalleled joy in life when your reflection resonates with your heart and empowers you to live every second of your life sensationally. To do that, you must address what is holding you back. It’s about easing the reminders of past hardships visible on your face, aiming not for perfection but peace.

Guilt has no place in our lives.

Perhaps moving to a new city and putting a shoe on a billboard with my mantra—“Insist on the Fairytale”—was showing up in a big way. It was met with much unanticipated dismay. I honestly never thought it could be perceived as it was. I was so excited to share my thoughts as a divorced, single-mother facial plastic surgeon.

For me, it was hard, beyond hard, to re-write the fairytale. But I had to, or live with the fact that I would never have one. The “fairytale” became living confidently and loving how you look. It became about my life and my passion for re-uniting women with their youth— instead of an undeserving prince and a shoe (even if it is a great shoe).

There is a time when your confidence becomes unshakable. You know what you are doing is right for you. This is when you stop standing there waiting to be squashed by someone else’s last-season Pradas.

Make your life a fairytale. Insist on it.

Chapter 2

The Angel in the Marble

Michelangelo, perhaps history’s greatest sculptor, understood this concept to his bones. Two of his more famous quotes speak directly to it: “Every block of stone has a statue inside it and it is the task of the sculptor to discover it,” and “I saw the angel in the marble and carved until I set him free.”

I just learned that Michelangelo made his own paints. Why is that life-shattering for me? I really can’t explain it. I guess it’s because I can understand what it’s like to feel like nothing —when you’re trying to express yourself, and there’s nothing that will allow you to do it, so you rethink what it is that you’re using.

I am a very artistic person. I look at someone and I see what I see. What I do well is look at people, look at faces specifically. I’m not that interested in the rest of the body. I just don’t think it’s as pretty, there aren’t as many angles, it does nothing for me. In medical school, I dissected everyone’s heads; in exchange, they had to dissect the other body parts on mine. I love the face. I like the angles. I like the embryology and the way the face comes together. And I love looking at a face and restoring it to what highlights what’s beautiful. In the way we learn in medicine, we learn ratios, and we learn numbers. We learn “here’s the golden ratio, this is what you want.” Well, that means people that we all think are absolutely beautiful wouldn’t be considered beautiful by that math. It’s based on the distance between one eye and the other. It’s really not true, and it’s definitely not how I work.

I look at someone and I want to see what strikes me. I see the good first. I look and I think, “her eyes are beautiful,” or “I love the dimple on her cheek.” From that, I’m inspired. I will try to work everything around that beautiful thing. I’ve never done measurements. It sucks the fun out, it takes away the beauty. It’s really easy for people to miss what’s beautiful when they start marking and drawing, because then all you see are the lines.

I don’t think a ruler is the best way to get the most aesthetic, softest, most flattering face. Rulers are a great way to get the right furniture. What you want a face to do is highlight the most beautiful feature. You want what’s pretty to shine. You don’t want everything around it to be perfect; you just don’t want it to distract from what is so pretty.

Fluffing lips is one of my favorite things to do. The angles and shapes are always different, creating shadows that light up with the right shape. The perfect lip is always a custom cocktail—a dash of botox, a splash of laser, one maybe two shots of filler.

Overfilled lips are like a Dixie cup of expired boxed wine. The beauty, the art, the light is destroyed. Faces should look enhanced, not embarrassing. Skin should be placed, not pulled. You should look like you did, never like you never did. It’s a precise operation, not a plastic-looking one. It should give you energy, not anxiety.

When you lose volume in your face as you age, you just shrivel up. It’s like going from a grape to a raisin. A facelift can’t bring that back. You can grab fat, there are a lot of things you can do to make skin look youthful, but to actually grow collagen is the most magical thing you can possibly have to keep young, healthy skin.

Think of it this way: what you want as you age is to get rid of senescent cells. Those are cells that are dying. Think of it as an old, shriveled up person laying on the couch. They don’t get up. They don’t move. If they keep laying there, they’re going to get pressure sores and go straight downhill. That’s what senescent cells do in your face. They just sit there. If you can get rid of those cells and make new ones, they take over. You look younger, you feel younger, you’re happier, your skin looks hydrated.

You don’t want to look like a completely different person. You just want to wake up the cells that went to sleep on the couch. You want to carve away the marble until the angel is free again.

Chapter 3

When the Phone Falls in Your Lap

We all have that thing that drives us crazy. When it really gets to you, it stops you. Resistance is powerful even without having something physical that creates yet another barrier.

The neck seems to be the Mount Everest of aging. It reminds women of their mothers, grandmothers, and makes everyone feel old. The connection between how you look and how you feel simply cannot be overstated.

One of my beautiful patients shared how she felt before her mini-facelift. She said: “I was looking in the mirror at home, which I’ve done numerous times, and I felt that I’d gotten to the point that my face did not match my heart. The way I felt on the inside. I felt it got to a point that my spirit just felt a little depressed, a little downhearted. I would find myself feeling very young and happy, and then pass a mirror and my face had begun to sag. And my neck had begun to look a little heavy. Another thing is when my phone falls in my lap and the camera is turned on. I know that’s not happened to anybody but me. And the camera’s turned on backwards, and my neck is filling up the camera.”

We have all had enough of that. Stop hiding and waiting to live your best life. Stop feeling guilty that you would be doing something for yourself, and honor that feeling you deserve to have when you look in the mirror. It is okay to not want to see your mother in the mirror. She probably felt the same way about her neck. Not fixing her neck was my grandmother’s only regret in life.

She wanted to wear the neck she remembered. To look like the woman she was just a few years before. To not be asked if she was tired one more time. She wanted a lift—from the outside in.

When I see a facelift patient like this one, my soul shines. It is completely dust-free. The feeling is unmatched by any in the universe. Being a facial plastic surgeon is more than my career—it is my life. Shaping the shadows, looking for the light, and being able to alter it in subtle ways to reflect not only a younger version of someone, but their heart and how they feel inside is my Disney, my happy place.

This precious lady literally glows now, from the inside out. She looks how she feels inside. When a facelift is done well, no one knows—unless you tell them.

Nobody ages well. Nobody. You can put all the olive oil on your face that you want, but nobody ages well. We all lose collagen. We all lose elastin. We all lose the things that make our skin look like a grape instead of a raisin.

I hear people say all the time, “I’m just going to age gracefully.” And I think, “Okay, good luck with that.” Because what they usually mean is that they’re going to accept feeling bad about how they look because they think it’s vanity to care. It’s not vanity. It’s your life. You have to live in that face every single day. If your phone falls in your lap and you don’t recognize the person looking back at you, you don’t have to just accept it. You have options. I consider myself your partner, not your boss. It’s my job to help you see the options. Because you may think doing one thing is easy and going to be great, but there’s a chance maybe it won’t be, or it’ll take longer than you have, or you don’t want so-and-so to know. There are so many levels to this. I’m not going to desert you. I’ll be there.

If there’s something that bothers you and you fix it or even make it a little better, it’s a big deal. It makes you feel better. It makes you act better. It makes you nicer. And honestly, we could all use a little more of that.

Chapter 4

Make the Starfish Dance

I was born with music inside me. Music was one of my parts. Like my ribs, my kidneys, my liver, my heart. Like my blood. It was a force already within me when I arrived on the scene. It was a necessity for me, like food or water. Ray Charles used to listen to Ray Charles and sing “Hit The Road Jack” loud! My sister would get my momma to take it away, but I would always win that one by paging my dad: “Come home quick, your wife won’t let me listen to Ray Charles.”

Being a child that never quite fit in, I was always looking for a place to fit and to offer something to the world. As a child, I was restless, anxious, insecure, and constantly searching for purpose. My dad used to say, “Wherever you go, there you are,” but I knew better.

Fast forward through the trials and tribulations of high school, I went to Florida State because I loved palm trees and theater. After my mother’s research showed that Florida State had more palm trees than the University of Florida, the decision was made. My majors included Theater, English, History, Political Science, Psychology, and Biology.

Who was I? What did I want to do, and why did the pursuit of something that I didn’t yet know consume me? I was beyond obsessed with finding that “thing” that I just couldn’t figure out.

I decided to go to medical school because the rules in our family were to stay in school or get a job, and I didn’t want a job because I didn’t know what I wanted to do. I took the pre- requisites and the MCAT. Told my family I applied. My dad said, “What will you do if you get in?” I didn’t know. But I knew to go.

My hesitation in sharing this is that I seem ridiculous, but my willingness to share it is because I know there are people out there looking, searching, and waiting for clarity. Don’t expect your life decisions to come in a perfect timeline. Just make them and pay attention, because the moments will guide you.

I learned a lot about what I didn’t want to do along the way. I remember being in high school and refusing to dissect a frog. I would still refuse. I still think it’s wrong, the way I just do. I really did nothing in high school other than protest that frog. I was on the drill team and the dance team, and we had to wear these really stupid-looking costumes where your leg was cut up to there. I thought it was humiliating.

I had what my sister would call “thunder thighs,” and every time I put something on, my thighs stuck out. Somebody came up to me while I was in that drill team outfit and said, “Oh, look at her thighs.” I was like, okay, I quit now. This was fun, glad I was a part for a day, but I’m done. It hurt my feelings terribly. It made me self-conscious. It didn’t matter if nobody else noticed; that kid realized it, and I did.

So I decided I wanted to have something done about it. My dad sent me to one of his friends, who tried to scare me and told me all the things that could happen. I had to wait until I was in residency. I didn’t have any money, and I didn’t want to tell my dad because I knew he thought starting residency was more important than ridding myself of thunder thighs.

I finally went and had liposuction done. And it was pretty uneven. Uneven enough that people in aerobics class would say, “Hey, you might have a lipoma.” It was not subtly uneven. So I went back to the doctor who did it and said, “You know, it’s pretty uneven.” He patted me on the ass and said, “Well, I think you look great. You look better than most people.”

And I realized at that moment that when you go back to someone and you think they understand, and they just say “whatever,” it really sucks. Because then you really feel screwed. You feel embarrassed, and you don’t know who to trust. It’s an emotional intimacy for someone to operate on you. You feel like they should care about the result. I just have great parents, I guess, and I grew up thinking people were different. That was a shocker. But some people are like that. And I decided right then: I would never let that happen to anyone else. I want people to be happy with what I do. I want them to feel good about themselves. It actually really, really matters to me on a deep cellular level. I couldn’t handle it if it didn’t. I wouldn’t do what I do if it didn’t matter. I can’t imagine it being just a job.

As for choosing facial plastic surgery, that was easy. On an in-service test, I made 8% in otology and 98% in facial plastic surgery. It was literally my only option. I honestly couldn’t believe it was a job. That decision was the easiest of my life.

It was worth it. Four years of medical school, five years of head and neck surgery residency. The smell of Mountain Dew and dip with Hot Pockets in the microwave. The worst smells ever (except Funyuns). I would do it all again.

I have a line from Olivia Rodrigo that resonates with me: “I pay attention to the things most people ignore.” My obsessive focus on detail can destroy a day and make project deadlines a nightmare, but when it comes to facial plastic surgery, everything clicks. All the quirks and nuances that make me impossible on some levels—okay, more than some—also make me really good at what I do. And when that trait makes someone else really happy, everything makes sense.

As a facial plastic surgeon, attention to detail is my superpower, just like my hypersensitivity to odd aftertastes. I can be completely immersed in re-designing a room or a face while surrounded by people having dinner. It’s where I get lost, where I most deeply love. I am drawn to beautiful scenes, and that is where I relax. Or anxiously try to re-create it and figure out what isn’t right to bring the beauty back.

I literally live the career I find myself in.

Chapter 5

Frosted, Not Frozen

Do you remember your first experience with makeup? It is like magic. Begging your momma to let you wear that lipstick—the color that looks like candy. Do you remember? I know you do. We all do. The thrill is so real. And it never goes away. A trip to Sephora always leaves us excited to try on the newest color. For me, it was Mauve Glaze from Clinique. It gave me a feeling that every woman should always have.

Then one day you wake up, look in the mirror, and try to figure out what happened while you were sleeping. You go to the mirror and look away. The thrill is gone. Your lipstick runs, your lip flattens with age, and you feel like part of you—part of your womanhood—is gone. The truth is that makeup is magic. It’s like the fairy dust of our youth. When it “cakes,” we don’t just look messy in pictures—we feel messy from the inside out. Your skin truly is an outward reflection of your inside.

This is why I treat my forehead lines to make them “frosted,” not frozen, so that the makeup doesn’t cake in the lines. I want the movement, but not the mess.

I have a really small forehead and my brows are lower than I prefer, so I use Botox, Newtox, or Dysport to weaken the eye muscle that pulls my lateral brow down when I smile. That lifts my lateral brow, and really my life. Judge me if you want—it’s okay. But it does. Almost everyone looks better with a bit of lift on the lateral brow. The medial brow (next to your nose) is another story entirely. This is where brow lifts let us down. They are macro movements, and brows are in need of micro movements. Just a touch.

Micro manipulation of the muscles of the face can turn a smile upside down (weakening the muscle pulling the corner of the mouth down so the one that pulls up can do so unopposed), lift the brow, smooth the chin, tighten the neck, and even narrow the nose. Never underestimate the power of tiny tox. I love tiny things. I like tiny instruments, I like tiny changes. The little things can make all the difference in the world.

The same goes for your skin. The only way after 20 that you can keep up with your collagen and keep elastin being made is to continue to cause microtrauma to your skin so that it has to heal. You have to stimulate the cells. You can’t kill somebody, use them to make your skin better, and then criticize where they live—which is exactly how I feel about taking fish oil for collagen. I guess I just don’t trust people enough to take it. You never know what kind of fish it is. I feel like it might be a minnow.

The true way of stimulation is through controlled damage or bio-stimulatory products. When you see someone with really bad filler, you realize why so many people are afraid of it. They miss wearing masks because they feel like they looked better with one. It doesn’t have to be that way. It shouldn’t be that way. You should never look ridiculous. You should just look like the version of yourself that remembers how Mauve Glaze made you feel.

Chapter 6

The Healing Power of the Familiar

There is nothing as powerful as the familiar.

There is a confidence that comes when you feel beautiful, and there is a power that comes when you can do that in a sweatshirt. Feeling beautiful is sometimes looking in the mirror and putting on lip gloss; other times it is writing, working, or connecting with yourself. My very best childhood memories revolve around our animals. I had every animal except a bird or a ferret—that was a line my dad would not cross. Today I have Gabe, who gets me up to walk every morning, who with a wag of that tail can light me up from the inside out. Having these bonds with a pet reduces stress, improves moods, and gives unconditional support and love in abundance.

I was in the fourth grade and our class was going to see the movie Charlotte’s Web. During the movie, I was thinking how fun it was that we got to see this animated movie. But there came a point where I realized they were going to kill the pig, and my stomach dropped. I couldn’t take it. I mean, they were so attached to that pig and I didn’t understand why they would want to do that.

So I got up, walked out of the theater to the nearest pay phone, and used the quarter my dad gave me to call him. Mind you, this was back in the day when my dad, a surgeon, had a voice pager. “Dad, come get me quick—they are going to kill the pig!” He left the hospital and came to get me in his bloody scrubs because I knew he’d understand. I love pigs and people that get me. To really listen and understand someone is the greatest of all gifts you can give.

Perhaps my love of animals and nature relates to my work because their beauty is something that cannot be improved. A cat has absolute emotional honesty. Human beings, for one reason or another, may hide their feelings, but a cat does not. I love that animal aging doesn’t happen in their faces. I love that their eyes won’t ever look angry, mad, or sad unless they mean it.

That is really what we all want. To look how we feel.

The summer solstice is a week before my “sunshine”—the anniversary of my granddaddy’s death. There was no one more full of sunshine. I nicknamed him this at a very young age, and somehow it lasted. He truly was sunshine. The life lessons he taught me shine light on the darkest of days.

I made tapes of him for years, never knowing which would be my last. Asking him question after question, wanting to make sure I never forgot a single detail. Listening to them now, I see how he humored me—just another example of the purest, most beautiful ways to show love. He threw crabs back when everyone wanted to eat them, because he loved me. I was four, but I still remember it. Is there a greater love than that? He could have easily eaten those crabs, but my ridiculous heart mattered more than anything else.

That’s the kind of love that shapes your life. The kind of love that teaches you how to love. I see that same love in my mother. I inject her face. I use Sculptra on her. She hates needles, and she complains, but she lets me do it. During one session, she looked at me and said, “Thank you, Melanie, for caring about me.” I told her, “Mom, you don’t have to say that. No one believes that.” But the truth is, I wouldn’t put anything in my practice that I wouldn’t do on my mother, my sister, my dad, or myself.

If you want to know what I really believe in, look at what I do to the people I love.

Conclusion

Stop Apologizing

My momma used to tell us stories at night. My favorite was the story of the Ginkgo tree. I wanted to hear it literally every single night.

“There once was a little girl named Melanie,” she would start the same way every time. In the story, I would go sit under a Ginkgo tree with colored leaves—all the colors of the rainbow, and a few very special golden leaves. The leaves were shaped like hearts, and when they fell on your head, if they landed just right, your greatest wish would come true. It had to be a golden one to make a wish.

I always made the same wish. I decided to ask her about it. All the pieces of my life could be traced back to that story, waiting for a leaf to make a wish. “Why, Momma?” She answered me without hesitation. “Melanie, I was waiting for you to realize the wish was for yourself. That everything you need is inside of you.”

Ginkgo trees are magnificent, like fairytale trees with glitter leaves and the resilience to withstand 200 million years. We all have everything we need inside. Others can decorate our lives, but our roots come from within. Only then can we bear beautiful leaves. We all must be who we are. No resisting, no apologizing. Those things are dark clouds covering your sky. As Marianne Williamson said, “...as we let our own light shine, we unconsciously give other people permission to do the same.”

I used to think anyone doing anything weird was weird. Now I know that it is the people that call others weird that are weird. Being one of the weird ones, I really appreciate that. My social media sharing so many years ago created quite an upset. I kept on, and now it’s not so weird anymore.

I value honesty and openness. I want a life with the freedom to travel and create. I want my life to be beautiful—fresh flowers, horses, a farm—and I want it to feel free, with land and wide open spaces.

Never settle. Live your life. Let nothing hold you back. The internal-external connection is real—when you look good, you feel even better. People who truly feel who you are are like wind to your sailboat—they make you go. Go for your dreams, your passions, and your life. Embrace yourself. Whatever that means to you. Injections to look happy, surgery to look less tired, a new book, or an exercise class—live your life!

Strive to be more like my dogs and my dad.

Insist on the fairytale.