When 71-year-old Nancy Frederick looks in the mirror, she no longer sees the face nature dealt her.
"Sometimes at a department store, I would catch a glance of me in a mirror and say, 'Who is that old woman who looks like me,'" Frederick says.
Frederick thought about getting a face lift for years. It was photographs from her 70th birthday party which sealed the deal.
"You get all dressed up. You look at yourself in the mirror and you think, I look like a bassett hound going to a party or something," Frederick says. "I think it was looking at the pictures that really pushed me over the line and made me decide to do it."
More than a million people a year in the United States are deciding to have some form of cosmetic surgery. That number has more than doubled since 1992.
Liposuction is still the No. 1 cosmetic surgery. Breast enlargement is next, followed by eyelid surgery and face lifts. The subject is still taboo to some.
"I'm very open about it. It's amazing, though, how many people are really shocked," Frederick says. "It's as if you told them some terrible secret."
Plastic surgeon Glenn Davis performed Frederick's surgery. He says more people in the Raleigh area are deciding to go under the knife.
"We haven't gotten to the point in southern California where it becomes a badge of honor, but people are more accepting now in the Raleigh area," he says. "You should feel comfortable with the surgeon that he's upfront with you, that he's telling you the risk as well as the benefits. He's not trying to talk you into or sell you a procedure."
However, Davis stresses that he is not a miracle worker.
"We're not going to make you look like someone else," he says. "We're going to make you look like you are, just a bit younger, more refreshed, more relaxed."
Frederick says she had realistic expectations about what type of surgery that she wanted done.
"That's important. I didn't want to look like anyone but myself," Frederick says.
Davis also tries to prepare patients for recovery.
"There is pain, there is suffering. We try to minimize that, obviously, and prepare the patient for that," he says. "It's a little bit like childbirth when you're going through it, you think this is really the most horrible thing, but time has a way of diminishing your memory of the pain."
Along with pain, there is some risk and a hefty price tag, which can run anywhere from about $2,500 to $12,000.
"This is not something to be taken on lightly, either financially or from a risk standpoint," Davis says.
Frederick says the surgery was something that she could not put a price tag on.
"To me, there is a great difference, and it was worth every single penny and every single pain that I went through," she says. "If it can be done safely and affordably, that's a nice thing to do to allow patients to feel better about themselves."
About five times as many women as men get cosmetic surgery, but the number of men having cosmetic surgery is steadily increasing.
Most cosmetic surgery patients are between the ages of 35 and 50 years old. California leads the U.S. in the number of people choosing cosmetic surgery. What did you think about this story?Send us feedback.