A steady flow of middle-age baby boomers is seeking to preserve fading youth with cosmetic surgery. More and more middle-age men are quietly electing to go under the knife to save their looks. But even as thousands of faces are reshaped and bodies resculpted, painful tales of lost looks and twisted egos warn of the cost of vanity and the false promise of the fountain of youth.

What is going on? What are we really talking about?The American Society of Plastic and Reconstructive Surgeons reports a 75 percent increase in tummy tucks, laser treatments, eyelid lifts and the like over the past four years. The organization explains that "cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient's appearance and self-esteem" and is usually not covered by insurance.

By contrast, reconstructive surgery is performed to correct or improve abnormal or defective structures and is generally covered by insurance.

Twenty years ago, cosmetic surgery was largely reserved for aging film goddesses seeking to preserve their glamour for the silver screen, or for the wives of wealthy business tycoons. In the 1980s and 1990s growing numbers of middle-aged and middle-class consumers began turning to cosmetic surgeons as well, not to become beautiful but to preserve their youth. Eyelid surgery, laser skin resurfacing, liposuction and breast augmentation became the procedures of choice.

Today the modern consumer can walk into a cosmetic surgery center and choose from a menu of procedures and price tags. The costs vary depending on the particular surgeon, region and the level of follow-up care. Many centers charge in the area of $20,000 for a face lift or $4,000 for an eye lift, with patients usually paying out of their own pockets. The fancier facilities offer board-certified surgeons, overnight and in-patient care, and a guarantee of confidentiality - and even allow patients to check in under assumed names for fear of being found out.

The boom in cosmetic surgery has stirred a backlash as critics wonder whether the search for eternal youth will lead to a dry hole of vanity and self-loathing. Dinner party chatter often begins with gossip of the latest friends or relatives to get a facelift and then turns to horrible tales of disfiguring outcomes. Take the case of Jocelyn Wildenstein, the soon-to-be ex-wife of a wealthy art collector. Dubbed "The Bride of Wildenstein," she had so much cosmetic surgery that her beautiful face became a taught, disfigured, unblinking sphere.

Writing in the Internet magazine Salon, columnist Cintra Wilson noted a similarity between Wildenstein and two other cosmetic surgery celebrities - Michael Jackson and Courtney Love.

"Neither Courtney's nor Jocelyn's nor Michael's ugliness was skin deep - it was much deeper. None of them were actually 'ugly' before the surgeries, but now, by negating all the natural architecture of their faces, they have somehow exposed their scarily infested inner selves in a way that their real faces would never have betrayed. Nobody should ever think that they look that bad."

Words to consider before changing your looks.

R.J. Whittier is a free-lance writer in Washington, D.C.