Mr. Boy

Mr. Boy

James Patrick Kelly

I was not only one in my family with twanked genes. My mom was a three-quarters scale replica of the Statue of Liberty. Originally, she wanted to be full-sized. But then she would have been the tallest thing in New Canaan, Connecticut. The town turned her down when she applied for a zoning variance. Her lawyers and their lawyers sued and countersued for almost two years. Mom’s claim was that since she was born human, her Freedom of form was protected by the Thirtieth Amendment. However, the form she wanted was a curtain of reshaped cells which would hang on a forty-two meter high ferroplastic skeleton. Her structure, said the planning board, was clearly subject to building codes and zoning laws. Eventually they reached the out-of-court settlement, which was why Mom was only as tall as an eleven story building.

She complained with a town’s request for a setback of five hundred meters from route 123. As Stennie’s Alpha drove us down the long driveway, Comrade broadcast the recognition code which told the robot sentries that we were okay. One thing Mom and the town agreed from the start: no tourists. Sure she loved publicity but she was also very fragile. In some places her skin was only a centimeter thin. Chunks of ice falling from her crown could punch holes in her.

Mr. Boy. Photo by Elena

The end of our driveway cut straight across the lawn to Mom’s granite-paved foundation pad. To the west of the plaza, directly behind her was a utility building faced in ashlar that housed her support systems. Mom had been bioengineered to be pretty much self-sufficient. She was green not only to match the real Statue of Liberty, but also because she was photosynthetic. All she needed was a yearly truckload of fertilizer, water from the well and a hundred and fifty kilowatts of electricity a day. Except for emergency surgery, the only time she required maintenance was the fall, when her outer cells tended to flake off and had to be swept up and carted away.

Stennie’s Alpha dropped us off by the doorbone in the right heel and then drove off to do whatever cars do when nobody is using them. Mom’s greeter was waiting in the reception area inside the foot.

“Peter”, she tried to hug me, but I dodged out of her grasp. “How are you, Peter?”

“Tired”. Even though Mom knew I did not like be called that, I kissed the air near her cheek. Peter Cage was her name for me, I had given it up years ago.

“You, poor boy, here, let me see you”. She held me at arm’s length, and brushed her fingers against my cheek. “You don’t look a day over twelve. Oh, they do such good work – don’t you think?” She squeezed my shoulder. “Are you happy with it?”

(Excerpt from The Year’s Best Science Fiction, eighth annual collection, edited by Gardner Dozois, 2008)

The Caress

The Caress

Greg Egan

So I called an on-line Britannica, and said “Lindhquistism”.

Andreas Lindhquist, 1961-2030, was a Swiss performance artist, with the distinct financial advantage of being heir to a massive pharmaceutical empire. Up until 2011, he engaged in a wide variety of activities of a bioartistic nature, progressing from generation sounds and images by computer processing of physiological signals (ECG, EEG, skin conductivity, hormonal levels continuously monitored by immunoelectric probes), to subjecting himself to surgery in a sterile, transparent cocoon in the middle of a packed auditorium, once to have them swapped back (he publicized a more ambitious version, in which he claimed every organ in his torso would be removed and reinserted facing backwards, but was unable to find a team of surgeons who considered this anatomically plausible).

In 2011, he developed a new obsession. He projected slides of classical paintings in which the figures had been blacked out, and had models in appropriate costumes and make-up strike poses in front of the screen, filling in the gaps.

Why? In his own words (or perhaps a translation): The great artists are afforded glimpses into a separate, transcendental, timeless world. Does that world exist? Can we travel to it? No! We must force it into being around us! We must take these fragmentary glimpses and make them solid and tangible, make them live and breathe and walk amongst us, we must import art into reality, and by doing so transform our world into the world of the artists’ vision.

The Caress. Photo by Elena

I wondered what ARIA would have made of that.

Over the next ten years, he moved away from projected slides. He began hiring move set designers and landscape architects to recreate in three dimensions the backgrounds of the paintings he chose. He discarded the use of make-up to alter the appearance of the models, and, when he found it impossible to find perfect lookalikes, he employed only those who, for sufficient payment, were willing to undergo cosmetic surgery.

His interest in biology hadn’t entirely vanished; in 2021, on his sixtieth birthday, he had two tubes implanted in his skull, allowing him to constantly monitor, and alter, the precise neurochemical content of his brain ventricular fluid. After this, his requirements became even more stringent. The “cheating” techniques of movie sets were forbidden – a house, or a church, or a lake, or a mountain, glimpsed in the corner of the painting being “realized”. Had to be there, full scale and complete in every detail. Houses, churches and small lakes were created; mountains he had to seek out – though he did transplant or destroy thousands of hectares of vegetation to alter their color and texture. His models were required to spend months before and after the “realization”, scrupulously “living their roles”, following complex rules and scenarios that Lindhquist devised, based on his interpretation of the painting’s “characters”. This aspect grew increasingly important to him:

The precise realization of the appearance – the surface, I call it, however three-dimensional – is only the most rudimentary beginning. It is the network of relationships between the subjects, and between the subjects and their setting, that constitutes the challenge for the generation that follows me.

At first, it struck me as astonishing that I’d never even heard of this maniac, his sheer extravagance must have earned him a certain notoriety. But there are millions of eccentrics in the world, and thousands of extremely wealthy ones – and I was only five when Lindhquist died of a heart attack in 2030, leaving his fortune to a nine-year-old son.

(Excerpt from The Year’s Best Science Fiction, eighth annual collection, edited by Gardner Dozois, 2008)

Teeth Brighteners

A Dim Report about Teeth Brighteners

Using your brush with teeth brighteners, you may be getting more than just a flashy smile.

When you brush with teeth brighteners, you may be getting more than just a flashy smile. Teeth brightener sales topped $52 million in 1993, up 25 percent over 1992. But the American Dental Association has raised serious concerns about the safety of teeth brighteners. Prompted by the ADA, the U.S. Food and Drug Administration is now investigating whether the over-the counter products should be regulated as cosmetics or drugs. None of the products currently on the market are accepted by the ADA.

Although dentists have used hydrogen peroxide as bleaching agents for years, the ADA worries that commercially available at-home kits involve hours of unsupervised exposure to hydrogen peroxide and that users may leave the product on their teeth longer than directed, thinking their teeth will be made even whiter the longer the product is applied. The brighteners often contain acids that can damage enamel, they say, and overuse can also cause tooth sensitivity, gum irritation, and throat and stomach problems. In some cases, oxygenating agents can damage mouth tissues, delay healing, harm the interior of teeth, cause cell changes, and enhance the effects of other cancerogenics, they claim.

Bright teeth. Photo by Elena

One study published in the Journal of Periodontology found that hamsters given hydrogen peroxide orally developed precancerous growths. When hydrogen peroxide was combined with cancer-causing products, such as cigarettes, the likelihood of cancer increased greatly.

FDA safely regulations are more stringent for drugs than for cosmetics. According to the FDA, a drug is intended to affect the structure and function of the body while a cosmetic is defined as anything “introduced into or otherwise applied to the human body for promoting attractiveness or altering appearances.”

At prices that can be twice as high as regular toothpaste, teeth brighteners carry a healthy profit margin. The FDA will have to determine if they are also as safe.

Straight Talk About Braces

Straight Talk About Braces

An early trip to the orthodontist can spare you a fearsome dental bill

Dr. Tom Graber has been in the forefront of orthodontic research since he began practicing in 1945. He authored several textbooks on the subject and has edited The American Journal of Orthodontics and Dentofacial Orthopedics since 1985. Though he’s never worn braces himself, three of his children have.

What does an orthodontist do?

Just as an orthopedic surgeon guides the growth of an abnormally forming leg or arm, an orthodontist guides the growth of the jaw and face, particularly for children with underdeveloped jaws or when the upper and lower jaw don’t fit together.

What are the tip-offs that preventative measures like an appliance might be needed?

The most obvious problems are the inherited ones, such as when a child inherits a small jaw from one parent and large teeth from another, leading to jaw disorders. Also, the upper jaw can be deformed by finger sucking or, more likely, compensatory tongue-swallowing habits. This happens when kids continue natural back and forth tongue-thrusting when they stop nursing, which pushes the front teeth out. Kids whose front teeth stick out tend to get their lower lip under them every time they swallow, which pushes the teeth even further out. Mouth-breathing or enlarged adenoids and tonsils can also cause compensatory problems.

Starbucks. Photo by Elena

What can be done to prevent such problems?

Children should be seen by a qualified orthodontist by the time they are six. A pediatric dentist may not have the training to recognize the early developmental problems that can be solved with simple interceptive orthodontics, and recognizing these problems can save a lot of trouble down the road. By the time your girl hits 11 or 12 or your boy hits 13 or 14, all you can really do is shove teeth around. Better to start with simple appliance procedures than to go in there later with an expensive long-term procedure.

A simple appliance, for instance, can be used to expand a narrow jaw or to prevent the deleterious effects of bad habits. You probably will want to use a simple fixed appliance which is cemented to the child’s upper teeth. A removable appliance relies too much on patient cooperation, which is hard to come by with very young children.

What about braces? What are some of the reasons one would get them?

Mostly for cosmetic reasons, but braces also help to correct abnormal jaw growth and function. The cause of real dental health problems is not necessarily crooked teeth but the way the teeth fit together, so you use braces to get a handle on the jaw. When the jaws are not in the right relationship, it places abnormal stress on the jaw joint, and that may cause pain and improper functions.

Are there any new technologies that can make wearing braces a less traumatic experience for a self-conscious young person?

Lingual braces, which are hidden behind the teeth, are fine for purely cosmetic reasons, but they are much harder to adjust and make eating and talking difficult. And they aren’t as effective because you can’t get the same kind of control over them.

The alternative is ceramic braces. The brackets are made out of the same sort of material as coffee cups and are nearly invisible against the teeth. Ceramic brackets are bonded to the tooth instead of being glued around it like the old metal bands were. They make very cosmetically acceptable brackets for the wires, which have also come a long way. The new thin nickel titanium wires are light and they need less adjustment. They work so well that you don’t need them as long.

In some specialized cases, small magnets can be used to speed up and simplify treatment, for example with growth guidance appliances and the eruption of teeth embedded in the jaw, but this is very unusual.

How can a parent know if a price quoted by an orthodontist is reasonable?

Early interceptive work with appliances may run you hundreds of dollars, but if it’s a difficult case that requires braces and a lot of treatment, it may be thousands and thousands of dollars. Of course, prices vary geographically, but in most cases, braces will run from around $2,000 up for involved programs.

In a lot of cases you have to rely on the integrity of your orthodontist. Make sure he is board certified, which only about 30 percent of orthodontists are. You can also call one of the dental schools in your town to get an idea of what the going rate for a specific procedure is. And, of course, you should always get a second opinion.

When does is make sense for adults to undergo an orthodontic procedure?

About 25% of the orthodontic work done today is on adults, mostly for cosmetic reasons. There is also a relationship between some gum problems and jaw problems that braces can help. You put up to 350 pounds of pressure on your jaw when you chew, and that can really affect your gums. A lot of adults tend to grind or clench their teeth at night, which, if your bite is wrong, can lead to a popped disc in the jaw joint. Orthodontists can make a splint that will help relieve that pressure.

Tinkering with Mother Nature

Tinkering with Mother Nature

Facial implants and chemical peels have joined tummy tucks and nose jobs in the panoply of cosmetic procedures that appearance-conscious Americans are resorting to in increasing numbers. The American Society of Plastic and Reconstructive Surgeons provides this guide to today’s most-elected interventions with nature.

Breast enlargement: Augmentation Mammoplasty. Enhances the size and shape of breasts using artificial implants.

Procedure: Lasts 1 to 2 hours. Local anesthesia with sedation, or general. Usually outpatient.

Side effects: Temporary pain. Swelling, soreness, numbness of abdominal skin, bruising, tiredness for several weeks or months.

Recovery: Back to work in 2 to 4 weeks. More strenuous activity after 4 to 6 weeks or more. Fading and flattening of scars: 3 months to 2 years.

Risks: Blood clots. Infection. Bleeding under the skin flap. Poor healing resulting in conspicuous scarring or skin loss. Need for a second operation.

Duration: Permanent.

Breast Lift: Mastopexy. Raises and reshapes sagging breasts by removing excess skin and repositioning remaining tissue and nipples.

Procedure: Lasts 1 1/2 to 3 1/2 hours. Local anesthesia with sedation, or general. Usually outpatient. Sometimes inpatient. 1 to 2 days.

Elvis and Priscilla. Photo by Elena

Side effects: Temporary bruising, swelling, discomfort, numbness, dry breast skin. Permanent scars.

Recovery: Feeling better, back to work in a week.

Risks: Thick, wide scars; skin loss; infection. Unevenly positioned nipples. Permanent loss of feeling in nipples and breast.

Duration: Variable; Gravity, pregnancy, aging, and weight changes may cause new sagging. May last longer when combined with implants.

Chemical Peel: Phenol, trichloracetic acid (TCA). Restore wrinkled, blemished, unevenly pigmented or sun-damaged facial skin, using a chemical solution to peel away skin’s top layers. Works best on fair, thin skin with superficial wrinkles.

Procedure: Takes 1 to 2 hours for full face. No anesthesia – sedation and EKG monitoring may be used. Usually outpatient. Full-face phenol peel may require admission for 1 to 2 days.

Side effects: Both: Temporary throbbing, tingling, swelling redness; acute sensitivity to sun. Phenol: Permanent lightening of treated skin; permanent loss of ability to tan.

Recovery: Phenols: Formation of new skin in 7 to 21 days. Normal activities in 2 to 4 weeks. Full healing and fading of redness in 3 to 6 months: New skin within 5 to 10 days.

Risks: Both: Tiny whiteheads (temporary); infection; scarring; flare-up of skin allergies, fever blisters, cold sores. Phenol: Abnormal color changes (permanent); heart irregularities (rare).

Duration: Phenol is permanent, although new wrinkles may form as skin ages. TCA is variable (temporary).

Collagen/Fat injections: Plump up creased, furrowed, or sunken facial skin; add fullness to lips and backs of hands. Works best on thin, dry, light-colored skin.

Procedure: Lasts 15 minutes to 1 hour per session. Collagen: usually no anesthesia; local may be included with the injection. Fat requires local anesthesia. Outpatient.

Side effects: Temporary stinging, throbbing, or burning sensation. Faint redness, swelling excess fullness.

Risks: Collagen: allergic reactions including rash, hives, swelling, or flu-like symptoms; possible triggering of connective-tissue or autoimmune diseases. Both: contour irregularities; infection.

Duration: Variable, from a few months to as long as a year.

Dermabrasion: Mechanical scraping of the top layers of skin using a high-speed rotary wheel. Softens sharp edges of surface irregularities, including acne and other scars and fine wrinkles, especially around mouth.

Procedure: Lasts a few minutes to 1 1/2 hours. May require more sessions. Anesthesia: Local, numbing spray, or general. Usually outpatient.

Side effects: Temporary tingling, burning, itching, swelling, redness. Lightening of treated skin, acute sensitivity to sun; loss of ability to tan.

Recovery: Back to work in 2 weeks. More strenuous activities in 4 to 6 weeks. Fading of redness in about 3 months. Return of pigmentation/sun exposure in 6 to 12 months.

Risks: Abnormal color changes (permanent). Tiny whiteheads (temporary). Infection. Scarring. Flare-up of skin allergies, fever blisters, cold sores.

Duration: Permanent, but new wrinkles may form as skin ages.

Eyelid Surgery: Blepharoplasty. Corrects drooping upper eyelids and puffy bags below the eyes by removing excess fat, skin, and muscle. (May be covered by insurance if used to improve vision).

Procedure: Lasts 1 to 3 hours. Usually, local anesthesia with sedation, occasionally general. Usually outpatient.

Side effects: Temporary discomfort, tightness of lids, swelling, bruising. Temporary dryness, burning, itching of eyes. Excessive tearing, sensitivity to light for first few weeks.

Risks: Temporary blurred or double vision; blindness (extremely rare). Infection. Swelling at corners of eyelids; tiny whiteheads. Slight asymmetry in healing or scarring. Difficulty in closing eyes completely (rarely permanent). Pulling down of the lower lids may require further surgery).

Recovery: Reading in 2 or 3 days Back to work in 7 to 10 days. Contact lenses in 2 weeks or more. Strenuous activities, alcohol in about 3 weeks. Bruising and swelling gone in several weeks.

Duration: Several years to permanent.

Facelift: Rhytidectomy: Improve sagging facial skin, jowls, and loose neck skin by removing excess, tightening muscles, redraping skin. Most often done on men and women over 40.

Procedure: Lasts several hours. Anesthesia: Local with sedation, or general. Usually outpatient. Some patients may require short inpatient stay.

Side effects: Temporary bruising, swelling, numbness, and tenderness of skin; tight feeling, dry skin. For men, permanent need to shave behind ears, where beard-growing skin is repositioned.

Recovery: Back to work in 10 to 14 days. More strenuous activity in 2 weeks or more. Bruising gone in 2 to 3 weeks. Must limit exposure to sun for several months.

Risks: Injury to the nerves that control facial muscles, loss of feeling (usually temporary but may be permanent). Infection. Poor healing, excessive scarring. Change in hairline.

Duration: Usually about 5 to 10 years.

Facial implants: Change the basic shape and balance of the face using carefully styled implants to build up a receding chin, add prominence to cheekbones, or reshape the jawline. Implants may be natural or artificial.

Procedure: Lasts 30 minutes to 2 hours. Anesthesia: Local with sedation, or general. Usually outpatient.

Occasionally requires overnight stay.

Side effects: Temporary discomfort, swelling, bruising, numbness and/or stiffness. In jaw surgery, inability to open mouth fully for several weeks.

Recovery: Back to work in about a week. Normal appearance in 2 to 4 weeks. Activity that could jar or bump face after 6 weeks or more.

Risks: Shifting or imprecise positioning of implant, or infection around it, requiring a second operation or removal. Excess tightening and hardening of scar tissue around an artificial implant (“capsular contracture”), causing an unnatural shape.

Duration: Permanent.

Forehead lift: Browlift. Minimize forehead creases, drooping eyebrows, hooding over eyes, furrowed forehead, and frown lines by removing excess tissue and redraping skin. Most often done on people over 40.

Procedure: Length: 1 to 2 hours. Anesthesia: Local with sedation, or general. Usually outpatient.

Side effects: Temporary swelling, numbness, headaches, bruising. Possible itching and hair loss for several months. Change of hairline.

Recovery: Back to work in 7 to 10 days. More strenuous activity after several weeks. Bruising gone after 2 to 3 weeks. Limited exposure to sun for everal months.

Risks: Injury to facial nerve, causing loss of motion, muscle weakness, or asymmetrical look. Infection. Broad or excessive scarring.

Duration: Usually about 5 to 10 years.

Hair replacement surgery: Fill in balding areas with the patient’s own hair using a variety of techniques including scalp reduction, tissue expansion, strip grafts, scalp flaps, or clusters of punch grafts (plugs, miniplugs, and microplugs). Works best on men with male pattern baldness after hair loss has stopped.

Procedure: Lasts 1 to 3 hours. Some techniques may require multiple procedures over 18 months or more. Anesthesia: Usually local with sedation. Flaps and tissue expansion may be done with general anesthesia. Usually outpatient.

Side effects: Temporary aching, tight scalp. An unnatural look in early stages.

Recovery: Back to work: usually in 2 to 5 days. More strenuous activities after 10 days to 3 weeks. Final look: may be 18 months or more, depending on procedure.

Risks: Unnatural look. Infection. Excessive scarring. Failure to “take.” Loss of scalp tissue and/or transplanted hair.

Duration: Permanent.

Liposuction: Suction-assisted lipectomy. Improve body shape using tube and vacuum device to remove unwanted fat deposits that don’t respond to dieting and exercise. Locations include chin, cheeks, neck, upper arms, above breasts, abdomen, buttocks, hips, thighs, knees, calves, ankles.

Procedure: Lasts 1 to 2 hours or more, depending on extent of surgery. Anesthesia: Local, epidural, or general. Usually outpatient. Extensive procedures may require short inpatient stay.

Side effects: Temporary bruising, swelling, numbness, burning sensation.

Recovery: Back to work in 3 to 7 days. More strenuous activity after 2 to 3 weeks. Swelling and bruising subsides in 3 to 6 months.

Risks: Infection. Excessive fluid loss leading to shock. Fluid accumulation. Injury to the skin. Rippling or bagginess of skin. Pigmentation changes (may become permanent if exposed to sun). Excessive scarring if tissue was cut away. Need for second procedure to remove additional tissue.

Duration: Permanent.

Nose surgery: Rhinoplasty. Reshape nose by reducing or increasing size, removing hump, changing shape of tip or bridge, narrowing span of nostrils, or changing angle between nose and upper lip. May relieve some breathing problems.

Procedure: Length: 1 to 2 hours or more. Anesthesia: Local with sedation, or general. Usually outpatient.

Side effects: Temporary swelling, bruising around eyes and nose, and headaches. Some bleeding and stuffiness.

Recovery: Back to work or school in 1 to 2 weeks. Avoid hitting nose or sunburn for 8 weeks. Fina appearance after a year or more.

Risks: Infection. Small burst blood vesselss resulting in tiny, permanent red spots. Incomplete improvement, requiring additional surgery.

Duration: Permanent.

Tummy tuck: Abdominoplasty. Flatten abdomen by removing excess fat and skin and tightening muscles of abdominal wall.

Procedure: Lasts 2 to 5 hours. Anesthesia: General or local with sedation. In- or outpatient, depending on individual circumstances.

Side effects: Temporary pain. Swelling, soreness, numbness of abdominal skin, bruising, tiredness for weeks or months.

Recovery: Back to work in 2 to 4 weeks. More strenuous activity after 4 to 6 weeks or more. Fading and flattening of scars in 3 months to 2 years.

Risks: Blood clots. Infection. Bleeding under the skin flap. Poor healing resulting in conspicuous scarring or skin loss. Need for a second operation.

Duration: Permanent.

In aesthetic procedures, eyelid surgery is most popular among women, but men prefer to have their noses altered.