Plastic Surgery: Why Aftercare Facilities Are on the Decline — and Where to Go Now

Courtesy of Subject

Used to be that you could see Joan Rivers kibitz in full mummy mode or watch two people hook up with blood spurting from face-lift drains. Now, oddly, post-op facilities are on the wane.

A version of this story first appeared in the July 4 issue of The Hollywood Reporter magazine. - See more at:
A version of this story first appeared in the July 4 issue of The Hollywood Reporter magazine. - See more at:

A version of this story first appeared in the July 4 issue of The Hollywood Reporter magazine.

When talking about plastic surgery in Beverly Hills, the procedure is only half of the story. The recovery period, which is longer and more painful, also has its dedicated facilities. They sit perched on the edge of Beverly Hills, just outside city limits because — go figure — zoning in the city doesn't allow for overnight patient care (except in special, preapproved instances).

The aftercare industry — which was pioneered, naturally, in the shadow of unnatural Hollywood — began during the '70s before blossoming to the point where "almost every hotel I can think of in the Beverly Hills area had at some point that type of facility," says Dr. David Hopp, president of the Beverly Hills chapter of the Los Angeles County Medical Association. Since the heyday of the '90s and aughts, however, the business has contracted to the point of being virtually unnoticeable. The zoning laws always had been on the books but were not strictly observed until the industry began to grow. Since then, many businesses have burnished their reputation by using "Beverly Hills" in their name, even though they didn't fall in its ZIP code.

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Two very different aftercares have shaken out as leaders. Serenity in Santa Monica is the only hospital-certified aftercare in the region -- perhaps in the nation. Run by two brothers, it generally is filled to its capacity of two dozen patients. Called the "gold standard" by Dr. Lawrence M. Koplin, a prominent Beverly Hills surgeon, Serenity vets doctors before accepting patient referrals from them.

If Serenity resembles a hospital equipped with hotel-like suites, then Pearl Recovery Retreat, nestled on a sixth-floor wing of the SLS, is the flip side -- a high-end hotel with hospital-like amenities. There's chicken broth from chef Jose Andres, dim lighting and starworthy decor. Pearl counts on foreigners for nearly half of its business, thanks in part to regular trips to Moscow by the owners to recruit business.

The aftercares that used to occupy Le Montrose, the Century Plaza, the InterContinental and the Palomar all have closed. Competition grew fierce, regulation is strict, and the 24/7 nature of caring for delicate individuals has worn down the professionals in the business. So where do all the patients go? Some opt for smaller facilities, such as Majestic Recovery in Westwood and Beverly Hills Surgical Aftercare. More and more patients, though, are hiring nurses to spend a night or two in their own home, celebrity-style, away from prying eyes. Observing this trend, Michelle Farrell expanded her at-home nursing services by hiring fellow registered nurses to launch 90210 Aftercare in 2010. About 25 percent of the company's clients are in the entertainment business.

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What happens in aftercare? If all goes well, not a lot. A typical scenario: The patient is transported in a tinted-window luxury car, with a nurse attendant, to a private, unmarked entrance. He or she is led to an adjustable bed and offered something to eat. Meds are administered, if needed, and the patient is monitored.

Complications from standard plastic surgery procedures are not common but can be serious when they do occur. Hematomas, or pooling blood from a broken blood vessel, need to be drained quickly and are the type of problem spotted faster by an RN than a layperson. "Once I had a bleeder," recalls RN Maggie Lockridge of an aftercare patient. "She fainted twice, and it was hard to revive her, so I called 911. She had 4 quarts of blood in her belly. Had she gone home from surgery, she would have bled to death."

Lockridge probably has cared for more post-plastic surgery patients than any other aftercare RN. But she didn't pioneer the idea. That honor goes to Severyn Ashkenazy, onetime owner of the Beverly Hills hotel L'Ermitage. During the late '70s, he observed bandaged patients using the hotel's secondary underground entrance and holing up for up to a week. Seizing the opportunity, he bought an adjacent building in the '80s and dubbed it Le Petit Ermitage (not to be confused with the current West Hollywood hotel of the same name). There, he hired Lockridge, who decorated the two stories in European finery. "It was so plush!" recalls Dr. Hopp. "Gorgeous rooms, lots of nursing staff, beautiful linens. All my patients went there." As with most aftercares that followed it, Le Petit Hermitage maintained a 3-to-1 ratio of patients to nurses.

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Shenanigans at Le Petit Ermitage included Joan Rivers kibitzing in full mummy mode with invited friends; a female rock star, whom Lockridge says was a "known drug addict," throwing an ashtray at her; and an ex of a Malibu-based music mogul using said record producer's credit card, against his wishes, for a deluxe stay. A porn star cavorted with a young man on her suite's balcony, and another patient spouted blood from his face-lift drains while hooking up with a fellow invalid. Good times.

Le Petit Ermitage's only competition in the '80s and '90s was Hidden Garden, a nine-room facility barely a mile away. The latter suffered when James Brown's wife Adrienne died there in 1996 following liposuction (turns out it was heart disease and PCP use that did her in, according to the coroner). Hidden Garden moved to Westwood and later closed, following Le Petit Ermitage, which closed in 1993.

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Today, competition among aftercare facilities keeps nightly rates under $1,000. And even though that type of money can buy an in-home nurse, away from strangers' eyes or tourists marauding through your hotel wing, many see that as a less-than-ideal scenario. "More than 50 percent of our clients have young kids at home," says Nikki Simon, of the Beverly Hills Physicians chain of surgery centers. "You want to recuperate in a place where you can concentrate on yourself rather than worrying about your children."

Adds Dr. Koplin, "If you recover in a [hospital-style] bed and someone can be up with you 24 hours with ice on your eyes, you get better faster. And for a lot of people, that's worth it."