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Madonna's publicist isn't talking about what her clients like the Material Girl and Cher are doing to their faces ("I have never represented anyone who has spoken to me about plastic surgery. Nor have I asked them. I don’t want to know!"), but that doesn't mean the doctors, the "dermatologists" and other illustrious characters in the pageant of A-list cosmetic surgery aren't offering up a ghastly state of the union regarding their trade in this week's New York Magazine. Which naturally includes Madonna, the issue's cover girl and unauthorized representative of the New New Face — as opposed to the "Old" New Faces belonging to the mishandled likes of Melanie Griffith and Meg Ryan. What's the difference? It's a little complicated, but let's start with "volumizing" — the part where you jam your own fat into your face:

[Pat] Wexler, who opened her practice 22 years ago, gets credit as a New New Face pioneer because she intuited that volumizing was the future: injecting and filling the face with either fat from the patient’s own body, collagen, or synthetic fillers, instead of stretching the skin tight over all that sagging infrastructure. “That’s what I call the Beetlejuice phenomenon,” she says when we meet. “You keep pulling and pulling, and your head gets smaller, and your body gets bigger as you age, and so you wind up with this little head on this big body. But we now know that you need volume to keep a face looking young. Volume means a face that goes out. And it’s all about the cheeks and the jawline.” When I tell her that making the face bigger or “fatter” seems counterintuitive, she says, “I know, that’s why no one was doing it twenty years ago. ... I was doing lipo and I don’t like to throw anything away.”

Another doctor uses the examples of Ryan ("Meg may think she looks beautiful") and Demi Moore ("What I see with Demi is more of an operation") to relate the old and the new, though the accompanying photographic evidence of Angelina Jolie's nose filing has us nervously wondering its eventual impact on her handsome, helpless young twins. Whatever — just as long as they don't inherit Grandpa Jon's "New New Teeth," everything else is resolvable.