HEALING, INSIDE & OUT

BYLINE: LAUREN GOLD, Palm Beach Post Staff Writer
DATE: September 4, 2004
PUBLICATION: Palm Beach Post, The (FL)
EDITION: FINAL
SECTION: ACCENT
PAGE: 1D

If the MTV cameras had entered Sara Moore's life, they would have started their filming at the small, pretty Northwood house where she lives with her boyfriend, Michael.

The producers would have met the couple's two big, goofy, affectionate dogs. They would have gotten a glimpse of the brand-new white Harley - just Sara's size - right next to Michael's big blue one.

They would have followed Sara to her new job, which she loves.
And they would have seen the Bible, opened to Leviticus, under the glass top of the couple's coffee table.

Sara and Michael are not very religious, but they stumbled on a quote that gave them both pause. Sara would have pointed it out:

Do not cut your bodies for the dead or put tattoos on yourselves, I am the Lord.
Last month, Sara - a 26-year-old chef and a recovering drug and alcohol addict - had laser surgery to remove a tattoo on her arm and scars on her face.

MTV producers called local plastic surgeon Fredric Barr while scouting for subjects for a makeover show called I Want a Famous Face. They considered featuring Sara's story, but Barr worried that the show's premise - using plastic surgery to make people look more like their movie-star idols - would send the wrong message.

The purpose of plastic surgery, he said, is to make people happier with their own faces . . . not to make them look like anyone else.

And Sara just wanted to look like herself - as she was before the years of heroin and cocaine abuse left her face and arms scarred.

MTV out of the picture, Sara went ahead with the procedures.

It was time to repair the damage she'd done.

Remember to breathe

Sara's T-shirt, on the day of the surgery, says I love nerds.

At her side is Michael - tall, bald and burly, the remnants of a giant Viking tattoo on his arm covered by a neat yellow button-up shirt.

Sara settles on the table and closes her eyes. In a series of quick, almost casual jabs, Dr. Barr injects her face with a numbing agent. Sara flinches, just barely. Michael quietly reminds her to breathe.

Barr waits for the anesthetic to take effect, then pokes at Sara's face to make sure it's numb. He tests the laser by aiming it at a tongue depressor. It makes a loud snap-snap-snap noise as it shoots straight through, leaving a string of holes and a curl of smoke.

Then, with a helper standing by with a suction machine, he holds the laser over Sara's face.
The smell of burning flesh - despite the suction machine - is unmistakable. The snap-snap-snap is loud and raw. Sara stays quiet and still as Barr moves the laser back and forth, like a child with a crayon, coloring in the square-inch area from under-eye to palate, edge of the nose to just below the temple.

The procedure takes about 20 minutes for both sides. Then Barr cuts two incisions in Sara's upper lip for a minor procedure there as well. He tugs and pushes at a Gor-Tex implant until it threads all the way through, then snips off the ends and closes the incisions. He asks if she wants her first tattoo treatment now, and when she nods yes, he injects her arm with anesthetic.

Sara rests for a few minutes, her face oozing and bloody. When Barr returns, she sits quietly as he traces the tattoo's swirls with a second laser.

When it's over - shaky, weak, and utterly depleted - she lets Michael drive her home.
From the beginning

Sara's drug use started - it seemed - innocently enough.

She'd always been a happy, involved kid. But at 13, she started experimenting at parties. Before she realized what was happening, she was using cocaine every day.

Something, back then, made her uncomfortable with herself. She wanted to crawl out of her skin. And the drugs made her forget that. "I kind of crossed that line," she says. "I just wanted to get out of me."

Her coaches kicked her off the basketball team, then the track team. Before long, the things that had been holding her accountable were gone.

She started dressing differently and accumulating tattoos. She left her parents' Ohio home at 17 to follow The Grateful Dead. "It was still pretty fun then," she says. By 20, though, she found herself in Arizona - desperate and homeless. "It just spiralled out of control. It wasn't fun anymore."

She couldn't function without drugs; particularly heroin and cocaine. Meanwhile the drugs - coupled with her dirty living conditions - were causing her face to break out, and she developed a compulsive habit of picking at her acne. "It was a ritual, along with getting high."

She checked into a series of rehabs - and followed with a series of relapses. Her parents (Mom lives in Michigan, Dad in Boca) tried to help. Once, after a long period of no contact, her mother said she'd called mortuaries all over Arizona looking for her tall, thin, tattooed daughter.
Two years ago, Sara checked into a Boca rehab - spent and hollow. Her family scraped together enough money to pay for the treatment, but Sara knew this was the last round.

So she stuck it out. After 30 days, she moved into a halfway house and got a job at Applebee's.
"For the first three months out of treatment I thought, I'm free to do what I want today - but I won't."

Instead, she thought about how empty she used to feel. She learned to meditate and pray. She formed bonds with people who understood.

By the six-month mark, she was settling into her new life. For the first time, she could look back and see how far she'd come.

From Applebee's she moved on to a chef job at Hanley-Hazelden, a drug and alcohol treatment facility in West Palm Beach. She met Michael Counes (Hanley-Hazelden's information technology manager) - and this year, she moved into his house. "We just have this awesome relationship," she says. "He's the love of my life. He's totally supportive. If I'm happy, he's happy."

Michael, meanwhile, was having laser treatments to remove a tattoo on his right arm. He sparked Sara's interest.

Specifically, she considered the tattoo on the inside of her left forearm - a wide, swirly blue dragon, head doubled back figure-eight style, devouring its own tail.

Her other tattoos (she has eight) are fish, stars, Winnie the Pooh and Chinese symbols. They're colorful and pretty; each discreetly placed and easily covered up by sleeves and high necklines.
The dragon, though, is dark and menacing, placed low on her arm and nearly impossible to hide. When she chose it three years ago, it was a metaphor for her life: self-destruction, embodied.
With Michael's help, she could afford to have it removed. And besides, it no longer fit.

Michael took her to Dr. Barr, who described the tattoo removal process: four to six treatments, spaced about six weeks apart. He also mentioned a laser procedure that could smooth out the scars on her face.

Michael offered to pay for it all. But Sara had to think about the other cost. Painkillers and sedatives were out of the question; they can trigger relapses in recovering addicts. All Sara would get was the numbing agent.

She decided she could live through it. The opportunity was too good to pass up.

The ups and downs Laser surgery can't actually remove scars. Nothing can.

Instead, the laser surgery Barr recommended works by burning away the first few layers of skin, exposing the fresh, evened-out layers below.

The treatment's side effects are generally happy ones: it leaves skin lighter (good for dark pouches under the eyes) and tighter. As with any surgery, though, it comes with risks (infection, reactions to anaesthetic and others.)

Under any circumstances, the procedure is unpleasant. With just a local anesthetic to numb the site, it is awful.

Sara also considered a Gor-Tex implant in her upper lip. It wasn't part of her original getting her body back to how it was before drugs premise, so she hesitated. "I don't want people to think I'm not happy with the way I am."

But she'd always thought her upper lip was disproportionately small - and this could help make it more like her lower lip. The recovery time could be the impetus she needed to quit smoking. Plus . . . well, "It's kind of fun . . . so, why not?" she said. "I know this is not the beginning of a whole long line of plastic surgery for me."

Facing the world A week after the surgery, Sara donned her work clothes - khakis, polo shirt, black apron with white towel looped over the ties, and black-and-khaki baseball cap - and stepped behind the serving line at Hanley-Hazelden.

Her face was still raw and pink, as if a sander had been over it. The oozing had stopped, though, and the vitamin cream Dr. Barr recommended wasn't as greasy and obvious as the ointment she'd used the first few days.

Within a few hours of being back, worries about the kitchen's heat had dissipated. "It's mostly getting used to being on my feet," she said.

But the first-day-back attention - reactions ranging from concern to appreciation - was somehow harder to take in. "I always thought that I was the only one who noticed (the facial scars). Now that it's clearing up, I can see it's not just me."

(No one, she added, noticed the lip implant - and she's glad it looks natural.)

As for the bigger changes - the symbolic fresh start, never going back kind of changes - well, that's about much more than a few scars.

Her fresh start began 23 months ago, when she stepped out of rehab.

"My recovery's the same. That's an inside job," she says. "This is not going to change who I am, or the things I do on a daily basis."

Still, something is different. The scars are barely visible, and the tattoo is on its way out. Her face is still tender, but when she looks in the mirror she sees a little less of the way her life was - "the flashes of what I used to do" - and a little more of what her life can be.

She hasn't smoked since the surgery. This month, she starts classes at Palm Beach Community College - the first step toward a career as a drug and alcohol rehab counselor. Down the road, when she talks to clients about change and recovery, she'll draw on her own experiences.
"There is a way out," she says. "We all make choices in life. Sometimes we make the wrong ones, but that doesn't mean it's forever."

By then, the self-consuming dragon tattooed on her arm will be long gone. So as she speaks, she won't worry about its symbolism contradicting her words.

Reminders of the past Painful as it was, the laser surgery has been the easiest part of her evolution. The inside job is ongoing.

How confident is she that she'll stay clean? "I'm not," she says. "That's the thing. I just have today."
But small as that sounds, it's the most important thing.

"I'm headed somewhere. That was a lot more than I had. That's more than anything that I had before. I don't take anything for granted. My whole perspective has changed."

During her most recent follow-up visit, Barr mentioned the possibility of another session under the laser to smooth out a few remaining scars near the bottom of her face.

She smiles. "I said, 'mmm, no. No. That's not my intention. I think I'll leave it.' "

This, too, is a change. "Me with my addictive behavior, when I like something, I want more," she says. "That's how I got so many tattoos."

When her face and arm heal . . . well, she can't guarantee she won't have an urge for another round. But she doesn't think that will happen. Partly because of the pain and expense; but more importantly, because each successive surgery will mean a piece of her history - of the experiences that have shaped her - harder to remember.

As her pink skin heals, she's reminded of the bad times less - and that's a good thing. But she doesn't want to forget those times completely.

"Sometimes the scars are OK; it reminds us that the past happened," she says. "It reminds me that I was there once.

"I don't take anything for granted. - and that's really a gift. I can sit in my skin today."
lauren_gold@pbpost.com

1. (C) THE NEW SARA: Sara Moore heads out to a dinner date while recovering from laser resurfacing surgery to her face, as well as tattoo removal surgery.
2. (C) TOUGHING IT OUT: Sara Moore works the griddle at the Hanley-Hazelden Center. Recovering from plastic surgery, she has a rough time in the hot kitchen.
3. (C) THE PROCEDURE: Moore undergoes laser surgery in the office of Dr. Fredric Barr to remove a swirly blue dragon tattoo from her arm.
4. (B&W) BILL INGRAM/Staff Photographer
Dr. Fredric Barr (right) and laser technician Rafael Tavares perform the resurfacing surgery on Sara Moore's scarred face, the result of drug abuse.
5. (B&W) BILL INGRAM/Staff Photographer
Despite the pain of the procedure, Moore found the opportunity too good to pass up.

Copyright (c) 2004 Palm Beach Newspapers, Inc