Final Touch: Cosmetic Work for the Dead

The recent boom in cosmetic procedures has raised the bar for many of us when it comes to appearance. And, it turns out, the dead are no exception.

As the population has becoming increasingly sophisticated about procedures to enhance their appearance, so have their requests, morticians say, for smoothing lines, plumping lips and even boosting sagging parts for that last big special occasion — their funeral.

“People used to say, just throw me in a pine box and bury me in the back yard,” says Mark Duffey, president and CEO of Everest Funeral, a national funeral planning and concierge service. “But that’s all changing. Now people want to be remembered. A funeral is their last major event and they want to look good for it. I’ve even had people say, ‘I want you to get rid of my wrinkles and make me look younger’.”

Morticians have always performed a bit of cosmetic magic when it comes to recapturing the lifelike appearance of a person who’s passed on. What's happening now, however, is some people are making advance arrangements for these final touches and in ways they never used to even think about.

“I’ve had people mention that they want their breasts to look perky when they’re dead,” says David Temrowski, funeral director of Temrowski & Sons Funeral Home in Warren, Mich. “Or they’ll say, ‘Can you get these wrinkles out?’ It’s all in humor, but I think people do think [more] about what they’re going to look like when they’re dead and lying in a casket.”

Typically, the mortician's craft, termed restorative art, involves everything from setting a peaceful facial expression (which has to be done before the embalming fluid enters the body’s circulatory system and “sets” the tissue) to erasing the ravages of age, disease, or trauma (using tissue filler, wax, stitches, or even Super Glue in the case of broken bones) to recreating the deceased’s individual style with regard to hair, nails and makeup.

Considering the similarities between their restorative techniques and today’s trendy cosmetic procedures, you might even call them the plastic surgeons of the dead.

“My brother’s a plastic surgeon and I joke with him all the time that funeral directors were doing Botox long before any doctor thought of using it,” says John Vigliante, owner and manager of the Branch Funeral Home in Smithtown, N.Y. “Or at least we use a material that’s similar. We‘ll inject tissue fillers into the lips, the nose, the cheeks, above the eyebrows, the chin, and the hands. It’s the same concept as Botox and dermal filler.”

While advanced cosmetic work is needed for those who’ve suffered traumatic deaths such as in a car accident, even “everyday” deaths require a fair amount of restoration in order to bring the person back to a recognizable state.

Lips are plumped, cheeks are filled and contoured, and hollowed hands are injected with filler to give them what Vigliante calls “a nice fuller appearance.”

Cosmetic concerns
These recent cosmetic concerns come as no surprise to Dr. Anthony Youn, a Michigan-based plastic surgeon who’s practiced in Beverly Hills, Calif., and appeared on the television show "Dr. 90210."

“Society is unfortunately getting more and more vain as time goes on,” says Youn. “Fifty years ago, no one would have thought about how good they’re going to look when they die, but now that’s probably something the ‘Real Housewives of Orange County’ talk about. If they die, they want to look good in their casket. It’ll be one last time to show off their new outfit and their plumped lips.”

Some are so concerned over their final appearance, they’re foregoing a funeral altogether.

“We do a lot of the movie stars and they usually don’t want anyone to see them dead because they can’t control their appearance,” says Noelle Potvin, a family service counselor at Hollywood Forever, a 109-year-old funeral home and cemetery in Hollywood, Calif. “They just want a private ceremony.”

According to funeral planner Mark Duffey, in today’s looks-obsessed climate it’s basically all or nothing at all.

“Right now, we have a population that’s grown up with plastic surgery and Botox and they’re leaning towards either looking really good at their service or not having their body there at all,” he says.

Oddly enough, some of those who’ve had work done in life may undergo one last procedure after death.

“I require that the mortuary remove any kind of silicone implant before the body is delivered here for cremation,” says Aida Bobadilla, manager of the Los Angeles Odd Fellows Cemetery and Crematorium. “Whether it’s in the breast or the calf or the bicep or the cheek or wherever. Silicone implants will explode. They’re like little bombs.”

According to Mike Nicodemus, spokesperson for the Cremation Association of North America, there are no national regulations that call for the removal of such implants and he’s not experienced problems with silicone during cremation. But others say enhancements are a bit of an issue now and will become more of one in the future.

“Our crematorium wants to know if the deceased has them,” says Vigliante. “And then we have to get permission from the family to have them removed. As boomers age, we’re going to be seeing more and more of this.”

Final touches
More commonly, families are consulted with regard to a loved ones’ overall appearance. They’re asked for pictures (which morticians use as a guide) and recommendations for facial hair, makeup, nail color (if any) and hair. Some families provide the funeral home with makeup and personal stylists.

“I have a lot of families who bring in a hairdresser or barber or makeup person to make sure the decedent looks good,” says Pam Vetter, a funeral celebrant (a funeral planner who creates personalized services) from Los Angeles. “If grandma went to get her hair done every Friday, they want to make sure her hair looks right.”

Occasionally, people will ask funeral homes to make other adjustments, especially if a long battle with illness has left their loved one looking emaciated or bloated due to medication.

“Some people will request that I ‘put a little more weight back on mom,’” says Margaret McKenna, funeral director for Nichols Funeral Home in Wilmington, Mass. “That’s an easy request.”

These final preparations are not for everyone, of course.

Embalming is avoided in Jewish and Muslim tradition, with interment taking place as soon as possible after death. Other people forego open casket funerals for personal reasons, preferring to remember their friends and relatives as they knew them in life.

But viewings — either public or private — are still very much a tradition in the U.S. In a 2008 survey of 385 consumers conducted by American Funeral Directors magazine, nearly 70 percent of respondents said their most recent funeral experience included the viewing of a body.

While sometimes traumatic, experts say these final goodbyes can be healing.

“Viewing the body helps move people along in the grieving process,” says Donald W. Steele, a Middleboro, Mass., psychologist who’s offered grief counseling for the last 30 years. “Seeing the deceased helps break through all the shock and disbelief and denial. It’s a vivid, visual acknowledgment that that person is no longer living.”

For those who’ve watched their loved one suffer through a debilitating illness, seeing them looking peaceful — sans hospital tubes, disorientation and pain — can also be comforting.

“My grandmother was extremely ill the last year of her life with ovarian cancer and a horrible case of shingles on her face,” says Annette Stanhope, a 36-year-old communications coordinator from Portland, Ore. “It was pretty rough. But at the funeral, she looked very relaxed. She looked like herself again.”

A badly botched embalming, on the other hand, can have the opposite effect.

“I went to my aunt’s funeral in 1988 and they did a horrible job,” says Georgia Migliuri, a 51-year-old advertising executive from Seattle. “She had liver cancer and you’d think that all that pain would have been erased from her face, but it wasn’t. She still looked like she was in agony.”

‘She looks better dead than alive’
Expectations – especially in an age of cosmetic miracles – can sometimes be tricky, though.

“Seventy percent of the time, people will bring in old photos or say, ‘I want my mom to look like she did in 1951,’” says Steve Murillo of Hollywood Forever. “That’s not possible. I’m a mortician, not a magician. But I always tell them, I’ll do my best.”

Just as in life, in death appearance is everything.

“One of the most important things in our business is how the body looks,” says Vigliante, the New Jersey funeral home owner. “Many people don’t realize the transformation that takes place. Their loved one will go from being unrecognizable to looking at peace, looking like themselves. It’s gratifying for us when the family walks in the room and says, ‘Thank you. That’s my mom’. We take a lot of pride in helping a person look good.”

As our appearance-conscious culture becomes more attuned to looking good — even to the grave — these skills may become as highly sought after as those of a Park Avenue plastic surgeon.

“If my family has an open casket, I want to be fixed up to the max,” says Migliuri, who says she’s still haunted by her aunt’s appearance. “I want to look good. I want them to fill in my wrinkles; I want people to say, ‘God, she looks great. She looks better dead than alive.’”

Diane Mapes is a Seattle freelance writer and author of "How to Date in a Post-Dating World."