I already feel bad about my neck ... sorry about my whole face, too, I guess.

I don't know who this is, but I wonder if she initially saw a plastic surgeon because she was concerned about her neck.

So I have this problem with my neck. To be specific, I have a problem with the way my neck looks.

What I didn't realize, though, is that I should be having a problem with my face, which is apparently kind of a mess; my neck is just a part of that mess. Oh, and my body could use some work, too.

I'm being flippant, but the opinions above were expressed during my first-ever visit with a plastic surgeon. To be fair, he was a nice guy who of course didn't say I'm a mess, and his job is to upsell, so he was steering me in a direction that was best for his business.

But, wow, what a sad and puzzling appointment. I guess I shouldn't be puzzled, but I have a certain naivete that frequently lends itself to such confusion.

Let me backtrack. When I visited my family doctor a couple of weeks ago, I remarked that while I'm pleased with my weight loss, the folds of extra skin on my neck have been bothering me. I have extra skin in other places as well, but strength training is helping somewhat; plus, most of those areas are covered by my clothing.

Plus, I'm not 20 and I don't wear a bikini, and if my husband isn't grossed out by me and I'm not grossed out by me, I figure we're good.

But the neck ... my neck is out there for all to see, and the skin is really loose and folded, and it makes me uncomfortable. My doctor commented that because I had had so many surgeries on my neck years ago during my thyroid-cancer odyssey and subsequent infection, the elasticity of the skin on my neck could have been impacted, leading to exaggerated problems with the area after weight loss.

"Let's have you see a plastic surgeon," she said. "Insurance just might pick up the cost of tightening that up, since you had trauma to the area."

Well, that sounded like an OK plan to me, and off I headed a few days later to meet the surgeon. I stressed, both to his nurse and to him, that I was concerned only about my neck; we went through my history, and then he poked and prodded the area, asking questions and listening to my thyroid story.

He admired my thyroid scar, asked who had done the work, and then noted that I'm missing the platysmal bands (those ropy-looking things you see when you stretch your neck) on one side.

"Your surgeon must have cut them," he said off-handedly, and I surprised myself then by tearing up, instantly flashing back to that period of my life some 15 years ago. My cancer was almost a side note to the staph infection that almost killed me, and my personal life around that time did a pretty thorough job of killing me inside. I wanted to hug the young woman I feel so disconnected from now, the one who lived with a drain in her neck for a year and a half and felt like a walking Halloween costume, the young woman who not only was physically ill, but felt unloved and vulnerable and made some heinous relationship mistakes because of those feelings.

And going back in time to that dark place probably was responsible for the way I began to feel as the plastic surgeon continued his critique. "You're pretty jowly," he said, pulling up the skin on either side of my mouth. "And your chin isn't well-defined; for some people, we do offer a chin implant. So when we're lifting the neck, we'll just want to go in there and make it a face lift. That will smooth out the lines you see here" -- again, prodding and pointing -- "and will give you more definition overall, and a more youthful appearance."

(A youthful appearance? Did I say I wanted that? I recall saying I just don't want my neck to look like the neck of a Shar Pei. A reasonable request, one would think.)

"I'm OK with looking my age," I told him. But he kept talking and pulling, and as he pulled, I began to see the faces of Meg Ryan and Joan Jett and every Real Housewife in my own visage; the flattening of the features. The stretching of the cheek plains. The shininess and perpetual look of surprise. The removal of any connection to my own face, my own past, my own imperfections.

I was looking at a Lisa Lavia Ryan mask in a funhouse mirror. And it almost made me want to throw up.

The doctor began talking price then, saying I'd be sent an estimate, chatting about potential complications ("Infection is rare," he said, and I almost smirked; really, buddy? Did we not just talk about my being a walking staph magnet?) and reassuring me that he doesn't "make people not look like themselves." I was gracious and polite, but I left there knowing that my sad, scrawny, wrinkly, deformed neck and I wouldn't be visiting there again.

And all the way home, I felt ... grateful. But I also felt really sad.

First, the gratitude: I felt thankful for the period in my life 15 years ago that brought me to where I am now, thankful for the resilience and the support and the faith that enabled me to see my own beauty and worth, as cheesy as that sounds. I felt thankful for the way I was raised, which allows me to feel valued for my intellect and curiosity, with any perceived physical shortcomings dramatically downplayed.

And I felt so very grateful to be secure enough in myself that when I flipped down the visor and looked in the mirror, I still liked my face, my 50-year-old face, jowls and undefined chin and all.

But then, the sadness: What about the other women, the ones who were where I was 15 years ago? The ones whose self-esteem has been trounced, the ones who see their worth only in unlined skin and perfect breasts and thighs that don't touch? I'm not saying that plastic surgeons prey on vulnerable women; especially when it comes to reconstruction, plastic surgeons perform a valuable service, and I respect the fact that they have businesses to build and maintain.

And to be fair: I went to his office because I was unhappy with an aspect of my appearance. I can't blame him for assuming I'd want him to fix all my physical flaws in one fell swoop.

I realized what was happening and didn't go for it. But what happens to women when they're essentially told they're not good enough, and they believe the people who are telling them that? For many people, white coats carry more than their share of weight. How many wide, flat, unlined faces are sculpted, and how many women, unhappy with those results, wish they could take back the imperfections that brought them to those doctors in the first place?

And me, with my neck issue ... am I really as evolved as I think I am? Or am I one snip away from allowing the kind of "work" that will render me indistinguishable from Marie Osmond or, for that matter, William Shatner?

I like to think not, and I like to think I'll just live with my neck. But if I can find another approach that's not so all-or-nothing, maybe I'll go with it. After all, I should be able to fix this small thing, this thing that could have been caused, at least in part, by the prior surgical trauma. I mean, come on: My neck itches all the time. The skin is crepe-y and weird, not like the rest of my skin. I don't like it.

But the real takeaway from this experience, for me anyway, is the full-on realization that a multi-zillion-dollar industry has been created from the ashes of our collective vulnerabilities, and that's indicative of so many issues.

And it's not even about my silly neck, this larger issue. In my ongoing naivete, I'm saddened that we can enter a doctor's office feeling fairly attractive, and leave feeling downright ugly. Because no matter how you slice it -- pun intended -- that's just not OK.