Just a few years ago, most people were resigned to living with the inevitable signs of aging, and few imagined that much could be done to change the face-or body-they'd drawn in the genetic sweepstakes. But medical advances-and the media-have changed all that. From ABC's Extreme Makeover to FX network's Nip/Tuck, makeover fever has seized the country, with millions of viewers mesmerized by the drama of physical transformation. Plastic surgery, once the pricey little secret of the rich and famous, has moved into the mainstream; and cosmetic surgeons say they're treating schoolteachers and senior citizens as well as socialites and professionals, all willing to invest in their own possibilities and ready to share the news with friends and family.

We interviewed four local residents who have been seized by makeover fever, with results that went beyond improving their appearance to lifting their spirit.

Dixie Petronella is used to looking her best. a model when she was in her 20s, Petronella revived her modeling career shortly after she moved to Naples, when she was in her 50s. She even graced a cover of Gulfshore Life in 1999.

So when people began asking her if she'd had a good night's sleep, she knew it was time to act. "I feel very young for 64," says Petronella, "and I wanted to look as young as I felt." Ignoring pressure from friends to "grow old gracefully," Petronella sought treatment from plastic surgeon Richard Maloney of the Aesthetic Surgery Center of Naples. He performed an endoscopic forehead lift and an endoscopic midface lift, designed to give the face a more taut and youthful look.

Advances in endoscopics have changed plastic surgery by quantum leaps, says Maloney. The endoscope allows for small incisions to be made in the hairline, where tiny instruments are inserted, along with a camera, and moved throughout the face. The surgery is less invasive than earlier procedures, has a shorter recovery time and leaves smaller, less visible scars. In addition, the surgeon can often do a better job of addressing the patient's individual needs and desires. In addition to the endoscopic procedures, Maloney gave Petronella a new procedure called a lip lift.

"As women age, the upper lip gets longer and drops down," he says. "In Dixie's case, as for a lot of women, you couldn't see much of her teeth when she smiled." The technique pulls the upper lip back to its more youthful level, and the scars lie unseen inside the nostrils. Maloney also transplants muscle from the back of the patient's neck to the upper and lower lip. The result is fuller, smoother lips that look and feel natural. And-unlike many other cosmetic lip procedures-the results are permanent.

Petronella remembers looking in the mirror in the days after her surgery, and despite the initial swelling, realizing, "This is going to look really good." Today, she says her appearance is more in tune with the way she feels, and that's given her a boost in happiness and confidence.

pamela templeton is a pretty woman who rarely smiled with her teeth showing. When she'd laugh, she'd instinctively put her hand over her mouth. The reason? The Fort Myers woman was among a generation of children who had received tetracycline as an antibiotic. Once she lost her baby teeth, her permanent teeth came in a muddy gray color, with the telltale striations of tetracycline staining. She's been self-conscious about her smile ever since.

For years, Templeton's daughter, Shannon, encouraged her to get her teeth fixed, but Templeton had a fear of major dentistry. Finally, the day Shannon left to begin Naval Officer Indoctrination School in Newport, R. I., Templeton took action. "I decided if she had the guts to go do that, I could get my teeth done," she says.

Templeton contacted cosmetic dentist Steven Krouse, whose Sarasota-based practice treats patients throughout Southwest Florida. "In Pamela's case," says Krouse, "you had a young, otherwise attractive person, but with the color of teeth of an 80-year-old." Bleaching wouldn't have helped, because tetracycline color striations go all the way through the tooth.

Krouse decided that Templeton was a good candidate for porcelain veneers, which are fused onto existing teeth. First, Krouse's staff made an impression of Templeton's teeth. Then, he and she worked on "designing" her smile, choosing the shape and tint of the teeth he wanted. The impression then went to a lab where the veneers were made, and a couple of weeks later, they were bonded to her stained teeth to give her the gleaming, white smile she has today.

Krouse says anyone can be a candidate for the procedure; he's worked on men and women, teens and 90-somethings. He's done the procedure on three generations of one family and numerous couples. The procedure is painless, though a tiny percentage of patients feel some discomfort when wearing the temporary veneers until the permanent ones come in. Though "after" pictures show patients looking dramatically younger and healthier, Krouse says benefits go beyond the cosmetic. Getting a good set of properly fused veneers can improve the strength of the teeth, bite and comfort, not to mention one's confidence, says Krouse.

Templeton had her new smile in time for Shannon's graduation last July. "I've got a beautiful smile, I have dimples, but I never showed my teeth. Now it's teeth-o-rama!" she says, smiling widely. "Now I look back at all those pictures of me with little or no smile, and I just wonder why I waited 40 years to have this done."

Medical necessity first drove deb Wright to the office of Fort Myers ophthalmologist Patrick Flaherty. Wright suffered from ptosis, a drooping of the skin on the upper eyelids so severe it can impair vision. Once she could no longer wear her contact lenses because of the condition, she decided to act. Wright asked Flaherty what he could do to improve her eyes, and she also told him she felt she looked older and more tired than her 56 years. He recommended corrective upper-lid blepharoplasty (a surgical procedure to remove fat, and often excess muscle and skin, from the eyelid), lower-lid blepharoplasty, an endoscopic mini-brow lift and laser skin resurfacing under her eyes, to remove the dark circles she'd been plagued with for years.

Wright was a sort of poster child for the brow lift, Flaherty explains. "Deb had heavy, droopy brows that pushed the skin down over the eye," he says. When the outer brow droops, he says, a person can look sad. But when the inner brow-that closest to the nose-droops, a person may look angry. "Deb had a scowl on her face that did not match her personality," says Flaherty. "She said kids in her neighborhood were scared of her." The eyelid surgery alone wouldn't have corrected her scowl, he explains, because it was the brow that was forcing the skin down over the eye.

For Wright, the transformation has been amazing. "I look in the mirror now and think, 'My heavens! Who is that person who's been hiding under those baggy eyelids all these years?'" she says. It's definitely improved my self-esteem. My husband likes the results so much he's going to have it done."

For Fort Myers resident Kelli Wood, large breasts were a burden rather than a blessing. A DDD cup by the time she reached middle school, Wood felt self-conscious and was often embarrassed to leave the house. Her breasts took a toll on her physically, as well. Wood had difficulty standing up straight, constant back pain and deep strap marks in her shoulders. After she had a baby in 1994, her cup size went up to a staggering II-that's double I. "I had to hire a tailor to custom-make bras for me," says Wood, "and they'd wear out after two or three months." On top of the discomfort her breasts caused, Wood had a protruding belly, the result of extensive scar tissue on her stomach from previous surgeries. She exercised, but to little avail, especially because she'd get winded easily due to all the weight on her chest.

After trying for years to find an insurer who would cover a breast reduction, Wood took matters into her own hands. She paid to have Fort Myers plastic surgeon Mark Schneider perform a breast reduction and abdominoplasty (tummy tuck). Schneider describes Wood's surgery: "The average breast reduction removes between one to one-and-a-half pounds of tissue from each breast," he says. "Kelli had eight pounds removed from each." While performing the abdominoplasty, Schneider found a large hernia in Wood's intestine-part of the reason for that protruding belly-and repaired that as well.

Schneider says that for Wood, as for most women who have breast reductions, the difference is noticeable almost immediately. "Patients usually come in a day or two after surgery to have drains removed and dressings changed, and while they have some pain in their breasts, their back and shoulder pain is gone," he says.

For Wood, the transformation is almost beyond belief. Her back pain is gone. "If I had known how much this would improve my life, I'd have paid twice as much for the surgery," says Wood, who's dropped four dress sizes since the operation. "Now I can work out, I feel great, I go places, I do things and I'm not afraid to go out in public. I have a totally different life."

There's some risk in every surgical procedure. Before deciding upon cosmetic surgery, make sure your doctor is a member of the American Society of Plastic Surgeons (www.plasticsurgery.org) or the American Academy of Facial Plastic Surgery (www.facial-plastic-surgery.org) or the American Board of Plastic Surgery (www.abplsurg.org). Interview several different surgeons to get alternate opinions and options. Make sure you are compatible and comfortable with the doctor you choose. Check your physician's medical liability his-tory at the National Practitioner Databank (www.npdb-hipdb.com). Ask if your surgeon has hospital privileges. Not everyone who performs plastic surgery does. Finally, be realistic about expectations. After the bandages come off, and the swelling goes down, you're still going to be the same person.