And make me some strong black coffee." Manuel raised his electric wheelchair to its maximum height. He would now be able to work from above the sleeping man's head and move easily around to the left and right of the table.Using a black marker pen to draw the lines on Mr. Smith's face where he wished to cut, Manuel lifted both eyebrows up and took a section from the brow. He marked the upper and lower lids and made a line around both ears for an auricular incision. He then marked the lips to augment with silicone and put dotted marks between the eyes for Botox.As he worked, he drank two small cups of thick black coffee, with heaped spoonfuls of sugar. His patient remained oblivious, eyes closed and sleeping.Enrico prepared the prosthetic implants for the cheeks and chin, and when Manuel was ready, he administered the second general anesthetic. It was, by now, almost six o'clock and cooler outside, but as always IManuel maintained a very low temperature in the operating room. They both went through the same procedure of scrubbing up, and now that the anesthetic had kicked in, work began.The first incision was to the eyebrows. Manuel removed a slice, like a small section of orange, drawing the skin upward, and stretching out the lines in the forehead. This took a lot of pulling and stretching before he was satisfied. Then he cut a long line from behind the ear, continuing down to the chin. He drew up the scraggy skin of the neck, again removing a slice like another section of orange, so he could restitch and pull tightly back toward the lobes of the ears. He also implanted a small section of what looked and almost felt like a sponge. He inserted a piece into the lower chin, then used a thin flattening spatula to ease up two more sections to rest over each of the cheekbones, working with the finest suture scissors. He removed the mole from Mr. Smith's right cheek and gave two neat stitches, before he began work on his nose.Twice, Manuel became concerned as his patient's pulse shot up; his heart rate was worrying too and it was a while before he felt he could continue.