Not for women only

The latest and most exciting trend in plastic surgery is not a particular procedure or a new approach but a new demographic.

Men are beginning to embrace the concept of cosmetic surgery in numbers never previously seen; and the procedures they are interested in have started to change as well. Though women still dominate requests for plastic surgery in the United States, men had more than 1.1 million cosmetic procedures in 2010, including 203,000 surgical procedures and 918,000 minimally invasive procedures. According to the American Society of Plastic Surgeons (ASPS), men accounted for 9 percent of all procedures in 2010, up 2 percent from 2009. Men are clearly more interested in cosmetic surgery. So what are some of our motivations and what procedures are we most interested in?

In the 17 years I have been in practice in Westchester, more men come in with a desire to look younger and fitter. With the difficult economic picture we have experienced over the past years, looking less tired and younger is perceived as advantageous in the workplace. In our increasingly tech-savvy offices, the perception is that younger people have an edge, and more men are looking for a little help in this area.

Many men are more active and are living longer and healthier lives and want their outside appearance to match the inner sense of vigor that they have as well. In addition, society as a whole has become more open about cosmetic surgery than ever before. With the multitude of media attention on this subject, men have been thinking about enhancing their appearance more. A recent study out of UCLA (yes I know, not far from Tinseltown) found that 23 percent of men were interested in plastic surgery, and recently, more of them are acting on this interest.

Historically, the most common procedures in men were body-sculpting operations such as liposuction and excision of gynecomastia, with facial procedures such as eyelid surgery and hair transplantation also very popular.  Newer and less invasive approaches have helped increase the breadth and range of procedures men undergo; and this trend is growing. For example, for men with excess breast tissue, often the extra skin would need to be excised and this would lead to more visible scars after surgery. With the advancement of techniques such as tumescent liposuction and combined laser and liposuction techniques such as SmartLipo, we can achieve better results with less extensive scars. In particular, the capability of SmartLipo to help contract the skin following liposuction has been particularly helpful in the treatment of male gynecomastia. The decrease in downtime following surgery is also an advantage for many men.

As for facial rejuvenation, eyelid surgery to remove the excess skin and prominent fat pads associated with a tired appearance remains the most common facial procedure in men in my practice. Following a seven-to-10 day recovery period, the dark, baggy eyelids associated with a lack of sleep are gone and patients are left with a refreshed appearance. Scars are hidden in the crease of the upper eyelids and in the shadow just below the lower eyelash line or, in some cases, can even be completely hidden on the inner surface of the lower lid.

Over the past five years, however, more of my male patients are considering facial procedures beyond the eyelids; and this trend is confirmed by the national statistics. The most commonly requested procedures are Botox and facial fillers, but facelifts are now also on the agenda for discussion. Botox and fillers provide excellent short-term results, but need to be repeated periodically. With the availability of short scar techniques and quicker recovery periods, facelift surgery has also been increasing in men, up 14 percent in the past two years, according to ASPS data. For many men, the key is being able to get back to work more quickly.

For men considering facial surgery, be aware that the blood supply to the face in men is richer in vessels, and there is an increased chance of postoperative bleeding. Also, any scarring after surgery can be more difficult to hide than in women, because men don’t wear makeup or style their hair over their faces the way many women do. As I have stressed in previous columns, if you are considering any type of surgery, do your homework and make sure your surgeon has experience with the surgical procedures you are interested in.

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