Dr. William H. Gorman, plastic surgeon with Austin Plastic Surgery Institute, discusses with us male focused facial procedures.
While it is true that in the past most cosmetic surgery patients have been women and this is certainly been the case in my practice of over 30 years, the number of men seeking cosmetic surgery is on the rise. In the past, most men would never consider skincare or cosmetic surgery. They also would not consider health-food drinks, going to the gym or spending $300 for jogging shoes. In this new era, men are recognized by news media, marketers and manufacturing as a potentially very large new demographic. Lifestyle has become extremely important. Men are now paying attention not only to clothes, fragrances and hair care, but also to the appearance of their bodies. Looking and becoming fit go hand-in-hand. Plastic Surgeons are beginning to see men accompany their wives for cosmetic surgery consultations. They are beginning to sign-up for skin care treatments and for their own personal consultations regarding possible cosmetic surgical treatments. Facial rejuvenation surgery, Lipo sculpting and treatment for gynecomastia are procedures that are becoming more and more requested by men. In this blog, I will address some of the more common facial rejuvenation procedures requested by men. Later, we will publish a blog that will discuss other cosmetic procedures requested by men including liposuction and treatment for gynecomastia.
Men and women alike are being educated better than ever before about the health benefits of good skin care. On an intellectual basis, men seem acutely aware of the carcinogenic risk of sun exposure to the skin, and most men will consider the use of sunblock if they know they will be outside in the sun for long stretches of time. Men, however, often fall woefully short of women when it comes to the daily routine application of sunblock. Most men are unused to the daily application of any skin care products. Hopefully, with education and good marketing, this trend is beginning to change. What may have seemed too metrosexual in the past is beginning to appear as smart proactive health care of the skin.
In addition to skin care products which can be applied by the patient in the privacy of their home, treatments and skin care clinics are now being considered by men. The use of fillers, Botox, skin resurfacing and hair removal is slowly becoming more common in our male patients.
Neck or Face Lift
A face lift is probably one of the most feared cosmetic procedures by most men. We have all seen some questionable or even bad results, especially in celebrities, when the patient appears overdone, looking not younger but different, too tight, mask like and unnatural. No one wants this look. My patients want to look younger but not different, relaxed and not tight and natural. They want their friends and family to notice how good they look but not to be readily apparent that they have undergone surgery. My male patients especially want to look normal- just younger; before gravity took over their neck and face. This result can be readily obtained by a well-trained, competent, experienced and conscientious plastic surgeon.
Men do, however, present with some unique characteristics which must be considered when planning facial rejuvenation surgery. The facial skin of the male is thicker than that of the female and it may bleed
more. The fact that the male face is bearded means that special care must be made in planning of the incisions so that hair bearing skin is not brought into or behind the ear.
Finally, oftentimes a neck lift or mini facelift will be enough for a man, because it is the neck and jowls that are often of most concern. This procedure requires a smaller incision and less dissection than a full face lift. Liposuction is sometimes used as well to remove some unwanted fat in the neck.
A brow lift procedure is an operation which will elevate some of the thicker brow skin from the upper part of the eye, thus opening the eyes more. It is also useful to reduce the frown lines between the eyebrows. The most common approach for this procedure is a coronal incision which is essentially an incision which goes from ear to ear across the top of the head behind the hairline. If a man is bald or balding, that scar may not be a viable option. The procedure can be done, although not as well, through small incisions using an endoscope.
Removal of redundant skin and protruding fat from the upper and lower eyelids continues to be a very popular procedure in both men and women. It makes a person look more awake and alert and yet does not alter the way a person looks. As a stand-alone procedure, the eyelid lift or blepharoplasty procedure rarely has to be redone even after many years, because the eyelids do not carry the weight of the cheeks and gravity has little effect on them. The blepharoplasty procedure is often done in conjunction with a neck lift or face lift but can be a stand-alone procedure.
The rhinoplasty or nose job in men is more commonly to straighten a crooked nose, to improve the ability to breathe through the nose or to reduce the size of the nose; as opposed to slight refinement often seen in female rhinoplasty patients. A nose which is deformed, too large or crooked will seem to dominate the entire face, drawing attention away from the eyes. It can also disturb the profile and the normal proportions which make a face proportional. Care for preoperative planning is critical using precise preoperative photographs, measuring angles and proportions, and consideration of her yes the patient’s desired end result.
A weak chin feminizes the face and alters the profile in a negative way. Looking at a lateral profile view, the masculine chin should approach a vertical line dropped from the brow, through the upper lip. If the man has dental malocclusion resulting from a small lower jaw or mandible, then advancement of the entire lower jaw may be necessary. More commonly the chin can be advanced with the placement of a prosthesis or implant through an incision inside the mouth or underneath the chin.
We see protruding ears more commonly in children but occasionally in a grown man or woman. This protrusion may be minimal or can be quite profound. It may be just one ear or maybe bilateral. In any case protruding ears can alter the appearance and self-esteem of the patient. An otoplasty procedure typically will alter the cartilaginous framework of the ear enabling the air to sit closer to the skull. This is usually performed through an incision behind the ear.
Over the years I have performed surgery on a large number of male patients and have observed a few things that generally set them apart from my female patients:
1. Once a man comes for a consultation, he is ready to move forward and does not typically ask a lot of questions
2. He wants to get the procedure done quickly with little fan fare and return to normal life as soon as possible
3. He does not want to look “operated on”
4. He may be less compliant in terms of post-operative instructions
5. He tends not to return for follow-up visits once all sutures are out
6. He typically has great results but may not return for follow-up photos
7. He may initially be resistant to the daily use of skin care products, but will be more likely to use them if the number of products is minimal, and it can be done quickly and easily
8. Understanding these fairly typical characteristics of the male plastic surgery patient can be very helpful in obtaining the excellent result we desire and assure a very happy patient.
Plastic surgery for men? Why not- it makes perfect sense!