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*From that French girl je ne sais quoi to the intricacies of the multi-step Korean skincare routine, the international cosmetic and aesthetic industries are as vast as they are unique. But, thanks to globalization, niche trends now have universal appeal. In this series, The AEDITION explores geographical markers of beauty and how they influence today's global patient and consumer.*

It’s safe to say that men care about how they look just as much as women. Forget the sitcom trope of a schlubby husband with the bombshell wife — men can be just as focused on their appearance as everyone else. In fact, studies show it’s the case around the globe. The difference is that how men want to look changes when you cross borders.

There is a reason the global men’s grooming industry grew to [$60.6 billion in 2018](https://www.prnewswire.com/news-releases/global-male-grooming-products-market-set-to-reach-81-2-billion-by-2024---analysis-by-product-price-range-distribution-channel-and-region-300883497.html) and is set to balloon even more (it is estimated to rise to $81.2 billion by 2024); men are much bigger consumers of beauty and grooming than people give them credit for. That extends to cosmetic procedures as well. According to the International Society of Aesthetic Plastic Surgery (ISAPS), [men made up 14.4 percent of all global cosmetic surgical procedures in 2017](https://www.isaps.org/wp-content/uploads/2019/03/ISAPS_2017_International_Study_Cosmetic_Procedures_NEW.pdf). And while they don’t break down gender divisions in individual countries, it’s clear that men are increasingly seeking out cosmetic procedures the world over.

But what these men are looking for varies by country. Much like women’s standards of beauty, what men aspire to look like has a lot to do with the culture they’re living in and is closely tied to their societal understanding of masculinity. In 2016, [UK-based Superdrug launched a “Perceptions of Perfection” study](https://onlinedoctor.superdrug.com/perceptions-of-perfection-part-ii-men/?utm_source=affiliatewindow&utm_medium=affiliate) that invited freelancers from around the world to alter a photo of a man to reflect the ‘ideal male’ of their culture. The results are, unsurprisingly, varied but do show that “men suffer equally with women around low body confidence as many strive to attain a standard of ‘attractiveness’ that is both often unattainable and driven by cultural perceptions and advertising ideals,” as the study notes. 

Understanding the [subtle differences in the male ideal](https://www.youtube.com/watch?v=aC7P-p0dPoI) around the world can shed a light on the global perception of masculinity and why more men are seeking out cosmetic procedures than ever before. Here, The AEDITION speaks with leading experts to find out what men are looking for in five regions around the globe.

## **1. Middle East**

In recent years, the Middle East has become a global plastic surgery hub, particularly Lebanon, Dubai, and Turkey. Some credit social media and western influence with this rise, but a decreasing cultural stigma around cosmetic work has also contributed to an increase in both procedures and medical tourism. Some estimate that as much as [30 percent of patients seeking cosmetic surgery are men](https://www.arabnews.com/node/1442116/saudi-arabia).

According to a [2017 study in the Saudi Medical Journal](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556282/), the most common cosmetic procedures were [rhinoplasty](https://aedit.com/procedure/ethnic-rhinoplasty) and [laser hair removal](https://aedit.com/procedure/laser-hair-removal). While they do not note how many of these procedures were performed on men, it’s in line with what experts see. “In the Middle East, rhinoplasty is number one,” says Beverly Hills-based board certified plastic surgeon [Leif Rogers, MD](https://aedit.com/provider/leif-rogers-md-578). It’s becoming more common not only in the Middle East itself, but also among people of Middle Eastern descent in the U.S., he says.

“They don’t necessarily want a Western looking nose,” New York City board certified plastic surgeon [Douglas Steinbrech, MD](https://aedit.com/provider/douglas-steinbrech-md-62), is quick to note. Instead, the ideal is a defined nose that still is culturally appropriate. “They may want it to be reduced, but to keep it within the bell-shaped curve that is the norm of their culture,” he says.

The Middle East is also rapidly becoming known as a hub for [hair transplants](https://aedit.com/procedure/neograft), especially in Turkey. It’s estimated that Turkey alone has more than 300 hair transplant clinics and has seen men flock from all over the world to have hair treatments. In a culture that has traditionally valued full beards and heads of hair, it’s unsurprising that hair-focused procedures are popular in the region. Couple that with an interest in manscaping (as seen through the amount of laser hair removal procedures) and it’s clear that hair is a defining factor in male beauty in the Middle East.

## **2. South America**
When you think about South American aesthetics, it’s impossible to overlook Brazil, which leads the charge in both beauty ideals and plastic surgery. Procedures like the [Brazilian Butt Lift](https://aedit.com/procedure/brazilian-butt-lift) have cemented Brazil as the gold-standard in body definition — not just for women but for men too.

Men in Brazil idealize a toned, athletic body but not overly muscular. “They’re all about big-time definition,” says Nashville-based board certified plastic surgeon [Jacob Unger, MD](https://aedit.com/provider/jacob-unger-md-2649), of Maxwell Aesthetics. It’s telling that [four of the top five most popular plastic surgery procedures](https://www.isaps.org/wp-content/uploads/2019/03/ISAPS_2017_International_Study_Cosmetic_Procedures_NEW.pdf) in Brazil are focused on the body, with [liposuction](https://aedit.com/procedure/laser-assisted-liposuction) and [abdominoplasty](https://aedit.com/procedure/abdominoplasty) top among them. Dr. Steinbrech also notes that he’s seen an increase in interest in other procedures among men in Brazil. “They do a lot of [gluteal augmentation](https://aedit.com/procedure/butt-augmentation-with-implants) and are very interested in implants,” he explains.  

While the ISAPS does not note how many men in Brazil underwent these surgeries versus women, given that Brazil is considered a plastic surgery capital around the world (thanks to inexpensive and accessible providers) it is not a stretch to assume that men are taking advantage to obtain their perfect beach body.

## **3. South Korea**
South Korea is a beauty-obsessed culture that has distinct ideas of beauty for both women and men. “Korea really sets the standards across Asia,” says Dr. Steinbrech. Look no further than the now-worldwide K-beauty trend to see that aesthetic trends often start there and soon have global implications. Men in South Korea are much more in tune with [skincare](https://aedit.com/aedition/best-skincare-grooming-ingredients-for-men) and makeup than men in other parts of the world and typically undergo cosmetic procedures like [jaw surgery](https://aedit.com/procedure/jawline-slimming-with-botox) and rhinoplasty to attain their desired look.

Dr. Steinbrech says K-Pop and the [Flower Boy](https://www.bbc.com/news/world-asia-42499809) aesthetic are the driving influences in South Korean aesthetics for men. “It’s a more androgynous feel where men want to have more delicate faces like a narrow jawline and a more pointed chin,” he explains. Unlike other parts of the world where stronger male features are preferred, South Korean men want a more stylized look that’s focused on their face and is even sometimes at odds with a more muscular body, according to Dr. Steinbrech. Similar to women, larger eyes are considered beautiful in men, but [double eyelid surgery](https://aedit.com/procedure/asian-blepharoplasty) (during which a Western-inspired crease in the eyelid is created) is very common as well, he says. 

To obtain more ‘delicate’ features many men turn to elaborate skincare routines and makeup, but there is a reason South Korea is considered one of the plastic surgery capitals of the world. In Seoul alone, there are [hundreds of plastic surgery clinics](https://www.academia.edu/18248718/The_dubious_enhancement_Making_South_Korea_a_plastic_surgery_nation), and, unlike in the United States, the most common procedures focus on the face and are considered ‘minor’ procedures. Double eyelid surgery is one, but so is double jaw surgery (to sculpt the jaw and augment the chin to create the desired V-shape) and rhinoplasty (to create a smaller, more delicate nose). These procedures are just as common for men as they are for women.

## **4. United Kingdom**

In recent years, male aesthetic ideals in the United Kingdom have shifted, some say as a result of the popularity of reality shows like *Love Island*, which features very fit women and men in various states of undress. *Love Island*, specifically for it’s constantly rotating cast of ripped, shirtless men, [has been said to be linked to an increase in anabolic steroid use and male body image disorders](https://www.huffingtonpost.co.uk/entry/love-island-2019-is-the-reality-show-affecting-male-body-image_uk_5cf61f85e4b0a1997b702181?guccounter=1).

Whether that is true or not, it’s clear that men in the United Kingdom are much more focused on their bodies and desire a toned, muscular physique. The ideal man is muscular, athletic, and heavily tattooed (the UK has emerged as one of the most tattooed nations), and while plastic surgery is less common for men than in other parts of the world, Dr. Steinbrech has seen this start to change. “The Brits are more conservative in general, but [UK patients] are starting to get more into body procedures,” he shares. “They’re starting to ask for them and it’s becoming a trend.”

According to the [British Association of Aesthetic Plastic Surgeons](https://baaps.org.uk/about/news/1708/cosmetic_surgery_stats_number_of_surgeries_remains_stable_amid_calls_for_greater_regulation_of_quick_fix_solutions), men in the UK are opting for non-invasive procedures like [Botox®](https://aedit.com/procedure/periorbital-botox) more frequently than surgical procedures. But while that may be the case when it comes to facial procedures, liposuction rose among men by 9 percent in 2018, further cementing the United Kingdom as an increasingly body-obsessed culture. 

## **5. USA**

“American [men] want to be tan and jacked like a Marine or a superhero,” says Dr. Steinbrech. “Basically, they want to look more like Thor.” But nailing down the aesthetic ideals of American men isn’t so easy. A lot of it has to do with where they live, at least according to Dr. Steinbrech. “There is a tendency with people (including men) in Los Angeles to want to look younger,” he says. “In California, people are rewarded for being fit, going to the gym, and appearing more youthful. They’re more likely to want to look very young and fit even into their sixties.” In other areas, like New York, he says men tend to be more focused on how their looks can make them more effective at their jobs. “In New York, they want a [big jawline](https://aedit.com/aedition/8-ways-to-get-a-more-defined-jawline)” because men equate that with confidence, leadership, and magnetism, he explains. 

Despite the subtle differences in geography, a peek at the top cosmetic procedures among men does shed some light. Liposuction and [gynecomastia](https://aedit.com/procedure/male-breast-reduction) surgery (a.k.a. male breast reduction) are common and men look to these procedures to obtain a more toned, fit shape. Rhinoplasty and [blepharoplasty](https://aedit.com/procedure/blepharoplasty-eyelid-surgery) (i.e. eyelid surgery) are also common, showing that men do seek to improve their facial features, though Dr. Steinbrech adds that the goals of these procedures among men is to make small, subtle tweaks that are not always noticeable. Still the most common cosmetic procedure of all is non-invasive Botox® (or other neuromodulators) and dermal fillers, which help men look youthful without surgery.

Whether it’s through non-invasive procedures or cosmetic surgery, the most common thing providers hear from their male patients is that they don’t want to look too 'done.' Men in the United States still often associate a certain ruggedness with a male ideal — a muscular body, a strong jaw, and a few (but not too many) lines on their faces. Perfection, in many ways, is considered feminine, but strength is masculine.

AEDITION rejuvenators-min

Medical Aesthetics Collection | The AEDITION

Aesthetics

Understanding the differences in the ideal male aesthetic around the world can shed a light on why more men are seeking out cosmetic procedures than ever before. Here, The AEDITION investigates what guys are looking for around the globe.

Male Beauty, Grooming, And Cosmetic Surgery Trends Around The World

Going Global: Male Beauty And Cosmetic Surgery Trends Around The World

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If the most wonderful time of year has you feeling more frazzled than festive, we’ve got the perfect present: A guide to the best non-invasive cosmetic procedures to keep you glowing while you’re going… and going… and going this holiday season.

## **Professional Holiday Skincare Prep**
Whether your skin is in need of brightening, firming, or just a bit of pre-holiday TLC, there is an array of minimally invasive in-office procedures that are light on downtime and heavy on results. 

### **Chemical Peels**
The top seasonal skincare suggestion of New York City-based board certified dermatologist [Julie Russak, MD](https://aedit.com/provider/julie-russak-md-4645)? A mild- to medium-strength chemical peel. “Peels can be customized to have zero downtime yet instant results, which is perfect for a last minute glow before a holiday party,” she shares, adding that she favors both Jessner peels and light TCA peels at her practice.

- [Jessner Peel](https://aedit.com/procedure/jessners-peel): Comprised of several acids (including salicylic acid, lactic acid, and resorcinol), the self-neutralizing, medium-depth peel affects only the top layer of skin and is generally safe for a variety of skin types to treat everything  from acne scars and sunspots to fine lines and wrinkles. Because patients must stay out of the sun before and after to avoid hyperpigmentation, Jessner peels are best performed in late autumn, winter, and early spring (i.e. an ideal pre-holiday pick-me-up).

- [TCA Peel](https://aedit.com/procedure/tca-peel): TCA stands for trichloroacetic acid, a relative of vinegar that can be used in varying strengths to exfoliate the epidermal skin cells. Like other types of chemical peels, it’s best performed in the winter months, and is commonly used to even skin tone, reduce fine lines, and smooth acne scarring. 

### **Customized Facials**
Come holiday time, Dr. Russak’s patients line up for customized facials at her Russak+ Aesthetic Center. “We combine dermaplaning, HydraFacial, and oxygen infusion to provide an instant pick-me-up,” she says. By incorporating techniques from all three procedures, she is able to provide immediate brightening, lifting, and firming results.

- [Dermaplaning](https://aedit.com/procedure/dermaplaning-treatment): During a dermaplaning treatment, a dermatologist (or highly trained aesthetician) uses a medical-grade scalpel to remove a thin layer of dead skin cells from a patient’s face. While it does not provide the same level exfoliation as a chemical peel, dermaplaning provides an instant refresh for dull skin, in addition to improving the absorption rate of serums and skincare and allowing for smoother makeup application (so long, peach fuzz!). But be sure to slather on the sunscreen — dermaplaning will make you more sensitive to UV rays (even in the wintertime).

- [HydraFacial](https://aedit.com/procedure/hydrafacial): The multifaceted treatment uses water to simultaneously suction out the pores and deliver potent infusions of active ingredients deep into the skin. It can be used to treat a variety of concerns — from acne to fine lines to sun damage — without any irritation or redness. Patients emerge from the 30-minute procedure with a radiance boost that lasts for about one week.

- __Oxygen Facial__: A favorite of celebrities like Madonna, the procedure involves spraying the epidermis with concentrated oxygen molecules that are infused with skin-boosting vitamins and nutrients. Proponents say the treatment enhances collagen production, detoxifies, and hydrates — leaving skin with an immediate dewy glow.

### **Dermal Filler**
[Filler](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers) is the number one treatment Dr. Russak recommends to patients looking for instant gratification. “I use fillers to lift the face and provide a contour that lasts, which can instantly take years off of the face,” she shares. “It achieves a refreshed, youthful appearance without looking ‘done.’”

Common treatment areas include the cheekbones, tear troughs, and jawline — with men, in particular, opting for the latter. Patients should allow about 10 days for any bruising or swelling to resolve.

### **Microneedling with PRP**
This non-surgical procedure is a go-to for Beverly Hills-based board certified plastic surgeon [Jonathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956), when treating patients who are looking for a quick fix. Also known as the ‘[vampire facial](https://aedit.com/procedure/microneedling-with-prp),’ the treatment involves piercing the skin with fine needles to create micro wounds that stimulate collagen production. Introducing the patient’s own platelet rich plasma (PRP) further maximizes the rejuvenating results, in addition to more quickly improving redness and healing time. 

Dr. Cabin advises scheduling one treatment per month for three months in a row for best results. But for but for patients who haven’t planned that far ahead, don’t fret. One microneedling treatment performed two weeks before a special event will still result in more radiant skin.

### **Neurotoxin Injections** 
Dr. Cabin suggests [Botox® and the like](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) to patients who are looking to both prevent and treat fine lines and wrinkles — especially around the eyes (think: crow's feet) and forehead. Results can last two to four months, but patients should plan to schedule their injections at least two weeks prior to any holiday event to allow effects to kick in and any injection site bruising or redness to resolve. 

## **At-Home Holiday Skincare Prep**
The chilly, dry air coupled with the hustle and bustle of both work and social engagements can leave your complexion looking like the Ghost of Christmas Past. It may go without saying, but the key to avoiding dull, dry, and irritated skin is to maintain a healthy lifestyle. While the holiday season is so often synonymous with overindulgence, sticking to a mindful, well-balanced routine can keep your skin looking rosier than Rudolph’s nose.

1. **Adopt a Seasonal Skincare Routine:** Just as you swap out your flip-flops and t-shirts for booties and sweaters, you should be switching up your product preferences to suit the change of season, says Dr. Cabin. He believes a tailored regimen (including daily sunscreen!) is the single most effective way to prevent and reverse skin damage. In addition to incorporating hydrating stalwarts like hyaluronic acid into your routine for winter, brightening and exfoliating ingredients like vitamin C and alpha- and beta-hydroxy acids can provide an instant pre-holiday glow boost.

2. **Don’t Skimp on Sleep:** It’s not called ‘beauty sleep’ for nothing. Getting the recommended seven to nine hours of sleep per night for adults is your body’s chance to recharge. Like many bodily functions, the skin undergoes a number of reparative processes overnight, so catching some zzz’s is tantamount to skin health. For an added complexion jolt, try an overnight mask, night cream, or serum that can complement the natural rejuvenation.

3. **Steer Clear of Sugar:** Indulging in cakes, cookies, and eggnog galore is not only a concern for your waistline. Decadent foods that are high in sugar or salt can wreak havoc on your complexion and trigger bloating, redness, and even acne. As always, enjoy in moderation. 

4. **Stay Hydrated:** Slathering on your favorite serum and moisturizer can only go so far if your skin is parched from dehydration. Aim to take in about half your weight in fluid ounces daily (up that quotient if you’re consuming alcohol). And, no, a peppermint latte doesn’t count as ‘essential fluids.’

## **Last But Not Least...**
If you’re just too busy — or still waiting on that holiday bonus — to schedule a cosmetic treatment, don’t give into your inner ‘bah, humbug’ just yet. Dr. Russak has a few self-care tips that can provide both mind and body benefits. “I’m a big fan of detoxing with an infrared sauna and lymphatic drainage massage,” she says, adding that “getting a good haircut can also provide an instant mood boost.” And, at the end of the day, all the procedures in the world can’t take the place of a little ‘me time.’ Dr. Russak’s advice to keep yourself feeling merry *and* looking bright? “Make sure to squeeze in some meditation to relax from holiday stress,” she says.

Whether your skin is in need of brightening, firming, or just a bit of pre-holiday TLC, there is an array of minimally invasive in-office procedures and at-home remedies that’ll leave you merry and bright. 

Non-Invasive Cosmetic Procedures To Look And Feel Your Best This Holiday Season 

Non-Invasive Tweakments To Look And Feel Your Best This Holiday Season 

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Let’s be honest: from our morning coffee habit to our afternoon sweet tooth, we put our teeth through a lot on a daily basis, and never is that more true than during the holidays.

In addition to enjoying the sugary drinks and rich foods that are key components of keeping spirits bright, the swing between Thanksgiving and New Years also puts a spotlight on our smiles. From office parties to family gatherings, a calendar chock full of [festivities can put your pearly whites in peril](https://aedit.com/aedition/the-impact-of-candy-sugar-sweets-on-teeth-and-skin). Fortunately, there are several steps one can take to mitigate any lasting damage from the season’s indulgences. 

The AEDITION spoke to New York City-based cosmetic dentist [Alina Lane, DDS](https://aedit.com/provider/alina-lane-7794), about how to get your smile in shape for the holidays and how to keep it merry and bright all season long. 

## **Last-Minute Smile Treatments**
It may be too late in the season to start a clear aligner treatment plan or have custom veneers fitted, but there are still options available for anyone looking to spruce up their smile before the onslaught of holiday photos and events begins. 

### Teeth Whitening
Professional [teeth whitening treatments](https://aedit.com/procedure/laser-teeth-whitening) are the gold standard for getting a noticeably brighter smile quickly, and your dentist may be able to ensure your pearly whites stay, well, white for as long as you need them to. “Many dentists can make custom bleaching trays for you to touch-up your teeth at home to ensure your holiday photos feature a brilliantly clean and bright smile,” Dr. Lane shares. If an office visit isn’t in the cards, over-the-counter whitening products can also be effective. For best results, look for ones that contain hydrogen peroxide to lift stains.

### Teeth Cleaning
In-office teeth cleaning is a quick (and cost-effective!) way to enhance your smile — though you’ll want to be sure you set your appointment in advance. Dr. Lane warns that many insurance cycles end in December, so there is often a rush to take advantage of the benefit. Professional cleaning treatments are minimally invasive and require no downtime. While you won’t see a dramatic change in the shade of your smile without a chemical whitener, an in-office cleanse is usually able to remove newer surface stains and leave your mouth looking and feeling fresh. 

## **The Best Foods to Eat (and Avoid!) For Healthy Teeth**

Even if you did schedule an in-office teeth whitening appointment or professional clean, it’s all too easy to neglect your smile once the season’s festivities get underway. Whether you’re indulging in potentially damaging foods a bit more than usual or forgetting to brush your teeth after snacking, there are a lot of hazards for your mouth to navigate this time of year. 

First and foremost, teeth are sensitive to the environment in which they exist. While sugar itself does not cause cavities, it does attract bacteria that lowers the mouth's PH, making it more acidic and leading to tooth decay. Failing to maintain an adequate brushing routine (who hasn’t had to do a last-minute drugstore dash because they forgot their toothbrush?!) can also result in a buildup of plaque that can cause lasting damage. 

But that’s not all. When it comes to eating for oral health, it’s not just about the ingredient list and nutritional facts. The texture of the foods we consume play just as big a role in limiting damage. Hard candies and crunchy foods, for example, can do quite a bit of harm (even if you are fastidious with your brushing and flossing regimen), which is why Dr. Lane encourages her patients to lay off a few holiday staples.

### Food and Drinks to Avoid Over the Holidays:

- Pecan and Pumpkin Pie
- Candy Canes
- Eggnog
- Rugelach
- Sugary Sodas and Alcohol

As a rule of thumb, she recommends staying away anything too sweet or sticky. And, if you choose to indulge, do so in moderation and brush your teeth as soon as possible after — the longer the sugar is in your mouth, the more chance it has to cause damage.

But it’s not all bad. In fact, there are a number of foods that are sure to be on the dinner table over the holidays and can actually improve your oral health. Squash, green beans, apples, and other fruit and vegetable dishes all contain vitamins and nutrients that are great for your mouth. Such foods also tend to coat your teeth less, which means the demineralizing sugars and acids that lead to tooth decay and cavities don’t hang around as long.

## **How to Maintain Your Oral Hygiene Over the Holidays**

In addition to being mindful of what you eat, Dr. Lane has a few at-home ideas for keeping your smile in tip-top shape over the holidays (hint: don’t forget your toothbrush).

1. If you’re going out or having a late-night snack, brushing your teeth before going to sleep is imperative.
2. Don’t be tempted to skip steps in your oral hygiene routine (i.e. you still need to floss!).
3. Invest in a travel-size toothbrush, toothpaste, and mouthwash that can easily be thrown in your purse or dopp kit for on-the-go cleaning. A package of proxabrushes (you know, the little spoolies that reach between your teeth) can be helpful, too, if floss is not an option. 
4. In a pinch (think: long flights, late nights, etc.), carry tooth wipes for a quick boost. And, of course, sugar-free gum is always helpful when you want to freshen up.
5. When traveling, research a local dentist that will be open over the holidays and save their contact information ahead of time, so you won’t need to panic if a dental issue arises while you’re away.

Oh, and don’t forget about your [aligners](https://aedit.com/procedure/clear-aligners). If you are currently undergoing clear aligner therapy, you will need to pay even closer attention to your oral health during the holidays. For starters, be careful not to eat crunchy, sticky, or chewy foods while the trays are in. Similarly, you’ll want to avoid eating or drinking anything that could stain the aligners. 

It can also be easy to leave aligners off for longer than you would normally, which is one surefire way to throw off your treatment schedule. If you do end up forgetting to wear them, let your dentist know ASAP so they can adjust your plan. 

## **The Takeaway**
They don’t call it the most wonderful time of the year for nothing, but doing your best to keep your oral hygiene in check around the holidays can go a long way toward ensuring your brightest and best smile year round. 

Brush your teeth at least twice a day, and be mindful of not only the ingredients in the foods you eat but the texture of the food, too (this is especially important if you have braces!). Holiday veggie dishes and protein-packed meals give your body and your teeth a great boost in vitamins and nutrients. When you inevitably choose to indulge, do so in moderation — and don’t forget your toothbrush!

From what foods to avoid to what treatments to book, The AEDITION breaks down the best ways to keep your teeth in tip-top shape from Thanksgiving to New Years and beyond.

How To Take Care Of Your Smile During The Holidays

Male abdomen

Why should women be the only ones taking advantage of body sculpting and toning treatments when [men also want to look and feel their best](https://aedit.com/aedition/what-you-need-to-know-about-male-plastic-surgery-trends)? “We are now entering a paradigm shift in aesthetic medicine where we are not designing and implementing gender-specific procedures,” says New York City board certified plastic surgeon [Ryan Neinstein, MD](https://neinsteinplasticsurgery.com/). “But we are creating procedures to meet society’s demands.” Because his patients are living healthier lifestyles than ever, both women and men are looking for non-invasive and minimally invasive procedures to be the last mile in their aesthetic and fitness goals. But that doesn't mean male body contouring treatments are the same as their female counterparts. Here, a guide to the body contouring procedures that are on the rise for men. 

## **1. Liposuction **

[Liposuction](https://aedit.com/procedure/tumescent-liposuction) is highly common in plastic surgery offices of late. It’s a cosmetic procedure that removes fat via suction and is performed with a thin tube called a cannula, which is attached to a vacuum. New York City-based board certified plastic surgeon [Umbareen Mahmood, MD](https://aedit.com/provider/umbareen-mahmood-md-23), says that “men are increasingly looking for a solution to address stubborn areas of fat that they may be unable to improve at the gym.” One of the most common areas they want to tone up are the flanks (a.k.a. love handles), she says, as many men complain that these persist despite a healthy lifestyle. Dr. Neinstein agrees that liposuction of the love handles is, to quote *Zoolander’s* Hansel, so hot right now. He notes that his version of liposuction does not simply remove fat, but uses energy to melt fat and tighten skin with virtually no scarring or downtime. “It is the most in-demand procedure for health-conscious men, as this is their most diet- and exercise-resistant area,” he says. 

## **2. Gynecomastia Surgery**

[Gynecomastia](https://aedit.com/procedure/male-breast-reduction-gynecomastia-surgery) is an enlargement or swelling of breast tissue in men, most commonly caused by male estrogen levels that are too high or are out of balance with testosterone levels. Gynecomastia surgery (i.e. male breast reduction) is popular at Dr. Mahmood’s practice. “Throughout the summer months when men are without a shirt at the beach and even throughout the year when they are in a gym locker room, wearing a fitted shirt, etc., the appearance of their chest can become a concern,” she explains. “More men are becoming vocal about feeling self-conscious about the appearance of their chest, and are seeking treatment for gynecomastia.”

## **3. EmSculpt® **

[EmSculpt®](https://aedit.com/aedition/why-everyone-is-talking-about-emsculpt) is the first FDA-approved device to build and sculpt muscle. The non-surgical treatment builds muscle safely and effortlessly in areas like the abs and buttocks. Oh, and it all takes a fraction of the time it would take if you were to do it via traditional exercise. “In conjunction with the desire to have a more toned abdominal and flank area, men are interested in the benefits of EmSculpt®,” Dr. Mahmood says. “Men find this appealing either to maintain their hard work at the gym, or to help boost their fitness efforts.” The EmSculpt® device causes 20,000 contractions of the target muscle (in this case, the abdominal rectus muscles) within 30 minutes. 

Dr. Neinstein says EmSculpt® is also one of the most popular procedures for men at his practice. “The real key is that for people who are already in shape, it helps push their muscle cells beyond their plateaus so you can get those extra results that are so hard to obtain in the busy day-to-day of our lives in the city,” he explains. Another great thing about this device is that it has a built-in resting phase so it washes away the lactic acid you create when you’re doing the contractions. “This means you don’t get the downtime and soreness that you would expect with 20,000 sit ups,” he says. 

## **4. Lymphatic Drainage**

Lymphatic drainage is popular when it comes to facial treatments, of course, but men are reaping the benefits of this practice to shape and tone their bodies as well. A lymphatic drainage massage is a form of gentle massage that encourages the movement of lymph fluids around the body. The lymphatic system’s fluid helps to rid your body’s tissues of waste and toxins. Dr. Neinstein says that he has incorporated a detoxifying and water-reducing massage practice that originated in Brazil and Colombia into his treatment offerings. “We started these massages to help patients heal faster from surgery, but we have found patients choose to continue them indefinitely,” he says, adding that it’s nice to be able to blend technology with human touch services like massage. 

## **5. Lipoetching (a.k.a. Abdominal Etching)**

As you've likely noticed, the midsection is a major area of interest for men. [Lipoetching](https://aedit.com/procedure/liposculpture) is a type of liposuction in which a very small, specialized cannula is used to carve shapes out of the fat that lies on top of the muscle anywhere on the body. It creates a chiseled look without the need for exercise. Who wouldn’t want a six-pack without enduring, you know, all the things that go along with acquiring a six-pack? 

In Dr. Neinstein’s office, abdominal etching is becoming more and more popular. In this procedure, finesse liposculpting is used to bring out abdominal muscles in males with good muscular tone but with some stubborn fat on top of the muscles that is restricting their visual appearance, he says.


Whether you're looking for chiseled abs or a leaner physique, these surgical and non-surgical procedures deliver body-sculpting benefits — without a trip to the gym.

Popular Surgical And Non-Surgical Body Contouring Procedures For Men

5 Go-To Body Contouring Procedures For Men

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It’s an undisputed fact that more men are getting cosmetic procedures. According to the American Society of Plastic Surgeons’ annual report, more than [1.3 million men in the United States went under the knife (or needle) in 2018](https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-full-report-2018.pdf) — a 29 percent increase since the year 2000. And while the majority of these procedures performed on men were minimally invasive, men still made up 13 percent of cosmetic procedures performed in the United States.

It’s not exactly surprising that men are increasingly seeking out the help of plastic surgeons to reach their aesthetic goals. Cosmetic surgery has never been gendered, but the divide can be traced back to our cultural misconceptions of what cosmetic surgery is and who gets it. Thanks to the internet and social media, both men and women have a greater understanding of just what these procedures entail and what they can do. “The conversation is a lot more sophisticated than it used to be,” says board certified plastic surgeon [Jacob Unger, MD](https://aedit.com/provider/jacob-unger-md-2649), of Maxwell Aesthetics in Nashville. He’s noticed an increase in male patients in his own practice in recent years.

Still, men who get cosmetic surgery are looking for different results and typically approach it differently than women. The biggest fear most men have when getting cosmetic surgery is that it is going being obvious that they got it. “They don’t want to look like they’ve had anything done,” says board certified plastic surgeon [Leif Rogers, MD](https://aedit.com/provider/leif-rogers-md-578), in Beverly Hills. They also want different results, particularly when it comes to common procedures like liposuction and rhinoplasty. Cosmetic surgery, after all, is not one size fits all, and men want the results to look masculine and blend with their existing features. 

Both Dr. Rogers and Dr. Unger’s patients reflect the current trends that the ASPS reports. “Men want a lot of body contouring, liposuction, and liposculpting,” says Dr. Unger. On the face, eye lifts and nose jobs reign supreme among men. “About a third of the rhinoplasties I do are on men,” notes Dr. Rogers.

The AEDITION asked the experts to break down the most common surgical and non-surgical cosmetic procedures for men, and what they have to say may surprise you.

## __1. Liposuction__
[Liposuction](https://aedit.com/procedure/liposuction) is consistently one of the top cosmetic procedures across the board, according to the ASPS, so it’s not surprising that it lands in the top spot for men as well. But that doesn’t mean that men and women are getting the same type of liposuction or looking for the same results. “Guys don’t want to be thin, they want to be defined,” says Dr. Unger. “They want to get rid of the pudge at their waist, but they also want obliques and the manly contours that make them look stronger.” For men, it’s not just about getting rid of unwanted fat, but augmenting and enhancing muscle. “They want broad shoulders, a narrow waist, and no hips,” agrees Dr. Rogers. 

To meet the desires of the male clients, Dr. Rogers, Dr. Unger, and many surgeons are using body contouring techniques with their liposuction. “I use the term lipo-sculpting or soft-definition liposuction,” says Dr. Unger. “The days of just removing fat and saying ‘job well done’ are over. What it really is now is definition liposuction.” That means not only removing fat, but doing it with the purpose of enhancing or creating muscle contours. 

In Dr. Rogers’ case, it also means sometimes redepositing the fat in other areas to further augment muscles. It’s particularly common, he says, in patients who want liposuction on their chest area. He often “puts some fat under the muscle or into the muscle to build the pectoral back up,” he says. “You actually still have volume, but it just looks like muscle versus fat.”

While there is no way of telling how many men are going to liposculpture or fat grafting for muscle augmentation since the ASPS does not differentiate between those procedures and liposuction, both doctors see in their own practices that it’s becoming the standard in male liposuction.

## __2. Gynecomastia (Male Breast Reduction)__
[Gynecomastia surgery](https://aedit.com/procedure/male-breast-reduction), or male breast reduction, is one of the other most common cosmetic procedures among men year over year. That’s partially because only men get it. Gynecomastia is the medical term for enlarged or feminized breasts in men and the surgical procedure usually involves removing the tissue in combination with liposuction to contour the area. Gynecomastia as a condition is common and affects about half of males at birth and one in four men age 50 to 69, [according to the Mayo Clinic](https://www.mayoclinic.org/diseases-conditions/gynecomastia/symptoms-causes/syc-20351793). 

As Dr. Rogers notes, however, getting a male breast reduction does not necessarily mean you’re getting a textbook gynecomastia procedure. “I have a lot of patients who are asking for liposuction or contour on their chest,” he says. “You could put them into the same category because I’m working on their chest, but they’re not there for gynecomastia specifically.” No matter how you slice it, whether these men are getting true gynecomastia surgery or not, it’s clear that procedures to augment and contour the chest are increasingly popular.

## __3. Blepharoplasty (a.k.a. Eyelid Surgery)__
“Men will come in and say, ‘I look tired and I look old’ but they don’t want a face lift,” says Dr. Rogers. The solution: an [eye lift](https://aedit.com/procedure/blepharoplasty-eyelid-surgery). Most men first notice signs of aging around their eyes and typically complain about eye bags or excess eyelid skin that they feel makes them look older. It’s expected, then, that blepharoplasty is consistently among the most popular procedures for men.

Eye lifts are performed on either the upper or lower lids (often both) and remove excess skin to smooth wrinkles and make the eye area appear smoother and more youthful. They’re popular among male patients, says Dr. Rogers, because they are relatively simple procedures that offer big results with little down time. “It’s a simple surgery,” he says. “The recovery is easy and there is little to no sign that you’ve had anything done.”

Dr. Unger notes that blepharoplasties among men are popular not only because, when performed properly, they aren’t obvious, but also because the results are subtle. “For men, it’s less about trying to be youthful and more about erasing the more obvious signs of aging around the eyes,” he says. 

## __4. Hair Transplant__
“Hair transplants are getting crazy popular,” says board certified plastic surgeon [Ben Paul, MD](https://aedit.com/provider/benjamin-paul-md-392), in New York City, who specializes in hair transplants and other hair-related procedures. [According to the American Hair Loss Association](https://www.americanhairloss.org/men_hair_loss/index.html), about two-thirds of men experience hair loss by the time they are 35 years old. That number climbs to 85 percent by the time they reach 50. The main culprit is androgenic alopecia (commonly referred to as male pattern baldness), and, as the name suggests, it is one of the issues men deal with most.

It’s understandable that hair transplants would be among the most popular cosmetic procedures for men, but one of the reasons that more men are seeking them out these days is that there have been technological advances that allow them to work better and leave less scarring. “In the past, the donor site was approached with a very big punch and many groups of hairs were transplanted together,” says Dr. Paul. That old way of doing it is what we call ‘hair plugs’ — and wasn’t very aesthetically pleasing.

“The average person has roughly 2.3 hairs per follicle,” he says. “Currently we do something called [follicular unit extraction](https://aedit.com/procedure/follicular-unit-extraction-fue) and that technique involves just taking the fundamental unit of hair (the follicle).” Individual donor follicles are taken from the back of the head and then transplanted into another area. “You can take up to half of the hair from the donor site before there is any visual decrease in density,” he says. The procedure has gotten so good, he says, that “we’re able to harvest through really small holes, so the healing is very rapid and the entire procedure is scalpel and suture free.”

While the procedure is time consuming (the average procedure takes six to eight hours), Dr. Paul says “the success rate is high with these techniques because you’re transplanting from your own body and you don’t have to worry that you’re going to reject yourself.” These new techniques are also effective treatments for facial hair and eyebrow hair.

## __5. Rhinoplasty (a.k.a. Nose Job)__
“A third of all the rhinoplasties I do are on men,” says Dr. Rogers, illustrating just how popular nose jobs are among men who get cosmetic surgery. “They’re great because they can completely change the way your face looks in one procedure and can make an enormous difference.”

Men, however, are usually looking for something different than women when it comes to their [rhinoplasty](https://aedit.com/procedure/rhinoplasty-nose-job). “In general men want a more masculine nose,” he says. “They usually want it a little straighter and less of what’s called a super tip break (when there is a little tip above the tip of the nose). They also usually want it a bit bigger.”

That’s because smaller noses tend to read more feminine, says Dr. Unger, as does an “overly-sculpted nose.” He’s noticed that his male rhinoplasty patients don’t want their noses to look too perfect. “They want to retain some flaws: not perfectly straight, not a perfectly refined tip, a little hint of a hub. It looks more natural and more masculine.”

## __6. Dermal Fillers__
Not all men who seek out cosmetic procedures are ready to go under the knife. [Dermal fillers](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers) are more common among men than surgical procedures that could address the same issues. Hyaluronic fillers like Juvederm® and Voluma® are typically used to replenish lost volume in areas like the cheeks, while poly-L-lactic acid (PLLA) and calcium hydroxyapatite (CaHA) fillers like Sculptra® and Radiesse® (respectively) are used because one of the most common places men want filler is along the jawline. 

“Men ask for filler along the jawline more than women,” says Dr. Rogers. “It can help with jowls because when you start getting them, you can make them go away with filler.” For many men, a sharp chin and strong jawline are signs of masculinity and youth, so using filler to keep the skin around the jaw from sagging is a common request.

## __7. Neurotoxin Injections__
Let’s just agree to stop calling it Brotox. [Neurotoxins](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) like Botox®, Dysport®, Jeuveau®, and Xeomin® are by far the most common cosmetic procedure for men. These injectable toxins smooth wrinkles on the forehead, between the eyebrows, and around the eyes, which makes them an easy way for men to combat visible signs of aging. 

Men, however, are not always looking for the same results as women. “Men can get away with some lines,” says Dr. Rogers. “Frankly, sometimes it looks better for them to have some.” His male patients are usually looking to smooth very deep wrinkles, but not completely erase lines altogether. The biggest thing men should consider when getting Botox®, he says, is who is administering it. “A lot of people have a ton of experience treating women, but not necessarily with men,” he warns. “You don’t want to get treated exactly the same way because you may get a frozen look.” Men usually need less neurotoxin to get the results they want.

More than 1.3 million men went under the knife (or needle!) in 2018 — a 29 percent increase since the year 2000 — and The AEDITION asked the experts about the most popular invasive and non-invasive cosmetic procedures. 

Top Surgical And Non-Surgical Cosmetic Procedures For Men

The Top 7 Cosmetic Procedures For Men

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While we colloquially know the condition as 'man boobs,' the medical term for the swelling of the male breast tissue is gynecomastia. [According to the Mayo Clinic](https://www.mayoclinic.org/diseases-conditions/gynecomastia/symptoms-causes/syc-20351793), at least 25 percent of men ages 50 to 69 are affected by gynecomastia, and gynecomastia surgery (read: [male breast reduction](https://aedit.com/procedure/male-breast-reduction)) is among the most popular cosmetic procedures in the United States. The American Society of Plastic Surgeons' (ASPS) [2018 Plastic Surgery Report](https://www.plasticsurgery.org/documents/News/Statistics/2018/cosmetic-procedures-men-2018.pdf) found that there were nearly 25,000 male breast reduction procedures performed in the U.S. last year — a 22 percent increase since the year 2000.

## __What Is Gynecomastia?__

Gynecomastia is an endocrinology disorder where there is swelling in male breast tissue. The cause of gynecomastia is a hormone imbalance where there is a higher percentage of estrogen than usual. During puberty, boys’ bodies mainly produce testosterone and only a little bit of estrogen, which is the dominant hormone in girls’ sexual growth. When testosterone levels are lower than usual, the ratio between the two sex hormones is unbalanced. The higher estrogen levels can stimulate the male breast tissue to swell up. While gynecomastia does not impact health, it can be a cosmetic concern with emotional ramifications.

## __Causes of Gynecomastia__

Gynecomastia can impact men at different stages of life and is often (though not always) caused by hormones. “At birth, newborn males often have enlarged breasts due to the residual effects of their mother's estrogen," says New York City-based plastic and reconstructive surgeon [Umbareen Mahmood, MD](https://aedit.com/provider/umbareen-mahmood-md-23). "A hormonal imbalance can again occur at puberty or in older men, resulting in a higher estrogen to testosterone ratio."

Boys born with enlarged breast tissue as a result of the estrogen in their mother's placenta will usually see the swelling dissipate after a few weeks. Pubertal gynecomastia, meanwhile, impacts young men during puberty (beginning as early as age 10) and can last for several years (up to age 18). Cases of gynecomastia peak again later in life. As men age, they experience declining levels of testosterone and an increase of fatty tissue, which can lead to senile gynecomastia.

But it's not just hormones. Causes of gynecomastia can include medical conditions like obesity, malnutrition, liver disease, hyperthyroidism, hypogonadism, prostate cancer, and kidney failure. It can also be a side effect of drugs (marijuana or heroin), prescription medications (anabolic steroids, corticosteroids, digoxin and calcium channel blockers, Flagyl, Propecia, Spironolactone, Valium, and Zantac to name a few), and even herbals (e.g. [lavender or tea tree oil](https://www.nih.gov/news-events/news-releases/lavender-tea-tree-oils-may-cause-breast-growth-boys)). "There is not necessarily a distinct difference in appearance based on etiology,” Dr. Mahmood says.

## __How to Diagnose Gynecomastia__

When gynecomastia first starts developing, the breast pain can be startling. The first sign may be a lump of fatty tissue (not unlike male breast cancer), and your doctor can perform a physical examination and tests (e.g. a mammography or blood tests) to rule out the possibility of cancer. As the swelling continues, the lump may feel tender to the touch but the sensitivity usually subsides. While one breast may initially be larger than the other, they tend to even out. 

Dr. Mahmood notes that the word 'gynecomastia' only refers to any enlargement of the male breast, but there are grading systems designed to categorize the various degrees of the condition. Dr. Mahmood personally recommends [the Simon and Rohrich classification models](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3706045/#JR27056-30), which have been condensed below:

- __Grade I__: Minor enlargement without excess skin (< 250g of breast tissue)
- __Grade IIa__: Moderate enlargement without excess skin (250 to 500g of breast tissue)
- __Grade IIb__: Moderate enlargement with minor excess skin (250 to 500g of breast tissue)
- __Grade III__: Severe enlargement (> 500g of breast tissue) with grade I ptosis (read: sagging)
- __Grade IV__: Severe enlargement with grade II or grade III ptosis 

## __Surgical Treatments for Gynecomastia__ 

While gynecomastia doesn’t necessarily cause medical concerns, male breast reduction procedures are on the rise to deal with the aesthetic and psychological impacts of the condition. The two most common (and effective!) procedures include liposuction, excision, or a combination of the two. 

“Patients with mild to moderate gynecomastia, involving breast enlargement with minimal gland hypertrophy and no excess skin, are good candidates for liposuction only,” says Dr. Mahmood. “Many patients also have a small amount of fibrous glandular tissue under the nipple and this part can be treated with direct excision by making a small incision around the areola. Techniques such as [power-assisted liposuction](https://aedit.com/procedure/power-assisted-liposuction) (PAL) or [ultrasound-assisted liposuction](https://aedit.com/procedure/ultrasound-assisted-liposuction) (UAL) are especially helpful when performing liposuction for gynecomastia as they can more effectively remove the fibrous tissue.”

More severe cases may require more invasive techniques. “Severe gynecomastia requires not only liposuction, but also skin excision to address the ptosis and excess skin,” Dr. Mahmood explains. “In many severe cases, the nipple-areola may need to be temporarily removed and replaced as a graft to a more appropriate position on the chest after the sagging skin and tissue has been removed.” 

During the recovery period, patients typically wear bandages and support garments to minimize swelling and support the chest as it heals. Depending on the type of procedure, a tube may temporarily be placed under the skin to drain excess fluid. Patients will experience swelling for several weeks, but most people can resume everyday activities within a few days.

The [ASPS reports](https://www.plasticsurgery.org/cosmetic-procedures/gynecomastia-surgery) the average cost of gynecomastia surgery in 2018 was around $4,000, and it should be noted that most insurance plans do not cover the procedure. 


## __Non-Surgical Treatments for Gynecomastia__ 

While non-invasive treatments for gynecomastia lack the same level of efficacy as their surgical counterparts, a recent study found there to be three classes of medical treatment for gynecomastia — androgens (i.e. testosterone, dihydrotestosterone, and danazol), anti-estrogens (clomiphene citrate and tamoxifen), and aromatase inhibitors (letrozole and anastrozole) — though many patients did not show significant improvement after the treatment.

“Testosterone can be given if patients have an abnormally low level of the hormone and danazol, a synthetic form of testosterone that decreases estrogen production, may be somewhat helpful,” Dr. Mahmood says. “Generally, there is no real medical treatment for gynecomastia.” 

Before turning to prescription medication, a better bet may be to eliminate any lifestyle factors that could be contributing to gynecomastia. “The first step in addressing gynecomastia is treating the underlying cause if it is due to a non-hormonal reason,” Dr. Mahmood explains. “This includes stopping any offending agents like medications or illicit drugs, removing a tumor, and treating underlying systemic disease.”

## __The Takeaway__

Gynecomastia affects a large percentage of the male population over the course of a lifetime, and, while the medical concerns related to the condition are minimal, men with enlarged breast tissue may seek treatment to reduce the size of their chest.

Whether patients opt for liposuction, excision, or a combination of the two, the results of gynecomastia surgery are generally permanent. It is important to note, however, that gynecomastia caused by non-hormonal factors like prescription medications, illicit drugs, or weight gain will require patients to maintain a healthy lifestyle. Consulting with a board certified plastic surgeon will ensure men receive the best course of treatment for their condition.

Gynecomastia surgery (a.k.a. male breast reduction) is one of the most popular cosmetic procedures for men in the U.S. Here, a deep dive into the condition colloquially known as 'man boobs' and how to treat it.

Guide To Gynecomastia And Male Breast Reduction Surgery 

Everything You Need To Know About Gynecomastia

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Minimally invasive cosmetic procedures are on the rise. According to the American Society of Plastic Surgeons’ [2018 Plastic Surgery Statistics Report](https://www.plasticsurgery.org/documents/News/Statistics/2018/cosmetic-procedure-trends-2018.pdf), the market grew 163 percent between 2000 and 2018, and the trend is expected to continue tracking upward. 

Among the go-to treatments? Injectables (think: [Botox®](https://aedit.com/procedure/botox-facial) and filler) and non-invasive fat reduction, which just so happen to be among the best ways to non-surgically lift, firm, plump, and contour the face and neck. Whether you are looking to combat visual signs of aging like volume loss, fine lines and wrinkles, and sagging or are simply looking to further define your facial features, there is an array of non-invasive cosmetic procedures that can reshape the face — sans surgery.

## __Dermal Filler__

Fillers aren’t just for plumping your pout. [Soft tissue fillers](https://aedit.com/aedition/everything-you-need-to-know-about-dermal-fillers) like Juvéderm®, Radiesse®, Restylane®, and Sculptra® can be used to re-shape the entire face. Made of hyaluronic acid, collagen, calcium hydroxylapatite, and poly-L-lactic acid (PLLA) to name a few, filler can be injected into the skin to restore volume, smooth out fine lines and wrinkles, and enhance facial contour.

While it probably comes as no surprise that dermal filler is often employed under the eyes to eliminate bags, in the mid-face region to to sculpt cheekbones or add volume to sagging nasolabial folds, and on the lower face to define the jawline, a board certified dermatologist or plastic surgeon can recommend less obvious uses as well.

“Dermal fillers can be placed on the bone and within the muscle of the chin to augment its shape and projection,” explains board certified dermatologist [Rita Linkner, MD](https://aedit.com/provider/rita-linkner-md-8907), of New York’s Spring Street Dermatology. “The chin is oftentimes forgotten but adds so much to facial structure. A syringe of filler in this delicate area goes such a long way.”

Using filler to augment the chin is a non-surgical solution to refine a facial feature that previously would have required a more invasive cosmetic procedure — like a [facial implant](https://aedit.com/procedure/alloplastic-chin-implant) — to correct. So-called [liquid rhinoplasties](https://aedit.com/procedure/liquid-rhinoplasty) and [chemical brow lifts](https://aedit.com/procedure/chemical-brow-lift) are other common examples of filler being used to mimic the effects of traditional plastic surgery.

One key difference, however, between non-surgical cosmetic procedures and their surgical counterparts is the level of permanence. The results of dermal fillers, while immediate, last an average of six months to two years (depending on the region being treated) compared to the much longer lifespan of surgical procedures. But the downtime associated with filler is minimal, with only about a week (or less) of minor redness, swelling, or bruising.

## __Botulinum Toxin Type A Injections__ 

Easily confused with dermal filler, botulinum toxin type A (BoNT-A) injections (read: Botox® and its competitors) work in an entirely different way. While dermal filler quite literally fills in the hollows of the face to restore volume and fullness, [BoNT-A injectables](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) like Botox®, Dysport®, Jeuveau®, and Xeomin® are FDA approved to reduce the appearance of fine lines and wrinkles caused by repeated facial expressions (think: frowning, squinting, smiling, and the like) by injecting it into the muscles underlying the affected area. But their usefulness goes far beyond smoothing wrinkles.  

BoNT-A injections can be used to complement cosmetic surgery procedures like [blepharoplasty](https://aedit.com/procedure/upper-eyelid-blepharoplasty) (a.k.a. eyelid surgery) or [brow lifts](https://aedit.com/procedure/traditional-midbrow-lift) and can be strategically injected to refine the face shape or define facial features. Botox® and the like can be used to slim out a round face, lift the corners of the mouth, and even soften the jawline (ideal for teeth grinders or those lacking definition).

“I inject neurotoxin into the masseter muscle to slim the face very commonly,” says Dr. Linkner. “It turns a square shaped face into a more aesthetically pleasing oval. Studies have been done that show the jawbone itself slims on CT scans with toxin use in the masseters. As the muscles exerts less pressure on the bone, the osteoclasts start to reshape the bone itself.”

Like dermal fillers, BoNT-A injections are temporary. Once injected, the results can take up to a week to kick in (patients may experience minor bruising and pain at the injection site) and typically last around three to six months.

## __Kybella®__

Another player in the minimally invasive injectable game? [Kybella®](https://aedit.com/procedure/kybella).

A form of deoxycholic acid (i.e. the naturally occurring molecule that aids in the breakdown and absorption of dietary fat in the body), Kybella® is FDA approved to reduce fat under the chin and thus improve the contour of the neck. Off-label uses include breaking down stubborn fat deposits on the stomach and back and above the knees and elbows.

When deoxycholic acid is injected directly into the submental fat under the chin, the fat-storing adipose tissue is destroyed. Over time, the fat cells are removed from the treated area via the body’s natural metabolic processes.

The best thing about Kybella®? The results are permanent. Dr. Linkner says that the body metabolizes the destroyed adipocytes (fat cells) over the proceeding six to eight weeks. Unlike [liposuction](https://aedit.com/procedure/power-assisted-liposuction), the fat will not redistribute, but most patients will need to multiple sessions (up to six), spaced at least a month apart to see the most optimal results. 

Additionally, there is a bit more downtime associated with Kybella® than, say, Botox® or dermal filler. “Expect a 36-hour period of swelling that truly peaks 12 hours post-procedure,” Dr. Linkner warns. “Bruising is common, so I give all my patients arnica post-Kybella.”

## __PDO Thread Lift__

While nothing can replace the long term lifting and firming benefits of a surgical [facelift](https://aedit.com/procedure/deep-plane-facelift), thread lifts are a worthy non-surgical alternative. Ideal for patients looking for facial rejuvenation (especially as it relates to the lower face and jowls), the minimally invasive cosmetic procedure involves the subcutaneous placement of polydioxanone (PDO) sutures to lift sagging tissue. 

Unlike facelifts, which surgically remove excess skin, [thread lift](https://aedit.com/procedure/pdo-thread-lift) techniques focus on repositioning the tissue beneath the surface of the skin. The result? A reshaped face with little to no downtime. In fact, Dr. Linkner says many of her patients can attend social engagements immediately after the procedure, which is performed under local anesthesia.

Like facelifts, however, thread lift results aren't permanent. While most facelifts last a decade or more, thread lifts typically have a one- to two-year lifespan because the sutures dissolve over time, allowing the tissue to move and sag.

## __The Takeaway__

Whether you are looking for a minimally invasive face-shaping procedure to replace or complement plastic surgery, volume-boosting fillers, fat-reducing injectables, and lifting thread lifts all provide face shaping benefits without going under the knife. While the results are not always permanent, cocktailing these cosmetic procedures under the care of a board certified dermatologist or plastic surgeon can produce restorative results with minimal downtime. 

From fillers to thread lifts, a guide to the best minimally invasive cosmetic procedures that can sculpt and contour the face — sans surgery.

How Minimally Invasive Cosmetic Procedures Can Reshape The Face Without Plastic Surgery

How To Reshape Your Face Without Plastic Surgery

shutterstock 481230421 (1)

The American Society of Plastic Surgeons (ASPS) reports that there were [more than 1.3 million cosmetic procedures performed on men in 2018](https://www.plasticsurgery.org/news/press-releases/more-men-undergo-plastic-surgery-as-the-daddy-do-over-trend-rises-in-popularity). Aside from [Brotox](https://aedit.com/aedition/the-rise-of-brotox-injections) — ahem, Botox® — and soft tissue filler, laser treatments were among the most popular minimally invasive procedures. The ASPS' [2018 Plastic Surgery Statistics Report found](https://www.plasticsurgery.org/documents/News/Statistics/2018/cosmetic-procedures-men-2018.pdf) that there were about 185,000 laser hair removal procedures performed on men last year, in addition to the nearly 76,000 laser skin resurfacing services and 30,000 laser treatments for leg veins. 

Part of the popularity can undoubtedly be attributed to the breadth of aesthetic concerns lasers can treat and the ease at which they relieve them. While laser treatments can range from relatively superficial to invasive, the most common cosmetic concerns (think: hyperpigmentation, unwanted hair, skin tightening, etc.) can often be addressed over several appointments with very little downtime.

"These treatments are all generally very quick. Depending on the areas treated and amount to be treated, most face treatments are less than 10 minutes," says board certified dermatologist [Elliot Weiss, MD](https://www.laserskinsurgery.com/Dermatologists/Elliot-T-Weiss-MD), of Laser & Skin Surgery Center of New York East in Southampton. Dr. Weiss does note that cocktailing multiple laser procedures together (as many doctors will suggest) could add additional time to the office visit, and patients usually opt to numb their skin with a topical anesthetic for about 30 minutes before the treatment begins. But, if you are simply looking to have a dark spot removed or redness zapped, "typical downtime is minor," he says

From hair and tattoo removal to minimizing the appearance of fine lines and wrinkles, lasers can treat a wide variety of cosmetic concerns for men and women alike — though anatomical differences may impact the types of devices used and treatment plans recommended for male patients.

“The thickness of the skin, especially on the face and neck, is different in men versus women,” says board certified dermatologist [Ron Shelton, MD](https://www.laserskinsurgery.com/Dermatologists/Ronald-Shelton-MD), of Manhattan’s Laser & Skin Surgery of New York. “Energy levels are often adjusted to compensate for this.”

So, what are the most popular cosmetic laser procedures for guys? The AEDITION asks the experts.

## __1. Laser Therapy for Facial Redness and Broken Blood Vessels__  

In the case of patients dealing with redness on the face as a result of skin conditions like rosacea and telangiectasia or broken blood vessels and  spider veins, vascular lasers can improve tone and texture of the complexion. 

"For treating redness and blood vessels, the [pulsed dye laser](https://aedit.com/procedure/pulsed-dye-laser) (VBeam® Laser 595nm) and the Excel® V (long pulse 1064/532nm) are work horses," says Dr. Weiss. "The treated area will usually appear red for about a day and slight puffiness can occur for a few days, particularly when treating the upper cheeks. It typically requires multiple treatments to get the best results."

Dr. Shelton also uses both the VBeam® and Excel® V lasers to treat vascular concerns and says the procedure lasts five to 10 minutes on average, with three to five treatments (performed once a month) providing optimal results. Since the treatments are [non-ablative](https://aedit.com/procedure/nonablative-laser-skin-resurfacing) and do not result in open wounds, he usually recommends covering up any post-op redness or bruising with concealer or tinted sunblock.

## __2. Laser Skin Resurfacing for Acne Scars__

Because the effects of acne can linger long after the pimples heal, laser skin resurfacing can be combined with other cosmetic treatments to improve the appearance of acne scars by smoothing skin texture and boosting collagen production. 

[Fraxel® Dual](https://aedit.com/procedure/nonablative-fractional-lasers), for example, is a non-ablative (read: non-wounding) laser that combines two different wavelengths to address both pigmentation near the skin's surface and deeper tissue damage. Dr. Shelton says patients may experience about a week of downtime with swelling and redness after the 30-minute procedure and multiple sessions are needed for best results. 

Treatments like [Infini®](https://aedit.com/procedure/infini-rf) and Genius®, meanwhile, combine radiofrequency and microneedling over the course of several treatments to improve elastin and collagen production, which, in turn, smooths the skin. Both Fraxel® Dual and [microneedling with RF](https://aedit.com/procedure/microneedling-with-radiofrequency) treatments are safe for patients with darker skin tones. 

For those who prefer a one-and-done approach, the ablative [Fraxel® Repair](https://aedit.com/procedure/fraxel-repair) laser provides total facial rejuvenation by reducing age spots and scars, plumping and softening wrinkles, and improving overall skin health. The initial downtime associated with a Fraxel® Repair treatment is 10 to 12 days, and redness may persist for a month or more as the skin continues to heal. While the recovery period is longer than some of the less invasive options on the market, only one treatment is needed and the results are long lasting.

## __3. Laser Hair Removal__

"Generally speaking, laser treatments are tailored to an individual’s skin type and particular concern, not the gender," Dr. Weiss explains. "However, in instances like hair removal, men may have thicker, coarser hair that requires slightly different treatment parameters and, possibly, a greater number of treatments."

Just as male and female hair follicles are different, so too are the areas of the body they most often treat. Dr. Shelton says back and chest hair removal is "common," and he occasionally sees men who wish to treat pseudofolliculitis barbae (i.e. the razor bumps on the back of the neck) that he says is "exacerbated by wearing collared shirts." 

When it comes to removing facial hair, it is important that the practitioner is well-versed in the potential side effects of the lasers. "Laser hair removal is often adjusted for the thicker whiskers on men than the unwanted hair on women," Dr. Shelton explains. "Certain devices are not used on the bearded skin, if there is a concern of possible long-term hair loss. [Intense pulsed light](https://aedit.com/procedure/ipl-for-unwanted-hair) (IPL) and broadband light (BBL) are avoided on men’s bearded areas."

Considering a patient's skin tone is also important. "For [laser hair removal](https://aedit.com/procedure/laser-hair-removal), the wavelength is usually longer and the pulse duration of the laser pulse is longer for darker skin tones to minimize the risk of post-inflammatory hyperpigmentation," Dr. Shelton says. "It will take more treatments though and possibly be less effective than when laser hair removal is performed on lighter skin color." 

He is a fan of both the Lightsheer® and GentleMax® Pro lasers, which can treat most areas in 30 to 45 minutes. Dr. Shelton says patients can expect about a week of the redness and swelling as the dark stubble flakes off and re-treatment is needed every six to eight weeks for the body and every four to six weeks for the face until full results are realized.

## __4. Laser Skin Resurfacing for Sun Damage and Age Spots__

Whether it's sun spots, age spots, liver spots, or any of the other forms of hyperpigmentation that both men and women experience with age, laser treatments can even skin tone and texture and restore a more youthful appearance.

"Many sun spots can be effectively removed with a single session — provided the patient uses strict sun protection for at least a month after treatment," says Dr. Weiss, who finds the Q-switched ruby and Fraxel® Dual lasers to be among the "most effective on the market" for addressing sun spots and pigmentation.

After a treatment, Dr. Weiss says spots on the face will often look darker for approximately five to seven days before flaking off to reveal clear skin. That process takes about 10 to 14 days for pigment on the neck, two weeks for spots on the arms and hands, and "several weeks" for the legs. And, since even the most vigilant sunscreen wearers are still exposed to some degree of UV rays on a daily basis, he usually recommends annual Fraxel® procedures "to clear up any sun damage, boost the skin's collagen production, and maintain a healthy glow."

## __The Takeaway__

Given the scope of cosmetic concerns laser therapy can treat, it should come as no surprise that multiple devices can be used together to achieve the best results. 

"I frequently combine multiple lasers in a single session," says Dr. Weiss, who likes to pair the Q-switched ruby laser with the Fraxel® Dual to "provide a highly effective treatment for sun damage and pigmentation."  Dr. Shelton, meanwhile, treats patients who have both "unwanted brown spots or acne scars" *and* "facial redness" with a combo of the Fraxel® Dual and VBeam® lasers. 

Regardless of what you are looking to address, consulting a board certified dermatologist or plastic surgeon will ensure you receive the best course of laser treatment(s) for your concerns.

From removing unwanted hair to minimizing fine lines and wrinkles, lasers are one of the go-to minimally invasive cosmetic procedures for men and women alike. So, what are the most popular laser procedures for guys? The AEDITION asked the experts.

Best Cosmetic Laser Procedures For Men 

A Guide To The 4 Best Cosmetic Laser Treatments For Men 

shutterstock 1049283200 (1)

*When should I start getting Botox? Is it time to incorporate retinol into my skincare routine? What is a “mommy makeover”? How about a “daddy do over”? Do I really need to, as the saying goes, sacrifice my ass for my face? Should I swap my hyaluronic acid fillers for something a bit more permanent?* 

*When it comes to beauty and aesthetics, there is no such thing as one size fits all. But there are some tried and true principles that will keep you looking and feeling your best. In this series, [Coming of Age](https://aedit.com/aedition/category/coming-of-age), The AEDITION answers your most pressing questions about the best treatments, procedures, and practices — from surgery and skincare to health and wellness and everything in between — to consider at any age.*

It was Jane Fonda (now 81) who quipped that her “she bought herself a decade” when she got a facelift, while Sharon Osbourne, 67, has been opening up about going under the knife for her rhytidectomy in August. At 65 years old, Christie Brinkley recently started working with [Ultherapy®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) skin tightening, and 53-year-old Robin Wright has professed her love of [Botox®](https://aedit.com/procedure/botox-facial). 

Needless to say, these stars can, first and foremost, credit a healthy lifestyle for their transcendent glow (a balanced diet, regular exercise routine, and daily sunscreen application are *always* musts), but they have also chosen to age on their own terms with the help of rejuvenating professional treatments that can serve both men and women alike. Here, The AEDITION dives into some of the best surgical and non-surgical cosmetic procedures to try after 50.

## __For the Face__

__Facelift__
While there are plenty of minimally invasive procedures that promise to lift and firm, the gold standard of gravity defying treatments will always be the rhytidectomy (a.k.a. [facelift](https://aedit.com/procedure/midfacelift)) thanks to its ability to reduce wrinkles and sagging skin around the face, neck, and jaw. 

Like any cosmetic procedure, the decision of when to get a facelift is a personal one — but there are some general markers to keep in mind. “Patients who were exposed to the sun regularly, who smoke, who have lost a significant amount of weight, who have undergone early menopause, or who have thinner skin (i.e. English or Irish heritage), will often age earlier and wish to have a facelift,” says New York City-based plastic surgeon [Melissa Doft, MD](https://aedit.com/provider/melissa-doft-md-63). “These patients usually visit the office in their early fifties, while patients with thicker skin (e.g. Asian, African Americans) may schedule in their later fifties.”

While facelift results are not permanent (they will be impacted by the aging process), they tend to last at least 10 to 15 years for most patients and, when coupled with less invasive treatments, can persist even longer. 

__Dermal Filler__
If a facelift is too still too invasive, you wish to complement your procedure, or you are simply looking to address a loss of volume, [dermal fillers](https://aedit.com/procedure/temporary-lip-fillers) — like Juvéderm®, Radiesse®, Restylane®, and Sculptra® — can both smooth and plump the skin.

“Fillers are great for the aging face,” says Dr. Doft. “They are used to restore volume where it is lost with age and to camouflage wrinkles. Adding fillers to the wrinkles changes how light reflects onto the face, and the shadows become less significant.”

While filler temporarily restores lost volume, it cannot correct excessive skin sagging like a facelift. But the inverse is also true. In fact, some patients may experience hollowness in certain areas after a facelift, at which point their surgeon may recommend dermal filler to enhance the surgical results.

Since the hollowing of the face is one of the most common signs of aging, Dr. Doft recommends routine maintenance of soft tissue fillers every six months to a year.

__Dermabrasion__
If skin tone and texture is your concern, [dermabrasion](https://aedit.com/procedure/dermabrasion) (and the less invasive [microdermabrasion](https://aedit.com/procedure/crystal-microdermabrasion)) can be performed to brighten and even out the complexion. The deeply exfoliating procedure involves using an abrasive brush or wand to remove the outer layers of the skin.

Many patients liken the post-op sensation to that of a burn, which subsides in a few days. The healing process, however, lasts several months, and sun exposure should be avoided for a minimum of six months. Dr. Doft says she suggests microdermabrasion (which yields a more superficial exfoliation) for people who are looking for less downtime, but dermabrasion is more effective in targeting deep wrinkles.

## __For the Eyes__

__Blepharoplasty__
Another common symptom of aging is drooping and puffiness around the eyes. According to the [American Society of Plastic Surgeons 2018 Statistics Report](https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-report-2018.pdf), the most popular procedure among people over the age of 55 was blepharoplasty (i.e. [eyelid surgery](https://aedit.com/procedure/upper-eyelid-blepharoplasty)). Yes, that means it was even more requested than a facelift. 

“As you age, the upper lid starts to sag and the lower lid fat becomes more prominent,” Dr. Doft explains. “A blepharoplasty will correct both and make your eyes look brighter and younger. Most patients will have a blepharoplasty alone in their late forties or fifties or in combination with a facelift.”

The procedure (usually performed under local anesthesia) takes about two hours to complete and involves cutting along the natural lines of the eyelids, separating the skin from the underlying tissue, and removing any excess fat and skin. 

“It is a very popular procedure and one which is easily tolerated,” she says. “I will often perform upper lid blepharoplasty under local anaesthesia in the office, but I usually will perform upper and lower eyelid surgery in the operating room.”

While the procedure is typically classified as cosmetic, patients who find that the excess skin interferes with their vision may be able to have their eye lift covered by insurance. After surgery, the eyelids usually heal in about two weeks. The results for the upper eyelid will last about five to seven years, while lower lids last indefinitely. But, as with a facelift, it is important to remember that the eyes will continue to age naturally.

__Brow Lift__
Frequently combined with other procedures (like a facelift), a [brow or forehead lift](https://aedit.com/procedure/traditional-midbrow-lift) can reduce the appearance of fine lines and wrinkles and address sagging skin. There are two types of brow lifts: classic and endoscopic. “The classic brow lift can make a more significant change than the endoscopic option,” says Dr. Doft. “But the endoscopic option leaves smaller scars and will affect hair regrowth less.” 

For both types, there is about two weeks of downtime and it is recommended to keep the head elevated and iced during that time.

## __For the Body__

__Sclerotherapy__
Due to poor circulation, genetics, hormones, skin tone, and more, varicose and spider veins can become more noticeable and troublesome with age. While they are not medically dangerous, they can cause aesthetic concerns and take form anywhere on the body — though the face (for spider veins) and legs (for varicose veins) are most common. 

While there are a few techniques to reduce the appearance of veins, [sclerotherapy](https://aedit.com/procedure/sclerotherapy) has become the go-to treatment. The targeted vein is injected with a fluid called a sclerosing agent, which irritates the vein and causes it to disappear. 

Dr. Doft recommends using sclerotherapy to treat medium and large veins, while laser treatments are the better choice for smaller ones. “It is important to treat the feeding veins that cause these small veins to appear,” she says. “I often recommend that patients consult with a vascular surgeon when they have a significant amount of varicose veins.”

There is minimal downtime from the treatment — though it may take around six weeks to see improvement and several sessions may be required. The upside? The results are permanent.

## __The Takeaway__

Whether you’re looking to take your minimally invasive cosmetic procedure routine to the next level or want to dive into the market for the first time, patients over 50 can consider an array of surgical and non-surgical procedures that lift, firm, and tone the face and body with long-lasting results. 

From facelifts to vein treatments, The AEDITION breaks down some of the best surgical and non-surgical rejuvenation procedures to try after 50.

Plastic Surgery and Cosmetic Procedures To Consider In Your 50s, 60s, 70s

Coming Of Age: The Best Procedures To Consider After 50

cristina-gottardi-u3hZnHpVxGc-unsplash

*When should I start getting Botox? Is it time to incorporate retinol into my skincare routine? What is a “mommy makeover”? How about a “daddy do over”? Do I really need to, as the saying goes, sacrifice my ass for my face? Should I swap my hyaluronic acid fillers for something a bit more permanent?* 

*When it comes to beauty and aesthetics, there is no such thing as one size fits all. But there are some tried and true principles that will keep you looking and feeling your best. In this series, [Coming of Age](https://aedit.com/aedition/category/coming-of-age), The AEDITION answers your most pressing questions about the best treatments, procedures, and practices — from surgery and skincare to health and wellness and everything in between — to consider at any age.*

In case you needed yet another reminder that the forties are the new thirties, Kourtney Kardashian, Rachel McAdams, and Adam Levine are just a few celebrities who turn the big 4-0 this year. 

Needless to say, the decade looks better than ever, and there are a growing number of non-surgical cosmetic procedures that can address visible signs of aging like fine lines and wrinkles, hyperpigmentation, skin laxity, and thinning hair. By taking a proactive approach to skin health and maintenance, patients can delay (or potentially even avoid) more invasive surgical procedures down the line. 

## __For the Face__

__Neurotoxin Injections__
If you didn’t start getting [Botox®, Dysport®, Jeuveau®, or Xeomin®](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin) in your twenties and thirties, it is not too late! According to the [American Society of Plastic Surgeons 2018 Statistics Report](https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-full-report-2018.pdf), Botox® (and it’s competitors) is the most popular cosmetic treatment for people in their forties. 

New York City-based board certified dermatologist [Cheryl Karcher, MD](https://aedit.com/provider/cheryl-karcher-md-4323), says that she has plenty of patients who do not start regular Botox® treatments until their forties and fifties, and they do so for a variety of reasons. “Everyone is different,” she says. “Some people are frowners, some people are squinters. Some people have had severe damage to their skin others have taken really good care of their skin and do not have much damage — even in their forties and fifties.”

While the muscle-paralyzing agent is used to help prevent the formation of wrinkles during the twenties and thirties, it can continue to have a smoothing and softening effect by inhibiting the muscle movement that causes lines and wrinkles. The injections take about a week to kick in and touch ups are needed every three to six months for best results. 

__Dermal Fillers__
Because the body’s collagen and elastin production decreases with age, men and women alike may begin to notice sagging, reduced elasticity, and less volume in the face, neck, and body. For women, the hormonal changes that accompany menopause can further impact this process.

In these cases, [soft tissue fillers](https://aedit.com/procedure/permanent-lip-fillers) can be used on various parts of the body (though they are most commonly used on the face) to plump and smooth unwanted lines and wrinkles. “Patients in their forties start losing a little more volume in the cheek area and they start getting jowls around the chin area,” says Dr. Karcher. “In that age group, I think fillers around the cheek and jawline are hugely transformative.”

Like neurotoxin injections, the results are both fast and effective — but maintenance is needed every six months to two years depending on the type or filler and area being treated. 

__Fractional Laser Treatments__
Uneven skin tone and texture is another complexion concern that increases with age (and the accompanying decrease in cell turnover). “By the time a patient is in their forties — depending on where they’ve grown up and what their lifestyle has been — signs of sun damage are usually present in the face. Brown spots called ‘solar lentigos’ and ‘mottled pigmentation’ are usually present,” says Dr. Karcher. “Also, due to the environment, the skin has lost some of its collagen and elastin and that’s were fine lines show up, a little bit of skin sagging shows up.”

[Laser skin resurfacing](https://aedit.com/procedure/ablative-nonfractional-lasers) — specifically, targeted fractional lasers, like [Fraxel®](https://aedit.com/procedure/fraxel-repair) — has the ability to solve many of these concerns. Whether you opt for an ablative or non-ablative treatment, the energy from the laser targets damage while stimulating collagen production, resulting in a brighter, smoother, *and* tighter complexion.

“Fraxel® helps rejuvenate the skin in a number of ways. It takes care of the mottled pigmentation, gets rid of the brown spots, and it also helps rebuild collagen and elastin,” says Dr. Karcher. “So, depending on how much damage a person has, anywhere from one to three Fraxel® treatments would be recommended.”

While wounding [ablative fractional lasers](https://aedit.com/procedure/ablative-fractional-lasers) have the ability to remove thin layers of skin for stronger results, the treatment comes with a longer downtime than their non-wounding [non-ablative](https://aedit.com/procedure/nonablative-fractional-lasers) counterparts. But it should be noted that non-ablative fractional laser can require anywhere from three to five sessions to see the brightening, toning, and evening effects. 

__Ultrasound Skin Tightening (a.k.a Ultherapy®)__
For tightening and firming without a facelift, [Ultherapy®](https://aedit.com/procedure/ultrasound-skin-tighteningultherapy) is a non-invasive ultrasound-based cosmetic treatment that addresses skin laxity. It works by sending concentrated ultrasound waves deep into the skin and SMAS muscle. Unlike laser skin tightening methods, it targets the inner (not outer) layers of the skin. The ultrasound waves heat up the underlying tissue to activate the body’s healing response, which, in turn, stimulates collagen and elastin production. 

“Patients in their forties have lost collagen and elastin, and there’s a little bit of skin sagging,” Dr. Karcher explains. On the face, Ultherapy® can tighten the jawline, under eyes, and forehead, while lifting the eyebrows. It can also be used to firm the skin of the décolleté and even the stomach. 

While the procedure is more impactful than Botox® and fillers, it doesn’t quite reach facelift proportions. Like most laser treatments, it requires several treatments (spaced three to four weeks apart) and offers a solution for those looking for rejuvenation sans scalpel.  

## __For the Hair and Body__ 

__Body Sculpting__
In case you haven’t picked up on it yet, many of the body’s natural responses and processes start to slow with age. The metabolism is not least among them. Coupled with the decrease in skin elasticity, patients in their forties may opt for surgical and non-surgical body contouring procedures that can remove unwanted fat deposits from most parts of the body (think: love handles, abdomen, buttocks, and thighs). 

There are a number of treatments, at varying degrees of invasiveness, that fall under the ‘body sculpting’ umbrella. Non-surgical procedures like [CoolSculpting®](https://aedit.com/procedure/cool-sculpting), [SculpSure®](https://aedit.com/procedure/sculpsure), and UltraShape®, for example, eliminate excess fat by heating or freezing it. Newer options like [EmSculpt®](https://aedit.com/aedition/why-everyone-is-talking-about-emsculpt), meanwhile, offer toning and strengthening benefits by employing high-intensity, focused electromagnetic technology that mimics the effects of 20,000 crunches over the course of a 30 minute treatment. 

These non-surgical treatments come with minimal downtime (especially when compared to a [tummy tuck](https://aedit.com/procedure/abdominoplasty) or [liposuction](https://aedit.com/procedure/tumescent-liposuction)), but three to four sessions will be needed to see results. While the effects are permanent and fully visible after about four to six months, they require patients to maintain their weight. 

__Hair Growth Treatments__
For men in particular, hair growth can slow in the forties, leading to a receding hairline, hair thinning, and baldness. For patients with severe hair loss, [hair transplant surgery](https://aedit.com/procedure/strip-harvesting) is the most effective *and* most invasive solution. While there are several techniques (micro-grafting, slit grafting, punch grafting, etc.), each hair transplant method involves moving hair from another part of the body to the desired area. 

The most effective non-surgical hair loss solution for men and women alike is [platelet-rich plasma (a.k.a. PRP) injections](https://aedit.com/aedition/kourtney-kardashian-prp-injections-to-treat-hair-loss). Similar to a vampire facial on the face, the process involves injecting a PRP solution composed of the patient’s own platelets (usually drawn from the arm) into the scalp and affected areas. The blood acts like fertilizer, promoting stronger and thicker hair growth. Each treatment lasts about a half hour and patients have monthly visits for the first six months before switching to a bi-monthly schedule. 

Over-the-counter topicals and supplements like [Nutrafol®](https://nutrafol.com/) and [Rogaine®](https://www.rogaine.com/) can also yield results — especially when combined with PRP injections and other professional procedures.

## __The Takeaway__

Whether you’re dealing with skin laxity, hyperpigmentation, hair loss, or weight gain, there are an increasing number of minimally invasive cosmetic procedures to tighten, brighten, and rejuvenate the face and body for patients of all ages.

From laser skin resurfacing to surgical and non-surgical hair loss solutions, The AEDITION breaks down the best cosmetic treatments and procedures to try in your forties.

Plastic Surgery and Cosmetic Procedures To Consider In Your 40s

Coming Of Age: The Best Procedures To Consider In Your 40s

yuliya-kosolapova-Zp0VSsp5c5M-unsplash (1)

*Since 1985, October has served as Breast Cancer Awareness (BCA) Month — a period devoted to educating the public on the disease that, [according to the Centers for Disease Control and Prevention (CDC)](https://www.cdc.gov/cancer/breast/statistics/index.htm), is the second most common form of cancer in women, regardless of race or ethnicity. Men can also be diagnosed with breast cancer (albeit at a much lower rate), and The AEDITION is devoting much of its coverage this month to BCA, from expert guides to mastectomies and reconstructive breast surgery to powerful patient perspectives and roundups of products that give back. *

Now that you have a better understanding of the physical and emotional toll of breast reconstruction and the importance of finding the right surgical team (read our overview of how to approach the breast and nipple reconstruction process [HERE](https://aedit.com/aedition/post-mastectomy-breast-reconstruction-process-breast-cancer)), it is time to dive deeper into the surgical options that exist for post-mastectomy patients to reconstruct their breasts and nipples.

Generally speaking, there are two categories of breast reconstruction: implant based and autologous tissue (a.k.a. “flap”) based. In some cases, a combination is used to achieve the most natural and symmetrical results. Similarly, there are two main types of nipple reconstruction. One involves tattooing alone, while the other is a hybrid of reconstruction and tattooing.

“I want all of my patients to understand their options so that they can make the best choice for them,” says Nashville-based plastic surgeon [Jacob Unger, MD](https://aedit.com/provider/jacob-unger-md-2649), who performs hundreds of breast reconstructions a year. “And then my job is to give the best result I can under those constraints.”

Here, a comprehensive guide to the most common types of breast and nipple reconstruction.

## __Reconstruction with Breast Implants__

The most popular form of breast reconstruction, breast implants offer a shorter surgery and recovery time that other reconstructive procedures. Implant reconstruction can either be delayed (performed in the months following mastectomy) or direct (performed in conjunction with the mastectomy surgery), and medical advances — like skin-sparing mastectomies, cohesive gel silicone implants, and internal support technologies like [AlloDerm](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4184054/) and [GalaFLEX mesh](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070449/) — have allowed surgeons to create increasingly natural-looking results.

Despite the popularity, the technique is not without fault. “The challenge with implant-based reconstruction is that there is no natural soft tissue of the breast to help camouflage and contour an implant or to help rearrange tissue and nipple position in the same way that you can when there’s native breast tissue,” says Dr. Unger.

With that in mind, it is important to understand the different facets of implant-based reconstruction.

### __Pre-Pectoral Implant Placement__

While [breast implants](https://aedit.com/procedure/breast-augmentation-with-implants) (both reconstructive and cosmetic) have historically been placed under the pectoral muscle to help achieve a more natural look, the trend is now toward pre-pectoral (read: over-the-muscle) placement. 

“Pre-pectoral implants allow for an easier recovery with less pain and discomfort,” says UCLA plastic surgeon [Jason Roostaeian, MD](https://aedit.com/provider/jason-roostaeian-md-449). Another perk? The lack of animation deformity. “When you have an implant under the pec muscle and you flex it, and it makes things look a little off,” he shares.

![JacobUnger (1)](//images.ctfassets.net/zw35sfestf1t/4kGyMFWGZDViCo4RyAozgb/7b738a9b9c468daccac9743810d02f07/JacobUnger__1_.jpg)
*A before and after of Dr. Unger's pre-pectoral breast reconstruction following a nipple-sparing mastectomy.*

Ideal candidates for [pre-pectoral placement](https://aedit.com/procedure/pectoral-implants) are those with younger, thicker skin, which better camouflages the implant directly below. Technique is also important. “Wrapping the implant in dermal matrix (sterilized cadaver skin) allows you to contain the implant well and gives it an extra layer of coverage,” Dr. Roostaeian notes. “But the most important technique we use to disguise the implant is fat grafting.”

Rather than using an implant alone, plastic surgeons will often recommend a hybrid procedure that involves harvesting fat from a donor site (think: the belly, flanks, or inner thighs) to be injected around the breast implant. The result? Smoother and more natural looking breasts.

“Fat grafting has changed the way I do breast reconstruction,” says Beverly Hills-based plastic surgeon [Lief Rogers, MD](https://aedit.com/provider/leif-rogers-md-578). “It can improve the outcome of any breast reconstruction, creating a more natural appearance and giving me the ability to fine tune my results in a way not previously possible.”

Additionally, Dr. Rogers has been having success with a new liposuction-alternative called [Renuva](https://www.mtfbiologics.org/our-products/detail/renuva). “Renuva is a biological allograft product that stimulates your body to grow its own fat cells,” he says. “This would be an ideal product for small contour irregularities after breast reconstruction as opposed to using a patient’s own fat.” 

### __Delayed Reconstruction Using Implants__

Depending upon a patient’s individual anatomy and treatment plan, he or she may choose not to combine their mastectomy and reconstruction procedures. Similarly, surgeons may recommend delaying the placement of permanent breast implants until a later date for better results. 

In such cases, tissue expanders are sutured into the breast pocket immediately following the mastectomy. In the weeks and months following the surgery, the expanders are gradually inflated in a plastic surgeon’s office using air or saline. “A tissue expander preserves the space where the breast needs to be,” says Dr. Unger. And, since placing a heavy silicone implant into an empty breast pocket would compress the fragile blood supply that remains post-mastectomy and lead to tissue death, he notes that the tissue expander “allows the mastectomy flaps to rest without putting undo weight there.”

![dr jason plastic surgery breast reconstruction subpec implant f (2)](//images.ctfassets.net/zw35sfestf1t/QWzB5aIWpQK0olqHTiNQD/617149c0afa434bc6b455775044c2c95/dr_jason_plastic_surgery_breast_reconstruction_subpec_implant_f__2_.jpg)
*A before and after of Dr. Roostaeian's unilateral subpectoral breast and nipple reconstruction.*

Although the expansion process can be uncomfortable, tissue expanders have the additional benefit of giving both plastic surgeons and their patients time to home in on an aesthetic goal. Once the expanders reach the appropriate size, they are exchanged for permanent breast implants. Dr. Roostaeian’s patient Caroline* (diagnosed at 39) admits that the expanders proved to be a necessary evil. “My expanders didn’t look natural, and were sometimes very painful after they were filled,” she recalls. “But they helped me get a really good idea of what size implants would ultimately be best for me.”

After years of monitoring benign tumors and then a cancer diagnosis at age 31, Dr. Unger’s patient Laura says she chose a nipple-sparing double mastectomy because of the quality of reconstruction available today. “I was tired of the breasts I had, but I wasn’t ready to give them up completely,” she confides. “I was really lucky because he was able to place the expanders on top of the muscle, which was a lot easier recovery for me.” 

Laura chronicled her journey on Instagram [@laura_birdwell](https://www.instagram.com/laura_birdwell/?hl=en) and her blog, [tatatocancer.blog](https://tatatocancer.blog/), and, once her expanders were filled, Dr. Unger exchanged them for permanent implants and performed simultaneous fat grafting. Like many reconstruction patients, Laura then had an additional surgery to further refine her results. “I think they look better now than they did before,” she says of her breasts.

### __Direct-to-Implant Reconstruction__

In some cases, women can skip the expander step by having their permanent breast implants placed immediately after their mastectomy. With its promise of only one surgery (which means less anesthesia and recovery time), the direct-to-implant option is understandably appealing — though it’s not for everyone. 

According to Dr. Unger, good candidates are usually women with “smaller, ideally shaped breasts,” who “want to be close to the same size, are very healthy, and have very robust mastectomy flaps” (read: ample blood supply). 

Hayley, diagnosed at age 30, initially had a lumpectomy. “That gave me time,” she says of the procedure. “They got the tumor out, and found out it hadn’t spread.” In her search for a highly skilled surgeon with experience performing pre-pectoral, direct-to-implant reconstruction, Hayley found Dr. Roostaeian after interviewing five or six surgical teams.

During this kind of reconstruction, Dr. Roostaeian uses a new fluorescence imaging technology called SPY to evaluate blood flow right in the OR. “It’s another tool in our arsenal to help ensure the long-term success of the reconstruction,” he says.

Kelly, diagnosed at 45, opted for a unilateral mastectomy and immediate reconstruction with Dr. Rogers. “I had cosmetic implants, and I really liked how I looked before,” she shares. “Whether or not to have reconstruction was never a question in my mind.” 

She was able to undergo a sub-pectoral, direct-to-implant reconstruction, in part because she already had breast implants placed under the muscle. Dr. Rogers also replaced the implant in the non-cancer breast to ensure symmetry, and Kelly ended up having a couple of subsequent surgeries — including fat grafting and nipple reconstruction — for further refinement. Eight years later, she is still very happy with the results. “You can’t even tell the difference,” she says.

While there are plenty of direct to implant success stories, there is also risk. Because of the fragile nature of post-mastectomy skin flaps, many surgeons prefer the two-stage (expander followed by implant) process. “Everybody wants less surgery. Everybody wants to be done and have it behind them,” says [Michael Newman, MD](https://aedit.com/provider/michael-newman-md-795), a plastic surgeon at South Bay Plastic Surgeons in Torrance, CA. “But it’s more important for me to give them a more durable, long-term result.” He prefers using a tissue expander because “it’s very light” and “doesn’t put any pressure on the skin or the mesh,” which “allows the sutures to heal.”

Additionally, the procedure is seldom as ‘one and done’ as it sounds. Patients almost always require additional surgeries to achieve their aesthetic goals. “Direct to implant is a nice concept,” says Dr. Unger, “But the vast majority of the time, you’re going to need to go back to the operating room to touch things up or round things out or add some fat.” 

## __Flap Reconstruction__ 

Autologous tissue reconstruction — more commonly known as “flap surgery” — involves the transfer of tissue from one area of the body (i.e. a donor site) to the chest to create a breast mound. Surgeons can either shift the tissue from one area to another, leaving the primary blood supply of the donor site intact (a.k.a. a pedicle flap) or completely remove the tissue from its original spot and reattach it to the chest in a free flap procedure. 

Free flaps require intricate microsurgery, during which plastic surgeons suture blood vessels together under a microscope to re-establish the blood supply between the donor tissue and the chest. It’s meticulous and time-consuming work (bilateral free flap surgeries can take up to 12 hours to complete), and patients are closely monitored in the hospital for up to five days post-op to ensure the flap is viable. 

The recovery process can be more complex than implant surgery because patients have multiple surgical sites to contend with (the chest and the donor area), though patients report similar pain and discomfort levels with each type of procedure.

### __Types of Flap Reconstruction__

Because of the donor site component, there are a variety of flap procedures for a patient to choose from based on their anatomy and aesthetic goals. The names are based upon the donor sites, including those from the abdomen (TRAM and DIEP), back or shoulder (LAT), inner thigh (TUG), and buttocks (GAP).

![10-16-2019 Editorial Before-After BreastReconstruction](//images.ctfassets.net/zw35sfestf1t/6tVaTrX0SELcdJYzGiEfbF/430d029fe1f2c807e002d916c354e783/10-16-2019_Editorial_Before-After_BreastReconstruction.jpg)
*A before and after of Dr. Newman's bilateral DIEP flap breast and nipple reconstruction.*

Among the plastic surgeons we interviewed, the most popular flap surgeries are the latissimus dorsi (LAT) flap and the deep inferior epigastric perforator artery (DIEP) flap. While a LAT flap is often used in conjunction with a breast implant reconstruction for better results, the DIEP is a free flap procedure that removes abdominal skin and fat only (similar to a tummy tuck) to create a breast mound. 

#### __LAT Flap__
- __Donor Site__: Composed of muscle, skin, and fat from the back
- Type of Flap: A pedicle flap (it remains attached to its primary blood supply)
- __Scarring__: Creates a donor site scar along the back that can usually be concealed in the bra line and an oblong scar around the new breast mound
- __Surgery Time__: 5 to 7 hours, on average 

#### __DIEP Flap__
- __Donor Site__: Composed of skin and fat (no muscle) from the abdomen
- __Type of Flap__: A free flap (it is completely detached from its original blood supply)
- __Scarring__: Creates a donor site scar between the hip bones (similar to a cosmetic tummy tuck) and an oblong scar around the new breast mound
- __Surgery Time__: 8 to 12 hours, on average

### __Advantages of Flap Reconstruction__

While flap procedures are more complicated to perform and require longer surgery times, Dr. Roostaeian says they remain the “gold standard” for breast reconstruction because they create a result that most closely resembles and behaves like a natural breast.

Unlike an implant, the new breast mound feels more like a natural breast because it is created with the patient’s own fat and skin. In the case of unilateral reconstruction, the plastic surgeon will be better able to match the new breast to the unaffected breast. Additionally, breasts created from flap procedures can fluctuate in size and shape as a patient gains or loses weight. 

“Flap surgery is ideal for patients who’ve opted for unilateral reconstruction because that flap changes with your body,” says Dr. Roostaeian, who adds that the results are, long term, much more permanent than implants. “When you choose the implant route, you’re basically signing up for more surgeries in your life because implants tend to have some issues down the road.”

![Flap Reconstruction (1)](//images.ctfassets.net/zw35sfestf1t/35Yvu4Q4Y1iyJmiDjQDUHU/9a54e787069024a30d7755bb2ce90c84/Flap_Reconstruction__1_.jpg)
*A before and after of Dr. Rogers' unilateral flap breast and nipple reconstruction.*

That lack of future revisions led Marjan, one of Dr. Roostaeian’s DIEP flap patients who was 47 at the time of her surgery, to choose the procedure. “I told him that because I was young, I didn’t want to have to go under the knife in my seventies,” she recalls. 

Dr. Rogers’ patient Meredith* didn’t want breast implants because she thought they’d look unnatural and possibly interfere with her active lifestyle. “When Dr. Rogers explained that the DIEP procedure would be a tummy tuck — replacing my breasts with my own tissue — and I wouldn't have implants, I was all in,” she shares. “I knew it would be a long 12- to 13-hour surgery the day of, but I was ready to go for it.”

Though she was initially concerned about scarring and the longer recovery time, Meredith is “beyond satisfied” with her reconstruction. And, with her nipple reconstruction also complete, she says her breasts appear so natural that it looks like she had a [breast lift](https://aedit.com/procedure/breast-lift) and [abdominoplasty](https://aedit.com/procedure/abdominoplasty) (i.e. tummy tuck) — not a double mastectomy.

Flap surgery is also an option for women whose implant reconstruction failed due to radiation or persistent capsular contracture issues. Dr. Roostaeian’s patient Caroline originally had bilateral, implant-based reconstruction, but radiation damaged her tissue and caused healing problems. “Dr. Roostaeian told me that the only way to permanently address the situation was to have a DIEP flap,” she says. “It was daunting, and I didn’t think I had enough fat, but he was able to create a small breast and augment it with an implant. It’s so natural that I wish I’d had enough fat to do the other side too.”

## __Nipple Reconstruction__

While skin- and nipple-sparing mastectomies have become commonplace, the patient’s diagnosis may not always allow surgeons to keep the nipples intact. This leaves patients with two reconstruction options: tattooing alone or combination of surgical reconstruction and tattooing. 

In the former, a medical tattoo artist matches the new nipple and areola to the existing one (after unilateral mastectomy) or creates two new nipple/areolar complexes based on the patient’s aesthetic preferences (after bilateral mastectomy). Shading and color variations help create the illusion of depth and projection.

Surgical nipple reconstruction, meanwhile, takes about 45 minutes and can be done either in conjunction with a follow-up reconstructive surgery or alone under local anesthesia. Surgeons use skin from the center of the breast to create a nipple, leaving a small horizontal scar. Patients can then have the areola and nipple tattooed for a more natural looking color and to conceal any visible scarring.

## __The Takeaway__

Just as no two breast cancer diagnoses are the same, the reconstruction process is a deeply personal experience that patients may choose to undergo when it is most comfortable for them. With that said, understanding the options available prior to having a lumpectomy or mastectomy can ensure the patient ends up with the best results for their anatomy and aesthetic goals. Finding the right surgical team and seeking the support of women and men who have been through the experience can help to make sense of the process.  

*Patient names have been changed

From immediate and delayed implant reconstruction to the numerous types of flap surgeries, The AEDITION has compiled an in-depth guide to post-mastectomy breast and nipple reconstruction.

A Comprehensive Guide To Breast Reconstruction And Nipple Reconstruction

A Comprehensive Guide To Breast And Nipple Reconstruction

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*When should I start getting Botox? Is it time to incorporate retinol into my skincare routine? What is a “mommy makeover”? How about a “daddy do over”? Do I really need to, as the saying goes, sacrifice my ass for my face? Should I swap my hyaluronic acid fillers for something a bit more permanent?* 

*When it comes to beauty and aesthetics, there is no such thing as one size fits all. But there are some tried and true principles that will keep you looking and feeling your best. In this series, [Coming of Age](https://aedit.com/aedition/category/coming-of-age), The AEDITION answers your most pressing questions about the best treatments, procedures, and practices — from surgery and skincare to health and wellness and everything in between — to consider at any age.*

Perhaps more than any other decade, the thirties are uniquely broken up into two parts: early and late. Aesthetically speaking, the “early” thirties are most similar to the twenties (check out guide to the decade [HERE](https://aedit.com/aedition/best-cosmetic-procedures-plastic-surgery-to-consider-in-your-20s)) in that the signs of aging are minimal, but visible signs of aging become more apparent on the face as elastin and collagen production slows in the mid- to late-thirties. The result: A newfound loss of skin elacticity. Below the neck, pregnancy, weight changes, and other life events may make procedures like body contouring, breast surgery, and hair removal more pertinent. 

While preventive measures like a good skincare routine, healthy diet, and minimally invasive treatments (i.e. [microneedling](https://aedit.com/procedure/microneedling), [chemical peels](https://aedit.com/procedure/deep-chemical-peels), and [botulinum toxin type A injections](https://aedit.com/procedure/botox-facial)) continue to have value, the thirties may also be the time to consider corrective face and body procedures into your routine. 

## __For the Face__

__Botulinum Toxin Type A Injections__
Neurotoxin injections like Botox®, Dysport®, Jeuveau®, and Xeomin® (read our guide to the muscle-paralyzing quartet [HERE](https://aedit.com/aedition/comparing-neurotoxin-botulinum-type-a-injections-botox-dysport-jeuveau-xeomin)) can be both preventative and corrective when it comes to the formation and appearance of wrinkles. “They will not only soften any pre-existing wrinkles that they may have but also to prevent ones that will develop over time,” says [Gregory Buford, MD](https://aedit.com/provider/gregory-buford-md-1015), a Denver-based plastic surgeon and founder of Beauty by Buford.

In aesthetic medicine, BoNT-A is used to reduce the appearance of fine lines and wrinkles caused by facial expressions (think: frowning, squinting, smiling, and the like) by injecting it into the muscles underlying the affected area. In turn, the lack of muscle contraction prevents the face from forming lines and wrinkles. Common treatment areas include the forehead, crow’s feet, and smile and frown lines, and results usually last three to four months. 

__Dermal Filler__
If your concern is less about preventing wrinkles from forming and more about plumping up or filling in ones that have already taken shape, [soft tissue fillers](https://aedit.com/procedure/periorbital-botox) like Juvéderm®, Radiesse®, Restylane®, and Sculptra® can be injected into the skin to restore volume, smooth out fine lines and deep wrinkles, and enhance the face’s natural contours. 

Made of hyaluronic acid, collagen, calcium hydroxylapatite, and poly-L-lactic acid (PLLA), to name a few, Dr. Buford says filler can be an easy way to mimic natural plumping and shaping in a way that complements the face instead of dominating it. Like BoNT-A injections, the results of filler are temporary and last anywhere from six months to two years. 

## __For the Body__

__Body Contouring__
While [plastic surgery cannot serve as a substitute for weight loss surgery](https://aedit.com/aedition/why-you-should-lose-weight-before-plastic-surgery), there are both surgical and non-surgical ways to lift, firm, and tone the body. Dr. Buford notes that he has seen an increase in men in their thirties seeking body contouring options for the “love handles, abdominal wall, and chest.” In the latter case, he says many of these patients have clinical gynecomastia (a.k.a. enlarged breasts) and a [male breast reduction](https://aedit.com/procedure/male-breast-reduction-gynecomastia-surgery) may be performed.

Another common procedure: [liposuction](https://aedit.com/procedure/laser-assisted-liposuction). The tried-and-true fat removal process works by suctioning excess fat from specific areas of the body (think: abdomen, thighs, hips, buttocks, upper arms, chest, and chin). It should be noted that while the fat cells are permanently removed during liposuction, patients can still regain any weight lost during the procedure if they do not stick to a proper diet and exercise. 

[Abdominoplasties](https://aedit.com/procedure/abdominoplasty) (read: tummy tucks) are also common for patients in their thirties — either alone or as part of a larger “mommy makeover” (*see below*). A tummy tuck can enhance contouring, reduce fat, and provide a lifted effect. For women who have been pregnant, a tummy tuck can serve as a means to bring the rectus abdominis muscles back together, if they became stretched or separated. Like liposuction, a tummy tuck also requires patients to maintain a healthy lifestyle post-procedure.

If you’re not in the market for surgery, non-invasive procedures like [CoolSculpting](https://aedit.com/procedure/cool-sculpting) and [EmSculpt](https://aedit.com/aedition/why-everyone-is-talking-about-emsculpt) offer toning benefits — sans scalpel. 

CoolSculpting destroys fat cells by freezing targeted fat deposits on the body (think: stomach, hips, thighs, chin, etc.) with an applicator applied to the skin. EmSculpt, meanwhile, improves abdominal muscle tone and strength by employing high-intensity, focused electromagnetic technology to induce 20,000 supramaximal muscle contractions over the course of a 30 minute treatment. Essentially, as you’re lying still, your body is experiencing the effects of 20,000 crunches. In both cases, best results require multiple sessions.

__Breast Procedures__
While men and women alike may choose to undergo a breast procedure in their thirties, women who have children may be particularly interested in a [breast lift](https://aedit.com/procedure/breast-lift), [augmentation](https://aedit.com/procedure/breast-augmentation-with-fat-transfer), or [reduction](https://aedit.com/procedure/breast-reduction-reduction-mammaplasty) after giving birth and breastfeeding (or may wish to revise a previous procedure) because pregnancy can cause large fluctuations in breast volume.

“While we know that pregnancy is definitely going to affect some changes in a woman's body, but to what extent is highly variable,” Dr. Buford says. “Many of our patients comment that the results of their breast enhancement is actually better after having kids, while others see changes from pregnancy to their breast augmentation that require small revisions once the baby weight has come off.” 

At the end of the day, Dr. Buford says choosing a procedure type and timeline is a personal decision that varies from patient to patient. Breast augmentation, for example, enhances size and shape and can restore fullness. A breast lift, meanwhile, will lift the sagging skin and treat drooping, which can often be a result of weight gain, pregnancy, and/or breastfeeding. Alternatively, a breast reduction can reduce the size of the breasts, while [nipple surgery](https://aedit.com/procedure/nipple-correction), which is less common, can adjust the size of the areola and correct inversion. 

__Hair Removal__
While [hair removal](https://aedit.com/procedure/waxing) can be pursued at any age, years of shaving and waxing may lead men and women to consider a more permanent solution in their thirties. Hair removal is a relatively permanent procedure — in other words, once you complete the required sessions, you will never have to shave, pluck, or wax that area ever again — and there are two main types: electrolysis and laser hair removal. 

While electrolysis is the only treatment classified by the U.S. Food and Drug Administration (FDA) as a permanent hair removal solution, patients who opt for [laser hair removal](https://aedit.com/procedure/laser-hair-removal) often experience similarly long-lasting results. Laser treatments work by pulsating highly concentrated light deep into the skin, generating heat that kills the hair follicle and prevents further growth. Treatments are scheduled around the hair growth cycle (read: every four to six weeks), with each session targeting new follicles until most (if not all) of the hair has been destroyed. Six sessions are typically required and minimal maintenance may be needed for the first few years. 

[Electrolysis](https://aedit.com/procedure/electrolysis), meanwhile, disrupts growth by targeting the hair follicle with shortwave radio frequencies through an epilator (i.e. a very fine needle). The device is placed into the natural opening of the hair follicle and emits a small electrical current to destroy the follicle and prevent new growth. It requires patience though. Depending on the area being treated, patients may need up to 30 sessions for full results. 

__Mommy Makeover__
For women who do not plan to have more children, the late thirties can be the ideal time to undergo cosmetic surgery that had been previously postponed. One of the latest buzzwords in medical aesthetics in the so-called “mommy makeover,” which can encompass any number of procedures. While it depends on the judgement of the plastic surgeon and the patient’s needs, mommy makeovers often include some combination of a breast surgery (lift, augmentation, or reduction), tummy tuck, liposuction, and circumferential abdominoplasty (a.k.a. body lift). 

A [mommy makeover](https://aedit.com/aedition/the-mommy-makeover-how-to-bounce-back-after-a-baby) is usually performed all at once and on an out-patient basis, meaning you can recover in the comfort of your own home. Because of the number and invasiveness of the procedures, recovery can take several weeks or months. During that time heavy lifting (including babies!) is forbidden, so women considering a mommy makeover — or any type of surgery — need to ensure they have sufficient help during the recovery process.

Since this is an all-inclusive option, a mommy makeover is not for everyone, but it can be the perfect solution for those looking for total rejuvenation after childbirth. Dr. Buford recommends women wait at least two to three months after they are done breastfeeding to ensure their bodies have recovered and they have had time to lose the weight gained during pregnancy.

## __The Takeaway__

While preventative care (think: [daily sunscreen](https://aedit.com/aedition/what-you-need-to-know-about-sunscreen), a healthy diet, plenty of exercise, and a [good skincare routine](https://aedit.com/aedition/celebrity-aestheticians-share-fall-2019-skincare-ingredients-products)) should continue to play a big role in people’s aesthetic journeys throughout their thirties, the mid to latter part of the decade is an ideal time to consider everything from minimally invasive to invasive face and body procedures. BoNT-A injections and dermal fillers, for instance, can help keep fine lines and wrinkles at bay, while larger procedures like liposuction, breast surgery, and “mommy makeovers” address the body.

From dermal fillers to body contouring procedures for men and women alike, The AEDITION breaks down the best surgical and non-surgical treatments to try in your thirties.

Plastic Surgery and Cosmetic Procedures To Consider In Your 30s

Coming Of Age: The Best Procedures To Consider In Your 30s

shutterstock 737351467

Just as brands like Band-Aid have become synonymous with adhesive bandages, Kleenex with tissues, and Wite-Out with correction fluid, “Botox” has been the colloquial term for botulinum toxin type A (BoNT-A) injections since it was approved by the U.S. Food and Drug Administration (FDA) for the temporary improvement of moderate to severe glabellar lines (i.e. the frown lines between the eyebrows) in April 2002. 

But Allergan’s wrinkle smoother isn’t the only BoNT-A injection in town. There is a quartet of cosmetic neurotoxins on the market — [Botox®](https://aedit.com/procedure/botox-facial), Dysport®, Jeuveau®, and Xeomin® — that each contain the same active ingredient (BoNT-A) and is FDA approved to treat the same aesthetic concerns. 

So, how do you differentiate between the four? The AEDITION is here to help. 

## __How Botulinum Toxin Type A Injections Work__

Before we get in to nitpicking the differences between Botox®, Dysport®, Jeuveau®, and Xeomin®, it’s important to understand what they are and how they work. 

For starters, botulinum toxin type A is the primary active ingredient in each product. And, while BoNT is considered one of the strongest and most lethal toxins discovered to date, small doses of the neuromodulator have the ability to temporarily paralyze muscles for cosmetic effect. 

In aesthetic medicine, botulinum toxin is used to reduce the appearance of fine lines and wrinkles caused by [facial](https://aedit.com/procedure/botox-for-dimpled-chin) expressions (think: frowning, squinting, smiling, and the like) by injecting it into the muscles underlying the affected area. In turn, the lack of muscle contraction prevents the face from forming lines and wrinkles.

The result? Smoother skin for three to four months (or until it wears off). 

## __Comparing BoNT-A Injections__ 

Now that you know what Botox®, Dysport®, Jeuveau®, and Xeomin® have in common, it’s time to understand what makes them unique — no matter how subtle the distinctions might be. 

“For the average patient, there is no difference between each of the products,” says [Johathan Cabin, MD](https://aedit.com/provider/jonathan-cabin-md-956), a facial plastic and reconstructive surgeon at the Center for Advanced Facial Plastic Surgery in Beverly Hills. “All of the products last a similar amount of time, and they all provide similar results.” 

Yes, the comparison is, essentially, apples to apples. But, as any Granny Smith apple fan knows, there is a difference between the tart green ones and, say, a McIntosh. The same logic applies to botulinum toxin injections. 

First and foremost, the four injectables are made by different manufacturers, which leads to different costs, potencies, and formulations. While the active ingredient in each product is botulinum toxin type A, some also feature protein blends that may affect the diffusion and efficacy of the injection. Such subtleties are why it is important to find a provider who is well versed in the market. 

“Dosage is slightly different for each of the products and the results they offer are subtly different,” Dr. Cabin, who prefers Botox®, shares. “The most important factor is to find a practitioner who is a very experienced injector and is confident using the product you wish to have injected.” 

![B8cYFUQJ (1)](//images.ctfassets.net/zw35sfestf1t/7ecXXAhyuKOYWTIOSX89p5/5131e5d0d1b24a7227c172dce1b456be/B8cYFUQJ__1_.jpg)
*A before and after comparison of one of Dr. Cabin's Botox® patients* 

According to the [American Society of Plastic Surgeons](https://www.plasticsurgery.org/cosmetic-procedures/botulinum-toxin/safety), the most common side effects of any botulinum toxin injectable are bruising and pain at the injection site, flu-like symptoms, headache, nausea, redness, and temporary facial drooping. While rare, it is possible that the toxin may spread beyond the treatment area, which could lead to botulism-like symptoms including trouble breathing and swallowing, muscle weakness, and slurred speech. 

If you’re one of the 7.5 million Americans who received a wrinkle-relaxing injection in 2018 or are looking to join the ranks, here’s everything you need to know about the four FDA-approved BoNT injectables on the market.

### __Botox®__ 

- __FDA Approval__: The OG was first approved by the FDA as a temporary aesthetic treatment to improve the appearance of frown lines between the eyebrows in April 2002. It has since been cleared to treat forehead lines and crow’s feet, too (in addition to all its "off label" uses). 

- __The Skinny__: Botox®, or onabotulinumtoxinA, is a product of Irish drugmaker Allergan, and it currently holds an estimated 80 percent of the BoNT-A injection market. With a molecular weight of 900 kDa, Allergan formulates botulinum toxin type A with protective proteins that a subset of patients may develop an antibody against over time, lessening the effectiveness of the treatment. The inactive ingredients in Botox® include human albumin (i.e. plasma proteins) and sodium chloride. There is also a therapeutic version of product that can be used to treat medical conditions like migraines, excessive sweating, and eye spasms (to name a few), but, as it relates to aesthetics, the average cost per unit is around $6 to the doctor and the number of units injected will depend on the area being treated. 

- __The Results__: Botox® is effective but not permanent. It takes about three to five days post-treatment for the results to appear (though it can take up to two weeks for the final effect to be visible), and it lasts about three to four months in most patients. The longevity depends on everything from the way a patient’s body metabolises the product to the area being treated.

### __Dysport®__

- __FDA Approval__: Dysport® was first approved to treat frown lines in April 2009, and, like Botox®, also has therapeutic uses to calm muscle spasticity.

- __The Skinny__: A product of Medicis Pharmaceutical, Dysport® (a.k.a. abobotulinumtoxinA) is slightly less potent than Botox® due to its molecular weight. While both have the same 150 kDa of BoNT-A at their core, the weight of the protective proteins in Dysport® are not uniform like those in Botox®. As a result, Dysport® has a higher rate of diffusion, which makes it ideal for treating larger areas (think: foreheads) — though more product may be needed to achieve results. Nonetheless, the cost is generally comparable to Botox®. Like Botox®, it is formulated with human albumin, and Dysport® also contains lactose and cow’s milk protein — making it unsuitable for patients with milk allergies. 

- __The Results__: While the effects of Dysport® may show up sooner (within 24 hours) than Botox®, some studies have shown that they may not last as long. The shorter lifespan could make it a good choice for patients who are unsure about whether they will like the results of BoNT-A injections. 

### __Jeuveau®__ 

- __FDA Approval__: The new kid on the block was approved exclusively for cosmetic use in February 2019. 

- __The Skinny__: You may recall the [splashy launch party](https://www.nytimes.com/2019/05/15/health/evolus-wrinkles-toxin-jeuveau.html) earlier this year that branded Jeuveau® (i.e. prabotulinumtoxinA) as “#NEWTOX.” Maker Evolus is hoping the newbie will prove to be a worthy competitor to Botox®, as they both carry a molecular weight of 900 kDa, are formulated with human albumin and sodium chloride, and offer similar results. But, with a price point 20 to 30 percent less than Botox® and marketing campaigns largely targeted at millennials, it would appear Jeuveau® is seeking to carve out its own patient niche. 

- __The Results__: Clinical data is limited due to the newness of the product, but trials have shown Jeuveau® to have a similar safety and efficacy profile to Botox®. Patients generally begin to see results in three to five days, and they last for three to six months.

### __Xeomin®__ 

- __FDA Approval__: Xeomin® was approved by the FDA for the treatment of frown lines in July 2011 (and it has also been medically approved to correct muscle spasticity and, most recently, excessive drooling). 

- __The Skinny__: Merz-made Xeomin® (a.k.a. incobotulinumtoxinA) is unique in that it is does not blend BoNT-A with complexing proteins (though inactive ingredients include human albumin and sucrose). As a result, the neurotoxin doesn’t need to be refrigerated and it may be slightly more comfortable to have injected because it is stored at room temperature. Xeomin® generally costs about the same as Botox® and Dysport® — but less units may be needed to achieve the desired result. Patients who show signs of resistance to Botox® and Dysport® may find success with Xeomin® due to the purified state of BoNT-A. 

- __The Results__: Results from Xeomin® injections take five to seven days to become visible and last a similar amount of time to Botox®, Dysport®, and Jeuveau®.

## __The Takeaway__

As you can see, each of the four neurotoxins have similar safety and efficacy profiles, but subtle differences do exist that may make one a better option for your particular needs. While nothing can replace a consultation with a board certified dermatologist or plastic surgeon, here are the key takeaways for each botulinum type A injectable.

### __Botox®__
- __Benefits__: Good for treating all areas — especially small ones (think: crow’s feet)
- __Onset__: 3-5 days
- __Results__: 3-4 months
- __Average Units__: 20 for forehead treatment
- __Drawbacks__: Patients may develop antibody resistance over time  

### __Dysport®__
- __Benefits__: Good for last-minute treatments because of faster onset time; ideal for treating larger areas (i.e. the forehead) because of diffusion 
- __Onset__: 24 hours 
- __Results__: 3-4 months
- __Average Units__: 50 for forehead treatment
- __Drawbacks__: Not suitable for small areas or patients with an allergy to lactose or cow's milk protein 

### __Jeuveau®__
- __Benefits__: Cosmetic nature eases government pricing regulations, which may lead to more affordability 
- __Onset__: 3-5 days
- __Results__: 3-4 months
- __Average Units__: 20 for forehead treatment
- __Drawbacks__: Newest to market, so long term safety and efficacy profiles have not been established 

### __Xeomin®__
- __Benefits__: Ideal for patients who have stopped responding to Botox® or Dysport®
- __Onset__: 5-7 days
- __Results__: 3-4 months
- __Average Units__: 20 for forehead treatment
- __Drawbacks__: Longer onset time

Wrinkle-smoothing botulinum toxin type A injections are the most common non-invasive aesthetic procedure in the U.S. And, while they are colloquially called “Botox,” there are actually four different BoNT-A injectables FDA-approved for cosmetic use. 

Comparing Botulinum Toxin Type A Injections: A Guide To Botox, Dysport, Jeuveau, and Xeomin

Comparing Neurotoxins: Botox, Dysport, Jeuveau, and Xeomin

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When considering a cosmetic procedure, it is so important to find the right doctor for you. This is a procedure that can last you a lifetime, and you want to be completely confident in the doctor you choose to work with. Throughout the entire research process, you should maintain a healthy dose of skepticism as you vet prospective doctors. As the number of people choosing plastic surgery procedures has increased over the years, unfortunately so has the number of unqualified physicians claiming to be experts in the aesthetics procedure industry. Follow the seven steps below to ensure you are selecting the right doctor for your procedure.

## 1. Confirm credentials
For a plastic surgeon, a board certification is critical. Unknown to most, in the United States, state medical boards do not require the surgeon to be specifically trained in the surgical procedure he or she offers. In other words, if a general surgeon one day decides he or she wants to start practicing cosmetic surgery instead of general surgery, he or she can! The board certification guarantees that the surgeon has been trained specifically in cosmetic or reconstructive surgeries. When consulting with potential surgeons, ensure they are board certified in plastic surgery as a first step. They should be board certified and members of either The American Academy of Facial Plastic and Reconstructive Surgery, The American Society of Plastic Surgeons (ASPS), The American Academy of Dermatology, The American Board of Plastic Surgery (ABPS), or The American Society for Dermatologic Surgery. 
 
Similarly, a certificate from the American Academy of Dermatology for Dermatologists and accreditation from the American Academy of Cosmetic Dentistry (AACD) ensure that doctors have received specialized training in the field dermatology and cosmetic dentistry, respectively.

*Ask: Are you board certified and a member of any professional organizations?*
 
## 2. Make sure the physician is skilled in the procedure you want
Once you have confirmed credentials, the next step is to inquire about the doctor’s experience with specific procedures. If you are looking to get a nose job, you want to make sure that the plastic surgeon you work with has plenty of experience performing [nose jobs](https://aedit.com/procedure/closed-rhinoplasty). While some of the knowledge is transferable, each feature has unique properties, requiring a completely different set of skills. For instance, [facial plastic surgery](https://aedit.com/procedure/midfacelift) would require the cosmetic surgeon to work with bone, cartilage, and potentially breathing passages whereas breast reconstruction is mostly soft tissue. The surgical techniques a plastic surgeon would use on soft tissue vary significantly from those used on bone or cartilage.

Take a step back for a second. If you (or a friend or child) needed a tutor to prepare for a history exam, would you hire an English teacher or a history teacher? While they are both teachers, the history teacher is an expert in the subject whereas the English teacher is less familiar. Opt for a doctor who is a specialist or has substantial experience in the procedure you are considering. A physician who names specific treatments, like [Botox](https://aedit.com/procedure/botox-facial), [veneers](https://aedit.com/procedure/veneers), or [breast augmentation](https://aedit.com/procedure/breast-augmentation-with-implants), will likely be a better fit compared to someone who claims to do all procedures equally as well.
 
*Ask: What did your training entail for the procedure I am considering?*
*How long have you been performing this procedure?* 
*How many times have you performed this procedure?*
 
## 3. Choose a doctor whose past work appeals to you
You found a doctor with top credentials and who is skilled in the procedure you are considering, but do you like his or her aesthetic? It is so important that both you and the physician you are aligned on what a successful procedure will look like. For instance, some plastic surgeons may like more turned up noses whereas others may not. Once you have an idea of what your ideal outcome will look like, begin browsing the before and after photos on doctors’ websites. If available, pay close attention to the before and after photos of patients with similar features to yours. This will give you good insight on the doctor’s consistency and how you may look after the procedure.
 
*Ask: In addition to what is online, do you have any before and after photos of patients with similar features to me?*
 
## 4. Inquire about the operating facility
One factor that should not be overlooked is the safety of the surgical facility. When undergoing a cosmetic surgery, you are not only working with the plastic surgeon but also an entire operating team and anesthetist. Accredited surgical centers adhere to strict standards, such as sanitation, staff, and equipment, to maximize patient safety. Accreditation is granted by passing regular inspections and submitting thorough records of the facility’s policies. With an accredited operating facility, you can expect qualified staff, a sterile operating room, anesthesia monitoring devices, and the up to date equipment for emergency situations and patient care. Look for facility accreditation certificates, such as AAAASF or AAAHC, and for an anesthetist who is either a Certified Registered Nurse Anesthetist (CRNA) or an anesthesiologist who is board certified in Anesthesiology. Additionally, when discussing the operating facility, you will want to see if the prospective plastic surgeon has hospital privileges to perform the considered procedure. If the plastic surgeon is only able to do the procedure in the surgeon’s office then that can be a red flag.
 
*Ask: Where do you perform surgery and what is the facility’s level of accreditation?*
*What is the anesthetist/anesthesiologist’s level of training?*
*Have you and your team handled emergency situations in the past?*
*Are you affiliated with a hospital and/or do you do surgery at one?*
 
## 5. Assess bedside manner and personality fit
Aside from poor results, the last thing you want is a pushy or rude physician. With such a life-changing procedure, it is essential you feel comfortable enough to express concerns or ask questions. A good plastic surgeon, cosmetic dentist or dermatologist will allow you to take your time as you absorb all of the new information and will lay out all of the pro’s and con’s of each procedure type so you can make the most informed decision. Realistically, there is not one perfect procedure and doctors must be open about the potential drawbacks of each option.
 
As you start scheduling consultations, take note of the doctor’s availability. If the schedule is wide open, that could be a negative sign. Typically, Mondays and Tuesdays are the busiest days for cosmetic physicians. If your schedule allows it, try to book your consultation for a Monday or Tuesday to gauge how much demand the doctor has. More so, speak to other patients in the waiting room about their experience with the doctor to get candid and honest feedback. If you are unable to get in-person insight, you can also read online reviews and forums, like AEDIT’s.

A certificate through the American Board of Medical Specialties (ABMS) is another positive indicator as you research doctors. ABMS certifies that doctors carry responsibilities safely and ethically as well as demonstrate empathy towards patients to provide optimal health care.
 
*Ask: What are some risks associated with this procedure?*
*What should I be most concerned about?*
 
## 6. Consider location
While it is important to work with a professional you trust, you want to ensure that the location is convenient as well. This is particularly important for invasive procedures, like a [breast augmentation](https://aedit.com/procedure/breast-augmentation-with-fat-transfer) or [tummy tuck](https://aedit.com/procedure/abdominoplasty). With larger surgeries, you want to make sure that you will be near a family or friend who will be able to pick you up from the surgery and act as a caregiver. Discuss with your doctor ahead of time what post procedure and recovery time will look like.
 
*Ask: Will I need a family member or a friend to pick me up from the procedure afterwards?*
*How long can I expect the recovery time to be?*
 
## 7. Review pricing
Expenses certainly matter, but this is not an investment to be stingy on. Keep in mind that “inexpensive” surgeries can turn costly if the end result is unsatisfactory. If the outcome is not right, reconstructive surgery may be needed, which can quickly increase the overall cost. That is why it is critical to get the results right the first time. 

Discuss pricing with the physician ahead of time and ask for a breakdown of all charges. In addition to the surgeon’s fee, you can expect fees for the operating room, anesthesia, and other services. Compare prices among different doctors to gauge what is reasonable for your desired procedure.
 
*Ask: Are there any additional charges to the surgery fee?*
*What can I expect as the total cost for the procedure?*

The most important thing to remember is to take your time in making a decision. While it can be a lengthy and labor intensive search, do not settle. Keep looking until you find a well-respected and board certified doctor that has the exact aesthetic you desire and has proper bedside manner. Cosmetic procedures can be absolutely transformative and life-changing when done properly, so remember not to rush!



When considering a cosmetic procedure, it is so important to find the right doctor for you.

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