Guys may not be talking, but the statistics speak volumes. More and more men are choosing to go under the knife — or needle — to combat their aesthetic concerns. The American Society of Plastic Surgeons (ASPS) reports that male cosmetic procedures (both surgical and non-surgical) rose 29 percent between 2000 and 2018, and the spike is changing the scope of dermatology and plastic surgery practices all over the U.S.
“I’m operating on three men this week,” says Nashville-based board certified plastic surgeon Jacob Unger, MD. “Out of about 20 patients I saw for consultations today, five of them were men.”
Fueled by today’s selfie-obsessed social media culture, the rise of less invasive procedures, and the marketing efforts of industry giants like Allergan (you know, the makers of Botox® and CoolSculpting®), men are increasingly more aware of the options they have to address cosmetic concerns.
“In my practice, I find that a lot of times it’s the wives who motivate their husbands to come in,” Dr. Unger says. “They see their spouse’s positive results and wonder, ‘So what can you do for me?’”
What Men Want
According to the American Society for Aesthetic Plastic Surgery (ASAPS), men represented seven percent of all plastic surgery procedures performed in 2018. Their top-five most requested treatments?
- Male breast reduction (up 47.9 percent between 2014 and 2018)
- Abdominoplasty (a.k.a. tummy tuck)
- Blepharoplasty (i.e. eyelid surgery)
- Rhinoplasty (read: nose job)
And then there’s the love affair with non-invasiveness. Last year alone, the ratio of non-surgical to surgical cosmetic procedures was two to one for men, with injectables, non-invasive body contouring, and hair removal among the go-tos.
“Men don’t like downtime,” says Dr. Unger, who has noticed an uptick in guys seeking minimally-invasive body tightening and fat reduction.
Another common request? “Brotox” — ahem, Botox®.
“One thing’s for sure: Men tend to need a lot more Botox®,” says board certified Los Angeles plastic surgeon Jason Roostaeian, MD, noting that male facial muscles are larger than their female counterparts, which leads to deeper expression lines.
While men’s skin tends to age better (guys are less prone to laxity and crepiness than gals) thanks to its thickness, blood flow, and numerous accessory glands, they are not immune to the visible signs of aging. As Dr. Unger explains, many men don’t invest time and consideration into their skincare and suncare routines like women, which can undermine some of the biological advantages.
Questions Men Aren’t Asking
Regardless of the invasiveness of the procedure, both surgeons find that their male patients usually approach the consultation and decision-making process differently than women. “Men don’t like to ask for directions. They also don’t like to ask about the intricacies and nuances of a procedure,” says Dr. Unger. “It’s often a game of 20 questions with men to pinpoint exactly what’s bothering them. Usually, you get to that ‘eureka’ moment where they’re like, ‘Yeah, that’s it!’”
Dr. Jason finds his conversations with male patients to be similarly one-sided. “The consultation is always a little bit more directed by me,” he explains. “I make sure I hit all the main points since they’re not usually asking all those questions.” Even so, men generally show up to the consultation ready to act — even when they don’t know exactly what they want.
Keeping It Au Naturale
One thing they do know? “Nobody wants to look done, and everyone wants to look natural,” says Dr. Jason, though the request is not as simple as it sounds.
As Dr. Unger explains, over-correcting aesthetic concerns in men can lead to more feminine features, so finding a surgeon who understands the balancing act of how to preserve a masculine appearance is key.
“It’s a whole different level of complexity because it’s not an idealized final result we’re looking for,” he says. “In men, a certain number of flaws or contour irregularities can be handsome, so it’s deciding what areas make a man look good but not old — what can you take away and still leave them looking like themselves? What is age-appropriate and strong without being overly smooth and overly youthful?”
Beyond the subtleties of technique, there are also physiological differences that surgeons must take into account when performing plastic surgery procedures on men. Take, for example, a rhytidectomy (a.k.a. facelift). Dr. Unger jokes that, before performing a male facelift, “you better eat your Wheaties” because the SMAS (the underlying facial tissue that’s manipulated during a deep plane facelift) is much tougher in men than in women.
Concealing the incisions from these procedures can present challenges as well. “Obviously you have to worry about the hairline,” says Dr. Jason. “Sideburns and beards are a huge factor. Plus, men tend to wear their hair short — or they could be bald.” He explains that strategic incision placement is critical because men are more sensitive than women about not wanting any telltale signs of plastic surgery. It should also be noted that face and neck lifts carry a higher risk of hematoma in men because they tend to have higher blood pressure and greater skin vascularity than women.
All of this is to say that, not only do men and women have different cosmetic concerns, but they also require different kinds of care. Dr. Jason and Dr. Unger put The AEDITION in touch with their male patients to get a better sense of what the plastic surgery process was like for them.
Robert* had concerns about “a few problem areas” around his torso that were becoming worse with age when he first visited Dr. Unger. But that’s not to say he was ready to take the plunge. He admits to having been “completely unsure” about having plastic surgery and was “mostly leaning toward not doing the procedure” due to the non-medical nature and risk of complications.
Ultimately, Dr. Unger put him at ease, and — with the support of his family — Robert decided to undergo liposuction to his abdomen, back, and love handles. He says that the recovery period, which included bruising and swelling, was much smoother than he anticipated, and he is “very satisfied” with the result. Although he currently has no plans to pursue additional treatment, he’s open to the possibility of having more plastic surgery in the future.
When Jared* went to visit Dr. Jason following a recommendation from someone at UCLA, he says he “wanted to look better facewise” but “didn’t want to go over the top.” Dr. Jason suggested submental liposuction to alleviate Jared’s concerns about his full chin area, but he was reluctant at first. “I never pictured myself getting surgery, no matter how big or small,” Jared recalls.
With the support of his family, however, Jared went through with the procedure and says he spent about a week in bed recovering. “I thought I'd have a Frankenstein-like face,” he says. “But the scarring was non-existent!” Despite being very pleased with his results, he has no plans for more cosmetic surgery at this time.
*Patient names have been changed
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