Plastic Surgery: It’s Not Just for Women Anymore
Plastic Surgery: It’s Not Just for Women Anymore | Male Plastic Surgery, Gynecomastia, Male Facelift, Body Contouring, Goco Center for Aesthetics, Dr. Paul E. Goco, Dr. R. Bruce Shack, Vanderbilt University Department of Plastic Surgery, BOTOX, Laser Resurfacing, Panniculectomy

“Before and after” facial procedures, compliments of Goco Center for Aesthetics
More Men Looking to Cosmetic and Aesthetic Options

You know the times are changing when BOTOX® injections are advertised as a Father’s Day special.

“We had a handful of takers, too,” said Paul E. Goco, MD, a plastic surgeon and owner of Goco Center for Aesthetics in Murfreesboro. “It’s becoming more common – and more acceptable – for men to have things done. In the past, it wasn’t so acceptable. It’s more mainstream now.”

In fact, according to the American Society for Aesthetic Plastic Surgery, men accounted for 9 percent of the cosmetic procedures performed in 2011, a 121 percent increase since 1997. That’s about 800,000 guys. When it came to surgical procedures in 2011, the top five for men were liposuction, rhinoplasty, eyelid surgery, breast reduction to treat enlarged male breasts and facelifts.


The Face and Neck

Goco said most older men usually don’t turn to a plastic surgeon for dramatic changes. They are, instead, looking to excise extra skin and fatty deposits around their eyes and/or eliminate sagging neck skin, known as the turkey waddle. Especially in today’s economic downturn, “older men want to look younger when they’re competing with the younger individuals,” he said. Some men also turn to fillers to take care of hollows under the eyes and to lessen shadows.

R. Bruce Shack, MD, chair of the Department of Plastic Surgery at Vanderbilt University Medical Center, said Vanderbilt’s most common plastic surgery on men is eyelid surgery. “That’s the central focus of the face and first thing people notice when they look at you,” he said. He noted the tendency toward “droopy eyes” is hereditary.

Men are also more interested in minimally invasive BOTOX injections, which lessen deep facial creases, and laser treatments or chemical peels that improve the skin’s surface. “They come in for BOTOX; they like it; and once they get a taste of it, then they look at other areas to work on,” said Goco, adding that he is having more important discussions with men about skin care and sunscreen. Men like to take “baby steps,” he added.

Even younger men in their 20s and 30s are opting for facial plastic surgery, particularly if they have what’s called a weak chin. Goco said studies have shown that a strong chin denotes authority and management prowess – and liposuction and a chin implant “totally changes a person’s look. That’s more of a metamorphosis with the younger person looking for more leadership qualities in their appearance. It’s more of image-projection.”


The Male Facelift

Men considering a facelift recoil at Internet pictures of Kenny Rogers or Bruce Jenner, whose surgeons pulled their skin much too tightly and literally changed their appearance. “It totally changed his face,” said Goco, referring to Roger’s now-notorious procedure. Goco added, “For men, it’s more subtleties. You want to stay very conservative when you approach a man’s face. For a male facelift, you don’t want to pull as tight as a lady’s facelift,” he said.

Shack concurred. “The number of male facelifts that we’re doing has actually gone up a little bit over the last few years as well,” he said. “In men, it’s a different operation than women.”

A male facelift is more challenging because of his beard and sideburn, and simply because the face is just bigger anatomically. Therefore, more dissection is required. On top of that, the male complexion is much ruddier with more vascularity in the skin. “That makes it a bloodier operation, and the risk of post-op hemorrhage is higher in men than in women,” Shack said.

Then there’s that finger’s width patch of skin in front of the ear and behind the sideburn. “When you do a facelift in men, you have to be very careful not to pull that sideburn back to their ear. It looks very weird, more Neanderthal, like you’re growing a beard on your ear. That’s not very attractive,” Shack said.


The Body

Body contouring also is more commonplace among men these days, particularly men who have experienced massive weight loss. Men may even need the so-called tummy tuck to get rid of the residual folds of skin. In fact, if the condition is severe enough, some third-party payers will cover a panniculectomy, which is the removal of an apron of skin that hangs from the abdomen.

“There have been some advances in some of the body-contour techniques that we use, modifications of the traditional liposuction techniques, that allow us to do things on the trunk that we weren’t able to do just a few years ago,” Shack said.

Other body-contour, plastic-surgery options are an upper- or a lower-body lift. The lower body lift, called a belt abdominoplasty, removes excess fat and skin circumferentially. The patient lies on his belly for half the operation, and then he’s flipped over to complete the operation. The procedure also involves lifting the lateral thigh and buttock.

An upper-body lift corrects a man’s gynecomastia (enlarged male breasts) and also excises excessive skin that hangs under the arms and wraps around the back. In women, that problem is colloquially called a bra roll.

Male gynecomastia may certainly be caused by weight gain, but it may also be a developmental abnormality that makes young men self-conscious. Shack noted that all boys experience minimal breast swelling when they go through puberty. In 99 percent of cases, the swelling goes away in a year or two. “But in some, that swelling actually exacerbates, and they have breasts that would be the envy of a teenage girl. In those cases, that requires surgical correction. Depending on the degree of the enlargement, modified liposuction techniques are all that’s necessary. But oftentimes it requires surgical excision of the excess breast tissue,” Shack said.


The Marketing

While men aren’t yet major consumers of aesthetic and cosmetic procedures, the numbers are growing – and they offer growth opportunities for physicians in the field. Asked how he markets his ever-expanding array of aesthetic opportunities for men, Goco replied, “Through their wives.”