Male ProceduresMen appear to age more slowly than women. Some basic differences between the sexes, which result in men’s aging more slowly, have been observed for many years. Think about the movie stars–Robert Redford, Michael Douglas and Sean Connery to name a few–who maintain the admiration and attention of many women despite their advancing years. The underlying reason for this aging discrepancy stems from the thickness of the facial skin. Men’s facial skin is much thicker due to hair follicles in the beard–added layers which make the tissues less elastic and, therefore, more resistant to the aging process.

Each year, over one million people have cosmetic surgery, with approximately 25%-30% of them being men. It is not surprising that men are concerned about their appearance. Many studies have documented the importance of one’s looks in determining success in the business world. How one appears can have a dramatic effect on self-confidence and interpersonal relationships as well.

This is not a new concept but one which dates back thousands of years. In one of the tombs of an ancient pharaoh, scientists were delighted to find a well-preserved inscription. Hoping to find a profound message, they were surprised to read a recipe to cure baldness! Through the ages, the Romans wore wreaths of olive branches on their heads to camouflage baldness. As recently as two hundred years ago, George Washington and the other colonists would shave their heads completely and wear ornate wigs, for style and vanity.

Styles may change over the years, but the desire to enhance one’s appearance is a deep-rooted basic instinct for most men. One of the most exciting things in the 21st century is the wide variety of options available for men to enhance their looks.

View before and after photographs.

Male Cosmetic Surgery Procedures

Dr. Brian Maloney offers several cosmetic procedures for men, including skin care and services including:

Botox Cosmetic
Facial Fillers
Eyelid Surgery (Blepharoplasty)
Brow Lift
Cheek Implant
Chin Implant
Facial Liposuction
Laser Resurfacing
Hair Restoration
Rhinoplasty
Ear Surgery (Otoplasty)
Facial and Neck Contoring

PreJuvenation and Male Cosmetic Procedures

An emerging trend called “PreJuvenation” indicates that young men between the ages of 20 and 30 are using Facial Fillers and Botox® Cosmetic as a preventative measure. Facial muscles that cause wrinkles can be trained to move less early on, thus stopping wrinkles before they start! Early maintenance can eliminate larger, more invasive procedures, and delay the need for cosmetic surgery later. It is important to  know that Social Media makes younger patients increasingly aware of their lines and wrinkles, and thanks to celebrities and the internet, they know that there are ways to correct it and maintain their youthful skin.

Skin Care and Skin Services for Men

A healthy complexion is the cornerstone of a youthful appearance. Fine lines and brown sun spots add years to one’s looks. Fortunately, great advances have been made over the past ten years in skin care products and skin care services.

Sun protection with a minimum of SPF-15 (which allows a person to stay out in the sun 15 times longer than if one were wearing no sunscreen) should be used daily. For early signs of sun damage, a good exfoliation program, combined with skin care services, such as lunchtime peels or microdermabrasion can help. These last two treatments involve no downtime but, if done regularly, can help to achieve and maintain a healthy complexion. Another benefit is that these peels will help reduce one’s chance of getting a skin cancer, the fastest-increasing type of cancer. Men are particularly susceptible to skin cancer because of outside recreation and work, combined with the thinning of the ozone layer. A good healthy diet, lots of water (at least eight glasses daily), and exercise also play a very important role in maintaining a healthy complexion.

Botox® Cosmetic
Generally, we think of muscles inserting into bones and tendons. The facial muscles are interesting because they insert directly into the skin. Therefore, each time they contract, the skin creases and, over time, wrinkles begin to appear. The forehead wrinkles are among the first to appear, usually in the thirties. The frown lines between the eyebrows generally develop next and then the crows’ feet or squint lines adjacent to the eye. One of the easiest treatments for these conditions is quick and generally does not involve any downtime: the injection of the muscles with Botulinum A, or Botox®. The procedure does not require any anesthesia. Ice or a topical anesthetic may be applied to the skin to dull the brief pricking sensation. However, Botox® is injected with the smallest needle made and as a result, is only a momentary inconvenience. Botox® lasts from 3-4 months for most men and can be repeated when facial activity begins to reappear. Complications are very unusual, making this one of the fastest-growing procedures for men.

Facial Fillers for Men
Fine lines and thin lips have been treated for years with collagen. The down side was that the collagen came from a cow; therefore, skin-testing to detect allergic reactions was necessary.
Dermalogen is a human collagen product which lasts about as long as collagen but doesn’t carry the possibility of allergic reaction since it is human tissue. AlloDerm® is also human collagen. In a study performed at our center, it was found to still be present in 89% of the patients a year after being placed. AlloDerm® initially came in sheet form, which requires a local anesthetic for placement. It has been popular in the lip area, the fold between the mouth and the cheek, and for acne scars. An injectable form of AlloDerm® called Cymetra® allows the patient to have an injection without the need of an anesthetic. Today, Hyaluronic Acids are the main type of fillers used to soften lines and add volume.

Eyelid Surgery for Men
As the aging process continues, excess tissue build up around the eyelid area. Due to the heavy male skin, the eyebrows commonly droop early, and men choose blepharoplasty in their late thirties to forties. Blepharoplasty refers to the procedure by which excess eyelid tissues are removed. Because the eyelid skin is the thinnest type of skin on the body, it heals the fastest.

Brow Lift
Before an eyebrow lift, as part of the examination, the position of the eyebrow should be evaluated. If the brows are drooping, or if there are deep frown lines between the brows, a minimal-incision or endoscopic brow lift may be appropriate. Men generally have low brows; therefore, typical brow height standards developed for women, do not apply. This is a good reason to make certain that your plastic surgeon has extensive experience in plastic surgery specifically for men. Previously, techniques to raise the brow would involve making an incision in the middle of the forehead, resulting in a scar which could take months to fade. The advantage of the minimal-incision face lift for men is that, even if there is thinning of the hairline, the small incisions that are generally about one to two centimeters long are difficult to find.

Forehead Lift
The endoscopic forehead lift can be done with a local anesthetic, but more commonly is done with general or twilight anesthesia. The procedure utilizes the latest in technology: very small telescopes and cameras which project the pictures to a large monitor from which the surgeon can view and perform the procedure. With this procedure, the frown muscles can be weakened permanently. (Because Botox® is a liquid; it generally gives a more absolute paralysis of the muscles, whereas the surgery weakens the muscles around 75 %.)

Men may experience bruising for one to two weeks and numbness for up to six months. A very important difference in male brow lifting versus female is that, in men, the brow should be raised to maintain a relatively flat shape. This is very important to avoid a post-operative feminine look. Generally, when women have their brow lifted, the goal is to arch the brow.

The goal of upper eyelid surgery in men and women is very different as well. In women, the goal is to create a crisp, sharply defined upper eyelid crease. In men, the eyelid should be underdone as compared to the women’s. Creating a sharp eyelid crease in a man generally creates a telltale sign of surgery. Most of the time, sutures are removed within a week, and the patient is back in action. The incision fades and ideally should be hidden by a slight overhang of the skin on the upper eyelid.

Options to treat the lower eyelid include removal of excess fatty tissue which causes puffiness. Laser resurfacing can be added to correct wrinkling or dark circles under the eyes. To remove a larger amount of loose skin, a small incision can be made to remove the tissues.

Facial and Neck Contouring for Men
With aging, tissues may accumulate along the jawline and neck. Three options are available, and all require a minimum of twilight anesthesia, with bruising possible for up to two weeks.
In the younger patient with fullness along the jaw and neck but good skin tone, facial liposuction can create a very nice improvement. A sling or suture may be placed from the chin to the ear to add definition in the neck area. Chin implants may be placed to help strengthen the profile.
With skin tone becoming more lax in the fifties, men may consider a facelift (rhytidectomy). The modern male facelift should consist of contouring the jawline with liposuction and tightening both the muscles and the skin.

As excess tissues develop, many men find a “wattle” of tissue directly under their chins. This “turkey neck” causes wear on shirt collars and is a noticeable obstacle when turning one’s head. The turkey neck can be excised in the midline using a relatively simple procedure, with a recovery period of about a week. The midline scar fades within a couple of months.

Laser Resurfacing for Men
Laser resurfacing is the gold standard for wrinkle removal. Surgery removes sags and bags, and the laser removes wrinkles and brown spots as well as helping to soften acne scars.

The carbon dioxide laser is a focused beam of energy, absorbed by the water in the skin. The laser vaporizes the outer layers of the skin, causing the skin to form new collagen. Exciting research indicates that the new collagen, which forms after resurfacing, is still present 20 years later. Patients look like they have had a sunburn at two weeks after the procedure. The sunburn look gradually fades over a period of 4-6 weeks. Laser resurfacing for acne scars may require pretreatment with AlloDerm® to build up some of the more depressed scars. Spot lasering can be done several times to gain additional improvement.

Rhinoplasty for Men
Plastic surgery of the nose is very popular with men. At The Maloney Center for Facial Plastic Surgery, a computer imager allows the patient and doctor to arrive at a common understanding of the patient’s goals, with the actual patient on one side of the screen and the desired changes opposite. The goals of male rhinoplasty generally involve maintaining a strong bridge, since a low bridge lends a feminine appearance. The tip of the nose should not be rotated up too much; an angle between the lip and the nose should not be more than 90-95 degrees.

Today, nose surgery is performed without packing, making it a much more comfortable procedure. Due to the male’s thicker skin, it may take up to a year and a half for all of the swelling to resolve. Men are also more prone to develop scar tissue, which may require a steroid injection during the follow-up period.

Ear Surgery for Men
Many times ear that are too large, or that protrude too far from the head, are corrected when a child is 5-7 years of age; however, many adults also have this corrected. The procedure is performed through an incision in the crease behind the ear. The patient may experience temporary numbness; otherwise, patients are back to their activities within a few days.

Candidates for Male Cosmetic Surgery

One of the first things Dr. Maloney will review is your health history. If you are in good health, we can begin to discuss the possibility of cosmetic procedures. Patients with poor health often consider Botox® or fillers. One of the most important criteria for having a cosmetic procedure is to have realistic expectations.

Benefits of Male Cosmetic Surgery

More and more studies show the direct connection between youth and beauty with respect to workplace success and personal happiness. A handsome man is one whose features are all in balance, working together. If a nose is too large, or ears too prominent, it will dominate the face and distract from other more attractive features.

Men seek the advice of a cosmetic surgeon to help achieve this well-proportioned and balanced look so that all their features are working together. Even if one started life with perfect facial proportions, due to the aging process, the balance begins to change: hairlines recede, noses lengthen, and chins begin to double-up with extra tissues.

When considering their options for a treatment program, men factor in the universal concerns of pain, bruising, and downtime necessary to experience a successful result. With advances in procedures, and better understanding of male facial structure, aesthetics, and proportions, results are much improved. Cosmetic surgery in men can offer a very exciting and rewarding change.

Additional Procedures for Men