Male Plastic Surgery: How is It Different?

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Beth Longware Duff, Medical Editor

Beth Longware Duff is an experienced writer and reporter whose work on a wide variety of topics has been published in numerous newspapers and magazines. Her health and medical writing credits include nationally distributed videos for the March of Dimes Birth Defects Foundation, and she is the recipient of numerous awards including an American Cancer Society Media Award and a New England Press Association Award for Health Reporting. She holds a degree in Communications from Ithaca College.


June 26 2008

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Plastic Surgery for a Man

Men may have accounted for only 9% of the cosmetic plastic surgery procedures performed in the United States in 2007, but their numbers are definitely on an up tick. Their surgical procedures increased by 5% over 2006, and minimally-invasive nonsurgical procedures like BOTOX® Cosmetic, microdermabrasion, and laser hair removal were up 21%. Over the last decade, male cosmetic surgical procedures have edged up by 3%, while nonsurgical procedures skyrocketed an incredible 886%.

The numbers would seem to indicate that American men have discovered plastic surgery and are glad they did. But, unlike some public restrooms, plastic surgery is not unisex. Male physiology requires some unique considerations when it comes to plastic surgery.

Take, for example, facial surgery. Surgeons know that a man's facial skin has a richer blood supply than a woman's. That means men are likely to bleed more during surgery and are at greater risk for forming a hematoma, a temporary pooling of blood under the skin, after surgery. So more care is taken to watch for both.

Speaking of faces, a plastic surgeon approaches facial surgery on a man differently than on a woman. For instance, if the hairline is receding or the hair itself is thinning, the surgeon will need to find another place to hide the scars of a face lift. Facial scarring is always an issue with men because they don't wear camouflaging makeup and generally don't style their hair towards their faces, the way women often do.

Another issue is the beard-growing skin on a man's face. Does it extend down the neck? If so, and the skin is pulled behind the ears during neck lift surgery, the patient may end up having to shave back there. One alternative to this scenario is electrolysis, a hair removal technique that destroys the growth center of the hair with a chemical or laser.

Hair transplantation was the fifth most popular cosmetic surgical procedure performed on men in 2007, and it has its own considerations. First, men should realize that the process requires multiple surgical procedures followed by long intervals of recovery. Natural-appearing hair replacement may take 18 months or more, during which time the incisions and transplant sites may be noticeable to others. If that seems excessive, there are alternatives such as flap surgery (a section of bald scalp is cut out and a flap of hair-bearing skin is lifted off the surface while still attached at one end) and/or scalp reduction (sections of hair-bearing scalp are pulled forward to fill in a bald crown).

Liposuction was by far the most popular cosmetic surgical procedure for men in 2007, perhaps because it is very effective for them. Men tend to retain their skin elasticity longer than women do, and the areas of fat under their skin tend to be firmer and have a better blood supply than in women. The ideal male body shape may be trim and athletic with broad shoulders and chest, a flat abdomen, and a narrow hip and thigh area, but fat tends to settle in the same areas as in women: the abdomen, breast area (where enlarged mammary glands are called gynecomastia in men), "love handles" or "spare tire", and along the chin and neck.

There are several cosmetic implants and sculpting techniques that are done almost exclusively on men. These include calf implants, originally developed to help reconstruct the lower legs of accident or polio victims and now often used to create cosmetic fullness, pectoral implants used to build up the existing chest muscles, and penis enlargement surgery. Abdominal etching, a relatively new procedure, is a liposuction technique that carves out a muscular, "ripped" appearance known colloquially as "six pack abs".

Finally, men who are seeking plastic surgery should understand that the postsurgical period is critical to recovery and that following their surgeons' orders is essential. These include taking adequate time off from work, wearing the requisite bandages and compression garments, getting plenty of rest, avoiding sun exposure, foregoing alcohol and tobacco, and laying off strenuous activity, including sports, exercise, and possibly sex. Numerous studies have concluded that men often don't admit to postsurgical pain, are hesitant to ask for help, and are as susceptible to postoperative depression as women. To avoid these complications, it's best to arrange for a support person to help out during the first week or so after surgery. That's the best way to guarantee a good recovery and optimal results.