Procedures for Men
Male reconstructive procedures are very different from those for women because goals are different. Differences in desired brow size and position, nose bridge thickness, eyelid fullness, cheek projection, jawline prominence, lip volume, and chin projection are just a few examples.
Cosmetic procedures for men have become very common. Among men, botulinum toxin and dermal filler treatments increased 23% in just one year from 2016-2017 in the U.S, while the number of surgical eyelid procedures increased over 26% in this same period! Why the growing surge in male revitalizing procedures? The answer, of course, is different for different people and among different age groups.
The 40-65 Year Old Man
These men make up the largest group of those seeking revitalizing procedures, perhaps because many studies show:
- Most men over age 40 feel younger than their actual age. The 40-year-old feels 35, the 50-year-old feels 40, and the 65-year-old feels 50. The mirror doesn’t reflect the memory.
- Men over 55 are perceived to be less productive both per hour and per dollar than younger individuals, and workforce pressures induce us to look and be more competitive.
- Although most men marry and date younger women, appearing much older than their partner carries its own stigma.
- Healthcare advances and virility-supporting medications keep men feeling younger and healthier.
- A “cleaner, less haggard” appearance is directly correlated with both better health and financial success.
- The issues facing men in this bracket straddle some of the goals of younger men and some of those with greater maturity.
The 65+ Year Old Man
For most men in this range, the majority of procedures are directed at ameliorating the long-term effects of sun damage, gravity, facial deflation, and skull remodeling. Tasteful tissue re-suspension, while maintaining an individual’s natural character, is often the foundation of care.
Skincare today can be as complicated and involved as a person wants to make it; however, most men are looking for quick solutions that don’t take hours of morning preparation. The quick brush on a powdered sunblock every day after shaving goes a long way to maintaining healthy skin. Powdered sunblocks leave no greasy sheen or discoloration, won’t drip down into the eyes, and are essential for outdoor activities such as tennis, golf, hiking, hunting, and fishing.
For those interested in more aggressive skin damage reversal, rather than just maintenance, many specific treatments are available to ameliorate rosacea, enlarged ropy blood vessels, enlarged pores, and lackluster, sagging skin.
As the male face ages, softening fat is lost, the midface of the skull flattens, supporting structures weaken, and everything deflates and drifts downward. HA fillers, of which there are currently over a dozen available in the U.S., are safe and effective volumizing products that can be used to re-sculpt and reshape the face. They can be used to soften dark circles under the eyes, give a gentle elevation to fallen brows, fill in gaunt hollows in the cheeks, straighten crooked noses, and strengthen jawlines and chins. These products are injected and require no surgery. They break down to CO2 and water, and their safety profile is well known, as they have been used in eyes during cataract surgery for over 30 years. Best of all, if there is anything about them that is undesired, they are immediately dissolvable with an incredibly safe enzyme.
The Botulinum toxins, Botox, Dysport, and Xeomin, have been used safely around the world dating back to the early 1980s when our practice was among the very first to use Botox. These proteins can be highly effective in wrinkle reduction. However, the male face needs to be treated very differently than the female face. In the male, small smile lines around the eyes are often desirable, whereas the deep concentration lines between the eyebrows can give an angry appearance, the over-acting depressors around the mouth may give a down-turned, sour expression, and falling eyebrows may convey fatigue.
A relatively new enzyme is available, developed within the last decade, that selectively destroys fat cells. So, while HA dermal fillers can replace facial deflation and lost tissue volume with an injection, Kybella can destroy unwanted, fallen fat with an injection. Typical places that most benefit men are along saggy jawlines, under the chin, beneath the jaw, and along the top of the neck.
When you look at someone’s face, invariably, the first place you look is the eyes. Are they awake or asleep? Bright and intelligent or dull? Attentive or dismissive? Interested and engaged or bored? Energetic or listless? What messages do YOUR eyes convey?
In contemplating eyelid surgery in a man, many issues require consideration including the overall face shape; size and projection of the nose; soft or sagging cheek mounds; sharp-lined angularities; ethnicity; hairline position; presence or absence of facial hair; eyebrow shape, thickness, and location; upper eyelid position and weight; lower eyelid bulge or sag; and various asymmetries. As a rule, compared to women, a slightly heavier upper eyelid, a lower brow, and greater overall facial angularity are more desirable in a male face, but rules in aesthetics are meant to be understood so that they can be thoughtfully bent or broken to meet the needs of each individual.