Unlike the average American female, the typical male isn’t focusing on his flaws when he looks in the mirror. According to studies, he’s either overestimating his appearance or he’s indifferent to his reflection. He might feel differently if he could hear what his wife or girlfriend is thinking. A casual poll found that women wish men would do something about hairy backs and shoulders, baggy lower lids and “moobs” (man boobs). Given the tight economy, some women suggest eyelifts and facelifts for men over 50 in the job market. And most agree that yellow teeth are a turnoff. Admittedly, some men already know they could use a little zap, nip or tuck. While they’ve yet to catch up to women, the ranks of male cosmetic surgery patients are growing. In 2013, there were 14.4 million cosmetic procedures on men—a 22 percent boost since 2000, according to the American Society of Plastic Surgeons’ “2013 Plastic Surgery Statistics Report.” (Figures for 2014 were not yet available.)“We’ve seen a significant rise in procedures for men in our office,” says Dr. Lawrence Chang of Advanced Plastic Surgery Center, which has offices in Newark and Rehoboth Beach. Chang recently turned a treatment room in the Newark office into a “man cave” for procedures, including time-intensive hair transplants. Here’s a rundown of popular treatments for men to consider. But, ladies, if you leave this open on the kitchen table, don’t forget that many procedures aren’t gender specific.
Brighten and Whiten those pearly whites
A visit to the dentist is as much about good looks as it is about good hygiene. Nearly 100 percent of adults believe a smile is an important social asset, according to an American Academy of Cosmetic Dentistry survey. Whitening is perhaps the most well-known cosmetic treatment. Witness the number of products on supermarket and drugstore shelves. Dr. David Isaacs of Isaacs & Isaacs Dentistry in Brandywine Hundred recommends trying those over-the-counter products. “If you’re not happy with the results, you can do professional bleaching,” he says. Dentists’ in-home treatments include custom-made trays, which fit snugly on your teeth, and gels with a high concentration of the bleaching agent. In-office procedures involve light-activating gels. (Patients sit under the light for up to 90 minutes.) The dentist may recommend a combination. Even patients considering veneers—porcelain laminates that improve appearance, shape, size and length of the teeth—need to whiten their teeth first, Isaacs says. “Veneers are thin and translucent,” he explains. “The more you can control the color under the veneer, the better the veneer will look.” He also supervises orthodontia treatments. Many adults now favor Invisalign, a custom-made series of aligner trays made of plastic worn over the teeth that are hardly visible. (They’re not suitable for all patients.)
Cease with the creases
Both men and women have made Botox a household name. More than six million people got Botulinum toxin type A injected into lines in 2013, making it the leading minimally invasive procedure that year. Botox can smooth out those deep forehead wrinkles common on many men, says Dr. Ian Lonergan of Aesthetic Plastic Surgery of Delaware in Wilmington. “A little bit of Botox can make a huge difference.” Men get Botox to tackle the “11s,” the twin lines between the brows that can make a man or woman look like they’re perpetually frowning, says Dr. Jonathan Saunders of Christiana Cosmetic Surgery in Newark. Botox isn’t the only option. Dysport and Xeomin are other brand names for products with similar results. When comparing prices, consider that Dysport is less expensive but sold in a lower strength; it takes more to do the same job. Brands may offer promotional incentives that lower the price. Results last from three to six months. Fillers are best for deep folds—such as the lines between the nostril and mouth—recessed scars, hollow areas and furrows. Product names include Restylane, Juvederm, Perlane, Radiesse and Sculptra. What’s the difference? The products have varying particle sizes and consistencies. They’re also different materials. The first three contain hyaluronic acid, which occurs naturally in the body. Radiesse is made with heavier calcium hydroxylapatite. Sculptra, made with Poly-L-lactic acid, is for areas that lost collagen—the protein in tissues that gives skin elasticity and strength. Sculptra can plump up the hollow cheeks men develop as they age. As a test run, Chang first injects a sterile saline solution into the area, which lasts for about 24 hours. If the patient is pleased with the look, the procedure is scheduled. Unlike some fillers, Sculptra takes time. The body must generate new collagen. A fat transfer can also beef up sagging or hollow areas. However, it’s more complicated because it requires harvesting fat from another area of the body—such as the thigh or stomach. Fat can also be unpredictable, Chang says. “Sometimes 1,000 fat cells may survive on one side of the face but only 650 to 700 on the other.” However, some patients prefer a fat transfer because it’s natural. What’s more, it can last longer depending on how the body absorbs the fat.
Show them an eye-full
Botox and fillers can only do so much around the delicate eye area, especially if there’s sagging skin and fat deposits. Like women, men can develop excess skin above the upper lid that can creep so low that it impedes their vision. Doctors may suggest an upper lid blepharoplasty to remove the fat and excess skin, and insurance may cover the procedure. Depending on the patient’s comfort level and the amount of work involved, upper lid surgery can be performed under a local anesthetic in a doctor’s office. Lower lid surgery is often more complicated. Surgeons cannot only tighten the area, but they can remove the heavy bags that make people look “old and tired,” Saunders says. “We do a fair amount of that surgery.” Men require some special treatment. Consider that men’s eyebrows are normally straight across; the muscle structure pulls the brows closer to the lid, says Dr. Abdollah Malek of the Centre for Cosmetic Surgery, which has offices in Newark and Lewes. If the surgeon pulls a man’s skin too tight or adds too much space between the brow and lid, he can wind up looking feminine. Think Bruce Jenner. (To avoid that arched brow, Dr. Joseph Danyo in Greenville often discourages brow lifts for men.)No matter the gender, doctors today are judicious about how much fat or skin they remove. “If you take too much, eyes could appear sunken,” Malek explains.
Lose the Love Handles
Both men and women can diligently exercise and diet, yet they still have stubborn fatty spots. Liposuction, also known as lipoplasty, can help. The doctor makes a small incision in the area and inserts a narrow tub that’s attached to a vacuum. He or she then moves it around to suck out the fat. Several enhanced devices reportedly improve and facilitate the standard procedure. Ultrasound-assisted lipoplasty, for instance, uses ultrasonic energy to explode the fat cell walls and liquefy the fat, making it easier to remove. This technology is ideal for men, who often have denser fat than women, Malek said. Other devices produce a tightening effect while removing fat. While women often turn to liposuction to tackle saddlebag thighs and post-baby belly pouches, men tend to get it on their stomach and waist. Liposuction can also target fat under the chin and jowls. There are also noninvasive devices that promise to zap fat cells. Among the best known is CoolSculpting, which kills fat cells by crystallizing them. The body then processes and eliminates them as waste. Vanquish Fat Removal, Danyo says, is the “machine of the year.” This machine destroys fat cells by heating them. Both treatments have no downtime.
Say Goodbye to Sasquatch
Laser hair reduction has been around for decades, and it’s among the top five noninvasive procedures in 2013, although down 4 percent from 2012, perhaps because of the economy. The treatment is perfect for men who’re tired of looking like they’re wearing a sweater even when they’re topless on the beach. While there have been advances—the machines are more effective and cause less discomfort than in the past—the devices still target pigment, which means the best candidates have white skin and dark hair. Those with fair hair don’t experience as much satisfaction. Since hair grows at different rates, multiple sessions are needed. Most offices and salons offer package deals, but that’s no guarantee that all the hair will be gone in that specific number of sessions.
Harvest and Plant
Removing body hair is seen as a good thing. Losing hair on the head, however, can be disturbing, particularly if a man can’t carry off baldness with the same aplomb as Patrick Stewart or Vin Diesel. Hair transplants are an incredibly laborious process for cosmetic surgeons, which is why so few in Delaware offer the service. Men also may shy away from the time involved. The traditional technique is another deterrent. It involves stripping six to eight inches of scalp and hair follicles from one site and painstakingly moving follicles to the balding areas. Patients can experience post-operative pain, possible loss of feeling and scars in the donor site. Chang’s practice recently began offering NeoGraft, which extracts individual hair follicles and places them in natural-looking groupings of one to four hairs in the balding patches. There are no stitches, staples or linear scars. NeoGraft sends skilled technicians to the doctors’ offices, so the surgeon isn’t tied up in what is often an eight-hour procedure. Waiting for results is a bit like “planting tulips,” Chang says. The bulbs are in the ground, but it takes some time for new growth to occur. Expect full results within a year. “It’s a very high satisfying procedure,” he says. But it isn’t cheap. Patients can spend up to $15,000, depending on how many grafts are needed. Transplants aren’t limited to the scalp. For those whose soul patches look more moth-eaten than like a hip fashion statement, Danyo suggests moving individual hair follicles from the scalp to better populate the beard area.
Don’t like what nature handed you? Fix it. Take, for instance, large ears that lead to nicknames like “Jughead” or “Dumbo.” The name-calling can lead to poor self-esteem, which is why some doctors recommend corrective surgery, known as otoplasty, while children are still in elementary school. “I prefer to do it when the kids are aware of it and perceive it as a problem that can be fixed,” Saunders says. “The child is involved in the decision.” But the surgery isn’t limited to youngsters. Danyo has had requests from people age 20 and up. In the 1990s, insurance paid for the operation. That’s changed. Many people must now pay out of pocket, which has reduced the demand for the surgery. Rhinoplasty—known commonly as a “nose job”—is also less popular than in the past. The procedure dropped 9 percent between 2012 and 2013. That said, it was still among the top five surgical procedures in 2013. The demand, though, differs depending on the area. In the multicultural Mid-Atlantic states, people are more accepting of their natural noses, Saunders says. For those who are unhappy with their nose, rhinoplasty can address myriad concerns, from the shape of the bridge to the shape of the nostrils. Those hesitant about undergoing surgery can make changes with fillers, a procedure that Malek calls “liquid rhinoplasty.” Ears and noses aren’t the only areas that men can reshape. Scrotoplasty involves lifting the scrotum. Admittedly, area doctors aren’t experiencing a rush of inquiries. Saunders performed one scrotoplasty at the request of the patient’s urologist because the man’s scrotum touched the water when he sat on the toilet. Phalloplasty, creating or enlarging a penis, is also not a specialty you’ll find in Delaware. Most doctors interviewed wouldn’t touch either procedure. (However, a few are doing labiaplasty, which reshapes the folds of skin surrounding the female vulva.)
Give it a Lift
The more common facelift is not as popular with men as it is with women, In fact, its popularity among men dropped 16 percent from 2000 to 2013. Men shied away from the procedure partly due to the scars. Unlike women, men can’t hide them with a hairstyle. As an alternative, men can consider fillers. “You can fill in the cheeks and the trough underneath the eye,” Malek says. “You can also make the lips fuller.” Men who do elect to go the traditional route should find a physician with finesse. For instance, surgeons need to consider the man’s shaving pattern while shifting skin. “Otherwise they’ll be shaving their ears,” notes Lonergan.
Nix the Wattle
Even men who don’t care about a facelift are bothered by that loose piece of skin dangling under their chin. In about a 45-minute procedure, Chang makes a small incision and removes the offender. “It’s a really nice procedure, and it’s safe,” he says.
Lose the ‘Moobs’
Danyo vows that “man boobs” will never happen to him. Most women in our poll would approve. They say excess fat and/or breast tissue is unsightly. Moobs aren’t all about aging. Up to 70 percent of adolescent males experience hormone-related breast tissue growth, known as gynecomastia. It can affect one or both breasts. Although often temporary, it can be embarrassing and even painful. Older men can develop enlarged breasts due to hormonal changes. Gynecomastia can also be related to diseases or cancer. “You need to do a hormonal study and tests—men can get breast cancer,” Malek says. If the condition is primarily due to excess fat, liposuction can be effective. If there is glandular tissue, the doctor may need to make an incision around the aureole to remove it. “It’s hidden nicely,” Saunders says of the scar. Lonergan says many patients seeking the procedure are between the ages of 16 and 40. In part, that’s because older men might be left with sagging skin that requires removal and the patient could have scars, which might be so significant that they’ll be just as embarrassed to take their shirt off after the surgery as they were before it.
Create an Even Appearance
By middle age, men also have their share of spider veins and brown spots, and there are numerous lasers that can get the red out or lighten dark patches. Is an old girlfriend’s tattooed name a sore spot? Newer lasers do a better job of breaking apart the dye in less time, Malek says. Intense pulse light (IPL), also marketed as a PhotoFacial, emits a broad spectrum of light in pulses to treat a variety of skin imperfections, including redness and large pores Malek says there’s a trend toward using more than one laser in a session to treat different concerns. “One can tighten up the skin, another gets the red out and another improves skin texture.” Despite all the cosmetic procedures available, there’s no substitute for a good lifestyle, he adds. “Don’t smoke, eat healthy and have a positive outlook,” he says. “It’s completely free.”