Plastic surgery for men must take into consideration certain factors such as the masculine beauty ideal, underlying anatomies like skin thickness, ethnicity, and personal goals of each patient.
Inland Empire plastic surgery expert Dr. Tarick Smaili explains what makes plastic surgery for men different from women’s.
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In facial rejuvenation surgeries such as facelift and brow lift, surgeons follow certain guidelines. For instance, men generally require a more conservative approach than women—i.e., minimal lifting of the forehead area and less work on the lower face—to preserve their masculine appearance.
An over-aggressive brow lift often results in effeminate appearance (high and more arched eyebrow) instead of a masculine brow, which appears lower and “heavier” than women’s.
The same rule applies to body contouring surgeries for men, such as liposuction and pec implants, in which the goal is to recreate the ideal masculine silhouette, or the V-shaped, athletic-looking body.
Men’s skin is generally thicker and more vascularized (more blood vessels), so they are more prone to hematoma or pooling of blood under the skin than women. For this reason, proper dissection is more important than ever when treating male patients during facelift, brow lift, and rhinoplasty (nose job).
To minimize bleeding at the time of surgery and postop hematoma, all patients are required to avoid blood thinners (aspirin and aspirin like products), certain herbal supplements, and tobacco products a few weeks before and after surgery.
Aside from gender-appropriate results, plastic surgery for men must also respect the patient’s ethnicity and his cultural based standard of beauty. This is particularly true of rhinoplasty, eyelid surgery, and other procedures that involve ethnically sensitive areas of the face.
It is important to note that what works for Caucasian patients do not always apply to people of Hispanic, Asian, and African background.
Cosmetic plastic surgery is a highly individualized procedure in which the goal is to make the patient’s happy and possibly improve his body image and self-esteem. For this reason, good communications are of paramount importance to achieve satisfying results.
Meanwhile, anyone who exhibits signs of body dysmorphic disorder, schizophrenia, and other mental issues is a poor candidate for any type of elective surgery.
Plastic surgeries are generally reserved for well-rounded and emotionally stable patients who know how to make an informed decision.
Blepharoplasty a second time (or revision eyelid surgery) generally requires a different approach than the initial procedure to achieve natural-looking results and avoid complications, as suggested by experts at the California Surgical Institute.
There are two reasons why a complete redo is warranted: 1.) Botched results due to aggressive scarring or eyelid retraction must be addressed. 2.) Further aging sometimes results in reappearance of redundant skin around the eyes, although this is quite uncommon.
In most patients the results of upper blepharoplasty are near permanent that in the event of sagging recurrence, they will most likely benefit from a brow lift—which can eliminate the fullness in their eyelid platform—instead of a repeat surgery.
In the event that more than one blepharoplasty is needed due to progressive aging, it is rare for patients to require skin excision or removal because it has already been done in the initial surgery. Oftentimes, the goal is just to address eyelid ptosis or drooping due to muscle weakness.
The levator muscle, which is responsible for raising the upper eyelid, needs to be tightened to correct the drooping appearance. Just like in standard upper blepharoplasty, the technique uses a small incision within the eye crease to hide any telltale sign of the surgery.
But tightening the levator muscle sometimes results in dryness of the eyes, as the patients may not be able to blink normally. But over time, they should be able to close their eyes without any problem.
In the meantime, patients who are experiencing dryness will have to frequently use ointment and/or drops to keep their eyes lubricated.
But should blepharoplasty a second time is needed due to botched results, it involves a more complicated approach especially if too much skin has been removed during the initial surgery, leading to eyelid retraction and incomplete blink.
The general rule of thumb is to wait a minimum of six months before a revision surgery is attempted. The idea is that allowing the scar to mature and all the residual swelling to dissipate will make the corrective procedure easier, safer, and more predictable.
However, it might be better to intervene sooner in situations where the eyelid is severely retracted or deformed, or the patient is experiencing severe medical and visual issues.
Due to the complexity of revision blepharoplasty, a prudent patient must only consult a board-certified plastic surgeon who performs primary and corrective eyelid surgeries on a regular basis.
A facelift surgery eliminates or softens the visible signs of aging in the face and neck with the use of hidden incisions placed behind the hairline and/or within the ear’s contour. However, a more important goal is to create results that respect the patient’s anatomy, motives and expectations, and gender.
Male facelift procedures face unique challenges because of issues involving the anatomy and the patient’s goals.
Men have thicker, more vascularized skin than women, which predisposes them to increased risk of bleeding and persistent bruising. For this reason, renowned Los Angeles plastic surgeons will avoid any unnecessary surgical trauma and may possibly consider “modified” or minimally invasive techniques.
Another anatomical difference is that men tend to have a less severe cause of jowling than women. And because they require less contouring in the area, the incisions typically just stop behind their ear.
On the other hand, patients who have jowling and neck sagging will need their incisions to be extended into the lower scalp or nape area. Nevertheless, the resulting scars remain well concealed within the hairline and “inside” the natural folds of skin.
Another challenge of male facelift surgery is the susceptibility of men from hair loss, making it trickier to hide the scars. But one compromise is to modify the incision pattern in which the scars are only around the ear’s contour, avoiding the temporal area (used in standard facelift technique) because there is no hairline to conceal the surgery’s “stigmata.”
However, a facelift technique that is limited to the ear’s contour will not provide the same rejuvenating effects as those delivered by the standard approach in which the scars start from the temple area, behind the hairline.
But despite the limited rejuvenating effects of minimally invasive facelifts, they are suitable for a good number of male patients because they tend to have a more conservative goal—i.e., to soften the deep wrinkles without actually eliminating them.
Some doctors will deliberately allow some wrinkles to preserve the masculine and “more mature” appearance. This is a way better option than rely on excessive skin pulling, which is tied to a wide range of cosmetic problems such as visible scars, overly tight look, and probably the worst, effeminate countenance.
In some cases, the only way to correct the overly tight appearance is to wait for the skin to relax again, which can take a couple of years.
Meanwhile, it is not uncommon for male facelift patients to ask for brow lift performed at the same time as their surgery. In this procedure, it is important to raise the brow conservatively to preserve the “heavy” masculine look.
Facial plastic surgery such as facelift, rhinoplasty (nose job), fat grafting, brow lift, and eyelid lift involves postop bruising and swelling that may prevent anyone to join social activities for a couple of weeks.
Take note that healing from such procedures takes many forms—e.g., social recovery, physical recuperation, and return of normal sensation.
For many patients, the hardest part of the recovery is not really the postop discomfort, which can be easily controlled by painkillers, but the interruption in their social activities.
The list below explains the length of social recovery after a specific type of facial plastic surgery and what kind of postop symptoms one should expect during the initial healing phase:
- Facelift. Five to seven days after surgery, the swelling and bruising will rapidly improve that most patients can return to their social activities by eight day, although usually with the “assistance” of camouflage make-up and/or fashion accessories such as sunglasses and scarves.
- Rhinoplasty. The postop bruises are the most apparent around the eyes and will take a week to subside to a significant degree. However, social recovery greatly varies from patient to patient, with some people able to look “more acceptable” within a week, while others have to wait for two to three weeks especially if they have a thick nasal skin.
- Fat grafting. This involves injecting a small amount of fat into the area that needs more volume, leading to mild swelling and bruising that can last for seven days, although some patients may have to wait for another week to appear “socially presentable.”
- Eyelid surgery. This involves a rather straightforward recovery with the use of very fine incisions made within the natural upper eyelid crease and close to the lower lash margin. For this reason, most patients can have “dinner with friends” after about five days, although big sunglasses remain helpful to hide any residual swelling and bruising, and to protect the scars from harsh elements.
- Brow lift. With endoscope or small camera probe, the procedure will only need several small incisions that can lead to about a week of social recovery; however, the initial healing phase could take longer with the standard technique in which one continuous incision from ear to ear, behind the hairline, is used.
A brow lift, also referred to as forehead lift, is a cosmetic plastic surgery that aims to raise the sagging soft tissues of the forehead, to remove or at least soften the wrinkles above the nose, and to correct the low-lying eyebrows. If meticulously executed, the procedure has a high patient satisfaction because of its rejuvenating effect.
However, over-aggressive surgical maneuvers more often than not lead to botched results manifested by a perennially surprised appearance, feminization of the face (on male patients), and visible scarring.
To avoid botched results, Beverly Hills plastic surgeon Dr. Karan Dhir shares his four guidelines to achieve natural results from brow lift.
1. Don’t perform it on someone who doesn’t need it.
The vast majority of botched brow lifts happen because the procedure is unwarranted in the first place. Sometimes, inexperienced surgeons perform the surgery on patients who only require an upper blepharoplasty (removing the excess eyelid skin).
As long as the lateral part of the brow is in good position and there is no excessive hooding of the skin in the area, brow lift is unwarranted.
2. Don’t be too aggressive.
A perennially surprised appearance is often caused by lifting the brow too high. For most patients, just a conservative amount of lift in the lateral aspect of the brow is enough to make a difference.
Because “less is more” in brow lift, temporal or short-scar techniques in which small incisions are positioned behind the hairline near the temple area are the most commonly used methods by skilled facial plastic surgeons.
3. The patient’s gender largely dictates the ideal brow lift technique.
For women, the outer brow (towards the temple) should curve higher than men’s to achieve a more rejuvenated appearance. Male patients, meanwhile, will look more attractive if their brows appear “heavier” and lower compared to females’.
In brow lift for men, being too aggressive in skin lifting is particularly detrimental because of the feminization effect. Nevertheless, both genders will benefit if the inner brow (above the nose) is left untouched or only lifted in a very conservative manner.
4. Brow lift involves attention to detail, especially when it comes its shape.
A youthful, feminine brow lies slightly above the level of orbital rim, i.e., upper border of the eye’s bony socket. Its shape also has some gentle curves, with its “tail” higher than the medial end.
Meanwhile, men’s brow is supposed to appear less “curvy” and heavier than women’s.