Male Cosmetic Surgery

Male cosmetic surgery refers to a number of cosmetic surgery procedures to enhance or improve the features of a male subject. It provides an array of opportunities to gain the look and confidence they long for with their appearance.

These aesthetic procedures offer a variety of surgical options, or techniques, to customize the desired look of the patient. Some of the most popular male cosmetic surgery choices include:

• Hair transplantation for the resolution of thinning hair or hair loss
• Facelift or neck lift to correct facial aging and drooping
• Rhinoplasty to reshape or revise the appearance of the nose
• Masculinization and augmentation of the chin, cheek and jaw with implants or dermal fillers

Am I a Good Candidate for Male Cosmetic Surgery?

A GOOD CANDIDATE for male cosmetic surgery is a patient in good physical and mental health willing to undergo cosmetic surgery to correct, improve or enhance their features. The ideal patient is:

• Free of any serious medical conditions which can increase surgical complications and impair healing such as diabetes, high blood pressure, bleeding disorders and heart disease
• Over the age of eighteen
• At a healthy weight

Patients who are NOT GOOD CANDIDATES include:

• Patients who are overweight as they are more susceptible to various complications both during and after surgery
• Patients with unrealistic goals and a clear understanding of what can be expected from the surgery

A patient that does not want to undergo surgery may be a good candidate for dermal fillers.

Candidates for Specific Procedures

• An ideal candidate for hair restoration is any patient who is losing or has lost their hair due to male pattern baldness, trauma or aging. Patients with some hair loss that has stabilized, and wish to fill-in the thinned areas for a more youthful look, are also prime candidates
• Male patients with signs of facial aging including moderate to severe lines, wrinkles, folds and sagging skin may be suitable candidates for a facelift. Ideal candidates include patients with good skin elasticity and bone structure with loose skin that can be trimmed and tightened. Patients looking for a more targeted surgery to correct an aging face may wish to have a brow lift or eyelid surgery. Patients with saggy or excess skin on the neck, as well as neck folds or a double chin, may benefit from a neck lift.
• Candidates for rhinoplasty may include anyone with functional issues and/or cosmetic issues pertaining to the nose. Rhinoplasty can correct the shape and size of the nostrils, reshape the tip, correct humps on the bridge and alleviate breathing difficulties caused by the structure of the nose. Patients who have thin nasal skin are more ideal for rhinoplasty than those with thick skin since delicate skin provides the best results.
• Asian males, who want more of an anterior projection of the cheek and more projection of the angle of the jaw, may be a good candidate for masculinization of the lower features.
• Caucasian patients who desire more masculine features or better facial balance may be ideal candidates for chin augmentation to gain a stronger chin, cheek and jaw.

How is Male Cosmetic Surgery Performed?

There are several cosmetic procedures which fall under male cosmetic surgery and each is performed in its own manner. Furthermore, many of these procedures can be performed in conjunction with other cosmetic surgeries. Male cosmetic surgery is generally performed in a surgical facility or hospital on an outpatient basis. Surgical procedures may be performed using local or general anesthesia. Dermal fillers and hair restoration procedures are generally performed in a doctor’s office using local anesthetic. The total surgery time depends on the type of surgery and whether a combination of cosmetic procedures is performed at once.

Hair restoration can be completed via one of two methods:

• Follicular unit extraction (FUE) involves individually removing hair follicles from the back of the head, in a diffused pattern, and transplanting them to the lacking area. Prior to the procedure, the back of the head will need to be shaved. This procedure will not leave any scarring.
• Follicular unit transplantation (FUT) involves making a linear incision, at the back of the head, and removing a strip of hair follicles. The incision will be sutured closed and the grafts of hairs will be transferred to the lacking area. Scarring from the incision will be covered by the rest of the hair since shaving is not necessary.

Facial surgery on a man is slightly different than a woman since the intent is generally to maintain and/or enhance the masculine features while (usually) correcting aged spots. Since men have facial hair, the surgeon must be careful when lifting or tightening the skin to ensure the beard area remains where it belongs. The best option for maintaining masculinity with a facelift is to perform a neck lift at the same time. There are various techniques used for a facelift and they include:

1. Skin Only Facelift – This technique lifts and tightens only the skin layer. It is not used that often since it can cause a pulled or unnatural look. With this technique, the incisions are made along the hairline and ears. The tissue is pulled in an outward direction and then sutured into place.
2. SMAS Facelift – This technique involves lifting and tightening the skin and the SMAS (muscle layer) of the face. It is performed by making an incision near the ear and away from the jowl. This type of facelift is better for patients who are specifically looking to improve the lower face in order to define the chin and jaw.
3. Extended SMAS Facelift – A technique that involves making an incision at the ear but also dissecting into the jowl and neck for a more effective lifting and tightening of the SMAS muscle layer. With this technique, the surgeon will also release some of the facial retaining ligaments. The surgeon will then reposition them into a more youthful state to give a more effective lift.
4. Deep Plane Extended Facelift/Vertical Neck Lift – A more advanced facelift technique that is a step beyond an Extended SMAS Facelift. During a deep plane extended facelift, the neck skin and underlying muscles (the SMAS-platysma complex which extends from the lower jaw to the collarbone) are all elevated as a unit and lifted in a vertical direction. The excess muscle and skin is re-draped vertically onto the face, rather than horizontally, to maintain or create a masculine jawline. With this technique, the surgeon will also release the cheek ligament so the malar fat pad (or cheek fat) is restored and lifted into a more youthful position. By releasing the chin, neck and cheek ligaments, and restoring them into a better position, the patient has a fuller, rejuvenated appearance. A deep plane facelift can treat the mid-face and the lower portion of the face and neck.

Scarring from a facelift procedure is not usually an issue since the incision is made behind the ears and follows the hairline.

Rhinoplasty can correct numerous conditions pertaining to the nose and can be done at the same time as a face and/or neck lift and also at the same time as chin and cheek augmentation. Rhinoplasty can be performed as:

1. A closed procedure which means that all incisions are made inside the nose.
2. An open procedure usually involves an incision across the columella which is the narrow strip of tissue separating the nostrils.

During the procedure, the skin is gently raised so the surgeon can access and reshape the nasal structures. Depending on the type of alteration desired, there might be a need to remove bone or cartilage. Cartilage grafts, taken from the ear or rib cage and/or implants may also be needed. Once the alterations are made, the nasal skin and tissue is re-draped and the incisions are closed with sutures.

An alternative treatment for rhinoplasty is non-surgical rhinoplasty which uses dermal fillers to augment the nasal structure. Dermal fillers can be injected to increase the size of the nose and smooth out humps or bumps in the bridge. The surgeon will mark the area to be treated, inject the filler into the treatment site and sculpt the area for a natural appearance.

Masculinization and augmentation of the chin, cheek and jaw with implants or dermal fillers is performed when patients do not want to undergo surgery but they still want a stronger, more masculine chin or jawline. However, patients looking for a one-time surgical procedure to masculinize their lower facial features may opt for chin or cheek implants. Chin implants usually involve making an incision inside the mouth between the gum and lower lip. The implant is inserted and positioned in front of the jawbone. Cheek implants will be placed in a pocket, created in the cheek tissue, from inside the mouth. After the implant is placed, the incision is closed with a suture.

What is the Cost of Male Cosmetic Surgery?

The cost of male cosmetic surgery depends on the type of procedure, technique used, geographic location of the practice and the skill level of the surgeon:

• Hair restoration costs in the range of $6000 to $32,000 depending on the amount of hair being transplanted.
• A facelift can range from $5,000 to $12,000 depending on the type of facelift and if additional procedures are done at the same time.
• Rhinoplasty has an average cost of $5000 to $14,000.
• Chin or cheek implants range from $3000 to $6000.
• Dermal fillers are generally priced per unit and the total cost depends on the type of filler used as well as how many units are needed. Therefore, the cost of dermal fillers can range from $200 to $1000.

Recovery and Downtime

The amount of RECOVERY AND DOWNTIME needed depends on the type of male cosmetic surgery performed and how quickly a patient heals.

After hair transplantation, the scalp will be tender and a bandage will be worn over the area for a day or two. Most patients can return to work between 2 to 5 days after the procedure. Seeping, crusting and itchiness is likely to occur a few days after hair transplantation. It is important not to scratch or pick at the scabs since an infection and/or scarring can occur. The newly transplanted hair will fall out within 2 to 3 weeks but the new hair will begin to grow within a few months.

Recovery time after any facelift technique is similar since there are no special instructions for one over the other. However, patients who have a deep plane facelift and/or neck lift will see minimal bleeding and bruising since the procedure is performed beneath the muscle which causes fewer traumas to the skin. Bandages will be placed over the surgical areas. Patients need to keep the head elevated and also apply cold compresses to minimize swelling. Strenuous activities and bending over must be limited for the first few weeks after surgery. Stitches are generally removed approximately one week after surgery. Patients should expect to take off work between 1 to 2 weeks for facelift recovery.

Rhinoplasty recovery can be quite extensive and this is especially true regarding swelling. The area around the nose and eyes may be swollen and bruised depending on the type of work that was done. A splint and bandage will be placed on the outside of the nose and will be worn for about 1 week. Packing is usually placed inside the nostrils and will remain there for approximately 5 days. The packing can make it difficult to breathe and can lead to dry mouth, sore throat and issues with sleeping since many patients are not mouth breathers. Ice packs can minimize swelling and reduce pain. Patients should keep their head elevated for the first few days after surgery. Extra pillows are recommended at night and when resting. Patients should not bend over or rub or blow their nose during recovery since these actions can increase bleeding and swelling. Swelling and bruising will improve after 10 to 14 days but the swelling can persist for several months. Most patients can return to light duty work after 2 weeks but strenuous activities should be avoided for several weeks.

After chin and/or cheek augmentation with implants, the treated area will be covered with bandages. A support brace should be worn while sleeping for the first few weeks to keep the implants from shifting out of place. The patient should keep the head elevated and limit movement for the first few days to help speed the healing process and recovery time. Cold compresses can help minimize swelling, bruising and ease discomfort. Chewing may be difficult for the first few days so a liquid diet is recommended. Swelling and bruising usually dissipates after 5 to 7 days but they can persist for several months. Patients can usually return to light duty work after about 5 days. Regular activities can resume after 1 to 2 weeks but exercise and strenuous activities should be postponed for 3 to 4 weeks. Sutures inside the mouth are dissolvable and will liquify after 10 days. Sutures outside the mouth will be removed after about 10 days.

There is little to no recovery time needed for dermal filler injections. There might be some redness, bruising and swelling after the injections. Patients can resume all activities immediately after treatment.     

Results

The results after hair transplantation can take some time to see since the newly transplanted hairs must regrow after they fall out. The new growth will begin to show in just a few months but it can take 6 to 9 months to see 60% of the new hair growth and up to 12 months to see 100% hair growth. The newly transplanted hair is permanent since it comes from the back of the head which is genetically different than the rest of the scalp. However, as a person ages, further hair loss can occur with the already existing hair.

The results of a facelift depend on several factors such as the patient’s health, lifestyle and the severity of aging or skin condition prior to the procedure. However, the deeper dissection of the face and neck with the deep plane facelift creates a dramatic change that most patients desire. A deep-plane facelift can actually create longer-lasting results for a patient. The results can provide a correction of the visible signs of aging for up to ten years because the heavier tissues are independently supported in a deep-plane facelift. Therefore, they can remain in place for a much longer period before the aging process weakens these tissues once more.

With closed rhinoplasty, scarring will not be visible since all incisions are made within the nostrils. Patients may have minimal scarring at the base of the columnar from open rhinoplasty but the incision usually heals well and the scar is very fine. Rhinoplasty results are permanent but further injury or trauma to the nose can alter and/or void the results.

Chin and cheek implant results are permanent since the implants are made of a durable, solid material. Scarring is not usually an issue since the incisions are generally in the mouth and heal quickly. Since the swelling can take some time to lessen, the final results may not be seen until around 7 months post-op. Over time, the facial features will continue to lose volume and the skin will become lax as gravity causes sagging and wrinkles which can lead to the results changing in appearance.

Dermal fillers can provide immediate results when used for non-surgical rhinoplasty, volume loss in the cheeks and providing a more masculine chin and jawline. Most patients are pleased with their results using fillers. If a patient does not like the results, certain fillers such as Hyaluronic Acid are reversible with a simple injection of an enzyme. The results of dermal fillers vary since there are many different kinds. They can last from as little as 3 to 6 months or as long as 2 to 5 years. Nevertheless, fillers are temporary so the patient will need further treatments to maintain the results.

Limitations and Risks of Male Cosmetic Surgery

Male cosmetic surgery has certain LIMITATIONS and they vary per procedure:

Hair transplantation may be limited by the amount of donor hair a patient has available. It is also limited by the amount of hair that can be transferred in one session.

Certain facelifts, such as a SMAS facelift, are limited to only lifting the lower portion of the face. They cannot do much for reversing age damage throughout the mid-face. A facelift procedure is not limited by age. As long as the patient is healthy enough to undergo surgery, and has a need for lifting and tightening the face, they generally qualify for the surgery. However, the degree of their need for lifting and tightening can limit how successful the surgery will be.

Rhinoplasty is limited by age. Male patients should not have rhinoplasty until after the age of 17 or 18 when the development of the nasal structure is complete.

Dermal fillers are limited with how much volume they can add and how long they last per filler.

When it comes to RISKS, all surgical procedures carry some degree of risks:

• Adverse, or allergic, reaction to anesthesia
• Bleeding
• Bruising
• Infection
• Nausea
• Numbness
• Pain
• Poor wound healing
• Rash
• Respiratory issues
• Scarring
• Sore throat
• Stroke and/or heart attack
• Swelling
• Vomiting

HAIR TRANSPLANTATION RISKS include a condition known as folliculitis which is inflammation or an infection of the hair follicles. This condition can void the results if not treated with antibiotics. Shock loss is also a possible risk which causes the pre-existing hair, in the treatment area, to fall out. However, this condition is not permanent and the hair generally grows back. Hair that grows back in a different direction or looks unnatural is also possible.   

MALE FACELIFT RISKS include risk to the facial hair. The surgeon must be cautious whenever lifting and tightening the patient’s skin to ensure the beard area remains where it belongs. Men have thicker skin than women so their skin has a richer blood supply. Consequently, men are at greater risk for excessive bleeding during and after a facelift. They are also at risk for developing a hematoma which is a pooling of blood under the skin.

RHINOPLASTY RISKS include skin irritation from bandages, skin necrosis, injury to the septum, excessive bleeding, serious nasal blockage caused by swelling, sinus issues and unsatisfactory results. The bursting of small blood vessels on the skin’s surface, scarring at the base of the nose and permanent nerve damage are also possible risks with rhinoplasty.

The biggest CHIN AND CHEEK AUGMENTATION WITH IMPLANTS RISK is the implants shifting or migrating out of place. Other risks include blood clots, seroma, asymmetry and numbness from nerve damage.

DERMAL FILLER RISKS are low but can include lumps, bumps, asymmetry, swelling and bruising. An allergic reaction is also possible but certain fillers require an allergy test prior to full injection. An embolism can occur if the material is injected into a blood vessel and travels to the lungs.     

Choose an Experienced Surgeon

When deciding on which procedure to have, it is important for males to seek out a doctor with the proper skills and experience to perform the surgery. Only an experienced and skilled surgeon can properly identify the differences in the surgical needs between men and women. Because of masculinity and facial hair attributes, a man seeking male cosmetic surgery should choose a plastic surgeon with extensive experience in operating on men in order to achieve the best possible surgical outcome. Cosmetic Town connects patients with the best doctors. Find a doctor in your area!

Written by Cosmetic Town Editorial Team – MA

Based on an exclusive interview by Dr. Benjamin Talei in Beverly Hills, CA