Men’s facial surgery

Men and surgery

Introduction to men's facial surgery

Facial Plastic surgery in men has gone from a taboo to just another consumer choice. A study by YouGov found that a quarter of all men in the UK would consider cosmetic surgery. Only a few years ago, men who wanted to enhance or freshen their look would more like likely be referred to a therapist than a plastic surgeon! But times have changed, and changed significantly. Whether due to media, television and magazine images, celebrity endorsement or a change in global social trend, male facial plastic surgery is the fastest growing sector in the cosmetic surgery industry.

Now that the social stigma has faded, men say that looking younger to fare better in the workplace is one of the primary reasons for having cosmetic surgery. With the advent of youtube, the internet, teleconferencing and 24 hour visual reportage, image in business has never been so important. It isn’t just the wealthy either who are undergoing tweaks, facial cosmetic surgery is a choice now taken by a wide range of professions and social groups from a wide geographical spread.

Changing of trends

In faces, as in fashion, trends change. Square jaws (think Michael Fassbender and Daniel Craig) are in, replacing yesterday's elfine features of Leonardo DiCaprio and Zac Efron. Keeping up appearances can be difficult for men, people are looking younger and fitter well passed their 50’s. Facial cosmetic procedures aren’t just the realm of fashion conscious metrosexuals either, in my practice, male patients seeking cosmetic correction are predominantly ‘men’s men’ who are looking to stay ahead of the game. And, rightly or wrongly (a whole different debate!) our image conscious society has set the benchmarks.

The awful results of yesteryear are thankfully a thing of the past. Small button noses on men, feminising windswept facelifts and hollow eyelids quite rightly have put off many men considering facial cosmetic procedures.

Fortunately for the time-strapped executive, facial surgery can now fit into the tightest of schedules. Instruments are finer, incisions are smaller and heal faster, anaesthetic techniques mean that a black and blue period of hiding away is no longer necessary. Micro-liposuction can define the jawline in half an hour under mild sedation, with no sutures and only minor bruising. Some newer procedures don't require any incisions such as Exillis, Radiofrequency skin tightening and laser resurfacing. These are ideal procedures for guys in their thirties who are starting to see some skin laxity. The results are subtle but significant, and patients can go back to work the next day.

But is this all just vanity? should men (and women) just ‘grow old gracefully’? I leave the philosophical musing up to others far more qualified to comment but in real terms the answer is an emphatic no. Real objective benefits are accrued from enhancing our subjective beauty. This has been proven time and again in the sociological literature. Better looking people get higher grades, find work more quickly, are promoted faster, and earn 10-15% more than those with below average looks. It doesn’t end there, we are more likely to help a better looking person in need of assistance and we want to be around and associated with good looking people too. This effect, coined the ‘Halo Effect’ by psychologists has never been better demonstrated by Friends, one of the most popular programmes in television history.

Specific differences in male facial plastic surgery

Whilst all the techniques and innovations in facial plastic surgery are cross-transferrable between the sexes, operating on the male face does have some very specific differences. This is all down to anatomy, more specifically facial skin thickness and hair bearing facial skin.

Men have much thicker skin than women, the fasciocutanous ligaments that bind the skin to the underlying tissues are stronger, more plentiful and the blood supply is greater. Male skin needs a greater blood supply to nourish not only a greater dermal thickness but the hair follicles in our beards. There are pros and cons to these differences. There is no doubt that male facelifting is harder work. I use the analogy of drilling for minerals. Lifting female facial skin is like drilling through sandstone whereas lifting male facial skin is like drilling through granite. This makes the operation slightly longer and increases the risks of bleeding. It has been proven that men are less compliant with post operative guidance too!

On the positive side, the skin thickness that makes my work harder has huge benefits for healing: men tend to heal faster, have less bruising and scar better.

Male hairlines and beards mean there are other gender specific considerations as well. High forehead and male pattern baldness makes the placement of incisions more challenging. Very careful planning of scars in front of the ear is necessary so that hair can still be worn short and beard hair is not advanced into the ear.

My male facial plastic practice

The techniques I have developed, specifically hidden hairline incisions, a 70º vector of facelift, exclusively day case local anaesthetic surgery and significantly reduced downtime seems to self select the male population of patients seeking facial surgical correction. All of my male facelift patients to date have been back at work 7 days after surgery. Some behind desks, others in front of television cameras.

Currently 20% of my practice is male facial rejuvenation but this is increasing exponentially. I am also seeing lots of men who have undergone previous facelift surgery who are seeking scar revision and concealment.

Michael, 55, before and 6 months after face and neck lift