What Men Want

If cosmetic surgery is considered a taboo for women, for men it’s even more of a stigma. That’s why so many men are flocking to get minimally invasive procedures that leave little evidence and no downtime

Why are more men than ever turning to cosmetic surgery? Some doctors will tell you it’s the economy. First it was the roaring real estate and stock market boom that peaked in 2006, followed by the Great Recession. The good times made it affordable, as disposable income soared. The tough times made it necessary, as men had to look younger to stay competitive in the workplace.

“The first jump in my male patient load came about three to four years ago, when the economy was doing really well,” says cosmetic surgeon Curtis Schalit, DDS, of Daytona Beach, Fla. “They used to make up about two to five percent of my patients. Now it’s closer to 15 to 20 percent… I thought that when the economy didn’t do well it wouldn’t stay at that level, but my older patients needed to get back in the workforce and compete with the younger guys.”

While these observations may be true, there is another big factor: the advent of noninvasive treatments.

Unlike women, men have little tolerance for the pain and travails of surgery. “What men want is noninvasive procedures,” says Douglas Key, MD, of Portland, Ore. “Men are anti-surgery to the core.”

Men, much more than women, also want to hide the fact that they have had any cosmetic work. “Unless you are a metrosexual, cosmetic surgery is still a little taboo for men,” says Dr. Schalit. “Guys want to have things done, but they want to keep it quiet.”

Fortunately, today’s fillers and other noninvasive techniques make this possible, providing procedures for which there is negligible or minimal downtime. And this migration toward nonsurgical treatments is clearly evident in the numbers.

The latest report by the National Clearinghouse for Plastic Surgery Statistics says American men underwent 1.1 million cosmetic procedures in 2009. Of these, 900,000 were for minimally invasive procedures, an increase of 42 percent since the year 2000. By comparison, just 200,000 procedures were surgical, a 49 percent drop for the decade.

“From a nonsurgical standpoint, what men want is Botox. About 25 percent of my Botox patients are men,” says Dr. Schalit. “They are also big on Juvéderm and Sculptra.” Both Juvéderm and Sculptra are fillers that initially use Dr. Key, who practices in an area of the country where
men are apparently less concerned with the minor details of their appearance, says that his male patients are not particularly interested in fillers, which they see as short-term.

“What men are looking for is not a temporary fix. Crows’ feet and brow lines don’t bother them, unless they are young. Most guys over 40 aren’t bothered,” he says. What they don’t like, and want fixed, are the sagging effects of gravity. “They don’t mind aging, but they hate droopiness–the jowls, the neck fat,” he says. In order to treat them, Dr. Key says he has turned to ultrasound technology, which tightens the skin beneath the surface.

In San Diego, meanwhile, Jeffry Schafer, MD, says that nearly half his patients are men, and what they want is body sculpting, not facial treatments. The top treatment requested by his male patients is gynecomastia, or male breast reduction.

“They say that the East Coast worships the mind, and the West Coast worships the body,” says Dr. Schafer. “The average male for us is concerned with the larger issues, the physical improvements.”

In terms of the hierarchy of treatments, Dr. Schafer says that after breast reduction, the number two procedure for his patients is stomach or love handle reduction, and “getting rid of that flab in the neck.”

For Dr. Key, the top treatment is the repair of heavy acne scarring, followed by reducing the jowls, followed by male breast reduction. For Dr. Schalit, it’s noninvasive injectables, followed by eyelid reductions and then neck lifts.

Regardless of the type of procedures, most cosmetic surgeons agree that men are easy to work with as patients. “If your wife went to Nordstrom’s to pick a pair of shoes, she might look at 100 and not buy one. Men would just pick one out and leave with it,” says Dr. Schafer.

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