Facing Surgery Facts for Men
Posted On Apr 08, 2016
John Travolta’s look in The People V OJ show has social media in a frenzy. Many who have watched the first episode are saying they are “distracted by his face,” and question whether it is a result of bad surgery or too many fillers or just an overzealous makeup artist? As cosmetic surgery evolves, more and more men are now considering elective procedures to lift their spirits and meet their need to look young and toned. So is John Travolta just the tip of the sculpted iceberg? And, does the world of cosmetic surgery still belong to women?
One might assume so, considering the disproportionate amount of news coverage and water cooler banter focused on women’s eye tucks and nose jobs. However, according to the 2010 American Plastic Surgery report, men’s facelifts are decidedly on the rise. In fact, Newsweek recently reported that 10 percent of men would seriously consider cosmetic surgery to boost their career. “To say that men aren’t vain is an unbelievably huge statement—one that’s incorrect,” says Dr. Brian Novack, board certified plastic surgeon in Beverly Hills. “There are four face lifts on my desk right now—two of them are women, two of them are men. Both of the men are multi-, multi-billionaires. One has had a wife for a long time. The other guy is a good 20 years older than his girlfriend, and she obviously loves him. Why do they want to do face surgery? Vanity.”
In our youth-obsessed culture, men are finding themselves under more pressure to look as young as they feel. Their inner vitality simply does not translate in face time, despite healthy diets or hours at the gym. There’s the added pressure of today’s workforce, as men and women vie for the same senior-level positions. Competition is stiff, and men have to look “up to the challenge.” Men are also working well past traditional retirement age, and they don’t want a sagging jawline or drooping eyes to kill their competitive edge. Gone are the days of Grandpa rocking on the porch, watching the setting sun.
Are men really willing to consider facelifts? “Believe it or not, they are, though they are 10 times more secretive about it—probably because of the stigma associated with a man having cosmetic surgery,” says Dr. Robert C. Silich, board-certified plastic surgeon in Manhattan.
Dr. Andre Aboolian, board-certified plastic surgeon in Beverly Hills, considers the answer twofold: “They see their wives or significant others do it, and most of the time the wives look a lot younger than them. They want to close the gap. Another reason is if they’re in the entertainment industry, where looks are part of the business. They want to stay fresh. Overall, however, men are not as accepting of doing facelifts.”
When it comes to actual procedures, doctors must make decisions based on the gender of their patients. Where does one put the incisions? On a woman, you can hide incisions by the ear, inside the earlobe, or inside the cartilage of the ear. The same cannot be done with men, as they grow beards. Were the skin pulled beyond a point they would have to shave inside their ears. “You usually do it right by the sideburn, and you have to just place the incision where the man has a natural crease,” says Dr. Silich. “For a man, you have to look at the length of the hair and how he wears it. Women can hide things better.” Another major difference is the thickness of the skin. “Women’s skin tends to be a little finer and more prone to fine lines and wrinkles, whereas a man’s subcutaneous fat and thicker skin are a little more age-resistant,” says Dr. Novack. “You’ll never see a man with smoker’s lines. It would be unbelievably rare, and he would have to be out in the sun a lot.”
The different types of facial surgery are facelift, blepharoplasty (or eye lift), neck lift or liposuction of the facial area, and rhinoplasty (or nose job). The most frequently requested facelift for men is focused on the neck and lower jawline. “Gravity is still going to China; pulling things backwards is not how you’re aging,” says Dr. Novack. “When you tighten the face in a vertical component, the neck automatically lifts up. By tightening the face, your neck completely takes care of itself, so the latest thing is full vertical lifting.”
“Everyone has natural creases,” says Dr. Silich. “For a man, you have to really be careful and look exactly where the crease is near the sideburn and behind the ear.” Most men are afraid of looking pulled and unnatural. Therefore, they’ll just ask for a neck lift. It takes a bit of counseling on the part of the doctor to explain the bigger picture. “Some guys can have a very saggy face and a very saggy neck, and if you just fix the neck he’s going to look silly,” Silich says. “He’ll have this beautiful, sculpted jawline, but then he has these bags under his eyes. Blepharoplasty in general is very feminizing, so you have to be very conservative with a man. With the upper eyelid, you can really change the shape of the eye, whereas in the lower eyelids you’re really just getting rid of big, heavy bags or sagging skin.”
What about the pain? “It’s not painful,” says Dr Silich. “Most people take Tylenol alone. There’s a little discomfort because you have the bandage, and most people say the sensation is ‘tight.’” If a facial surgery is painful, it usually means something is wrong. Rhinoplasty and liposuction can be painful, but facial work is primarily about moving the skin. Pain will depend upon how much loose skin a man has, and what has to be pulled up towards the ear. If the beard skin has to be pulled inside the ear, the man may have to consider laser hair removal treatments for a couple of years.
As for risk, all doctors agree that it is important not to take anyone on face value when it comes to their health. “Men need someone who’s going to take care of them,” says Dr. Novack. “If you’re talking about a facial rejuvenation surgery, that’s a multi-hour procedure. I’m not talking about a filler lift or pumping your face. We’re starting to talk about men in their late fifties, mid-sixties, or even seventies. They need to have a complete work up. This is serious surgery.”
Downtime after surgery depends on the patient, but it takes, at most, approximately two weeks. Cost varies from surgeon to surgeon, though the average starting point is between $10,000 and $15,000. Meanwhile, the staying power of your facelift depends on a multitude of factors. “If someone has no elasticity, they’re 60 years old, and their testoster.one is gone, the face is not going to last because you are dealing with a poor substrate,” says Dr. Novack. “The more elasticity someone has, the better shape they are in nutritionally, the better shape they are hormonally—plus if their own genetics and their own DNA are in place to aid elasticity—the facelift is going to last longer. Everybody’s different. One thing is for sure: The younger you do it, the longer it lasts.” Although there’s no textbook answer as to what age is best, facial aging starts for men around their thirties. Most men in their forties and fifties are in better health, with fewer medical issues, making them better candidates for facial rejuvenation than someone who is older.
Now for the million dollar question: Why? “It’s important to ask patients what their goals are,” says Dr. Aboolian. “I get young actors or models coming in and I tell them, ‘You’re going to look good and you may like it, but the camera may not like it.’ Sometimes people will think, If I do plastic surgery, I’ll look a lot better. It’s not a lot better, you just look different.” According to Dr. Silich, the most important lesson he learned was from a teacher in medical school. “You’ll ultimately distinguish yourself as a plastic surgeon more by what you don’t do rather than what you do,” he recalls. “The hardest thing you’ll ever have to do with patients is to say no to them.”
“As for the whole technical side of things, no two surgeries or surgeons are alike,” insists Dr. Novack. “One’s talent cannot be defined as ‘the best.’ It’s just talent. It’s very hard to define—especially if you’re doing a nose. What we do is art.” l
“Gravity is still going to China. Pulling things backwards is not how you’re aging. When you tighten the face in a vertical component, the neck automatically lifts up. By tightening the face, your neck completely takes care of itself.”
—DR. BRIAN NOVACK, BEVERLY HILLS
“You’ll ultimately distinguish yourself as a plastic surgeon more by what you don’t do rather than what you do. The hardest thing you’ll ever have to do with patients is to say no to them.”
—DR. ROBERT C. SILICH, MANHATTAN