As a busy plastic surgeon in Las Vegas, I have seen a steady increase in the number of male patients requesting plastic surgery.   Where plastic surgery patients were once overwhelmingly female, plastic surgery is becoming widely accepted among males.

The yearly number of male patients requesting plastic surgery in the United Sates has more than doubled since 2003.

 

The types of procedures males request are significantly different than those requested by my female patients.  Females most often request breast surgery (augmentation and lifts), tummy tucks, and liposuction of the hips and thighs.    Frequently, they are attempting to correct damage caused by pregnancy, aging, or simply want to look more feminine (ie. with larger breasts). 

 

The most common procedures male patients request are for gynecomastia (male breasts), liposuction of the flanks (love handles) and abdominal area, eyelid rejuvenation and rhinoplasty (nose job).   Men are most commonly attempting to look a little younger without having major surgery or correcting poor lifestyle choices. 

 

Gynecomastia or male breast development is actually a fairly common problem. This can be extremely traumatic, and men with gynecomastia are often afraid to take off their shirt in public.   Most good plastic surgeons are quite sympathetic to the psychological trauma associated with this condition, and therefore it is important for someone suffering from male breast development to come and seek consultation.   You will never be the “worst case” I have seen.  Temporary gynecomastia is common in puberty and usually resolves without treatment.    In adults, it is most frequently caused by weight gain or drug use, most often anabolic steroids or marijuana. So if you want to avoid needing a “bro,” the male bra as described in a Seinfield episode; don’t smoke “pot,” take “roids,” or gain excessive weight.  Some tumors can also cause gynecomastia, so it is important to consult a physician if you have a known cancer or concerns in this regard. 

 

Fortunately the treatment is usually fairly effective and relatively simple.   In my experience, most gynecomastia can be corrected with liposuction.  This involves using a tiny incision in the armpit area through which a liposuction cannula is inserted and liposuction of the chest area performed.   If the gynecomastia is severe or very firm, an incision may be needed in the areola (colored part around the nipple).    We choose this location because it is barely visible weeks after the operation.  Patients can usually return to work within a week and full exercise by three weeks.  

 

When men think about liposuction, they are most often interested in the flanks (“love handles”) and abdominal area.  Men tend to concentrate their fat in the truncal area and not on the legs and hips as women do.    Fortunately liposuction is a very powerful treatment of the flanks.   The flanks are mostly fatty accumulations that are easily liposuctioned.   Unfortunately, the male abdomen is not always easily corrected with liposuction.   This again relates to the male pattern of fat distribution.    As opposed to females, males tend to place a larger percentage of their fat intra-abdominally.   This means the fat is wrapped around the colon and intestines under the rectus abdominus (“six-pack”) muscles.   The best example of this is the classic “beer belly”.  

 

 

These patients have very firm bulging round bellies.   While alcohol does encourage the fat to be deposited within the abdomen (creating a “beer belly”), there can also be a strong genetic component leading to this same condition.  Because intra-abdominal fat cannot be suctioned, liposuction is less effective in the abdominal area on a male. In males with a very firm “beer belly” type abdomen, liposuction will have almost no effect.   A general rule of thumb is that if the fat can be easily pinched, it can be suctioned.  And, what cannot be pinched usually cannot be corrected with liposuction.  For those who do undergo liposuction, the recovery is fairly quick.  Patients can usually return to work after one week or slightly sooner, and usually return to full exercise after about three weeks.

 

Eyelid surgery is relatively common among males reaching their forties and fifties who want to look younger without a great deal of effort.   The eyes are usually the first area to show signs of aging, with crow’s feet and bags.    Eyelid rejuvenation surgery is relatively quick and the recovery is fairly easy.  Most often the surgery is performed under local anesthesia with some sedation.  The excess upper eyelid skin is excised in an elliptical fashion, placing the excision exactly in the natural crease of the upper eyelid thereby hiding it quite effectively.   The lower eyelid surgery is either done by pulling the eyelid forward so that there is no external incision or the incision is hidden immediately under the eyelashes.   Patients can return to non-strenuous activities as quickly as two or three days as long as they don’t mind the bruising, which is easily hidden by sunglasses. If a patient wants to return to work with no bruising, they should plan on 1 week.  Patients may return to full exercise as soon as two to three weeks. 

 

Rhinoplasty (nose job) is a common procedure in both men and women.   For various reasons, male rhinoplasty patients tend to be more difficult than women.   Men with Body Dysmorphic Syndrome- a psychological condition in which patients tend to excessively obsess about a personal illogically perceived flaw in their appearance- most often focus on the nose.   However, in the properly selected patient (most patients), the results of rhinoplasty surgery can be very gratifying.   In the past, recovery from this surgery was extremely miserable for the patient as the nose was almost always packed tight with gauze, often for as long as a week or more.   Today, surgeons who are on the forefront of rhinoplasty surgery rarely ever need to pack the nose with gauze.    I have not needed to pack a nose in my last 600 cases.   By eliminating packing, and by using very fine instruments in a precise fashion, recovery from rhinoplasty surgery can be relatively easy.   Often my patients will need only one or two prescription pain pills after surgery and then switch to Tylenol.  The bruising can also be quite minimal, and is usually completely gone after 4 to 7 days.   Most patients must wear a small nasal cast for about a week and if the patient wishes to return to work without anyone knowing they had surgery, they must usually wait about 7 to 8 days after surgery.    If a patient does not mind returning to work with the small nasal cast in place, they may return to work as soon as two days after surgery provided they are not doing anything that is physically strenuous.   Patients may usually return to full exercise as soon as three weeks after surgery.

 

While the procedures described above are the most requested male plastic surgical procedures, there are certainly many other possibilities available.  And as you can see, plastic surgery is not just for the ladies!  These procedures are geared specifically for males who are looking to improve their physical image and self-confidence.  In a world of metrosexuals, movie stars, high-stakes business deals, and the search for beautiful mates, men deserve to look their best.  And as many can attest, the gym cannot fix all physical imperfections!  If “man boobs,” “love handles,” and tired “baggy” eyes are not how you want to be identified, consider a plastic surgery consultation.  Nothing is lost in the consultation and the gains may indeed be priceless!