Mastering the Art of Fixing Your Face.
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Fillers! Botox! Neck liposuction!
Fillers! Botox! Neck liposuction!
For
most of my life, the idea of plastic surgery has seemed a bizarre,
almost perverse extravagance, the province of the idle rich and
appearance-obsessed celebrities. But as I've entered my late thirties,
and the lines around my eyes have grown a little deeper, my sense of
distancing judgment has somewhat subsided. Not that I ever plan on
having a procedure done myself, but at least I'm starting to empathize
with why someone might consider it in the first place. Getting old is a
hell of a scam.
I'm
certainly not alone. Between 1997 and 2012, the number of cosmetic
procedures performed on men rose by 106%, according to the American
Society of Aesthetic Plastic Surgery. In the five years leading up to
2014, procedures for men rose 43%. Last year alone, there were 68,106 aesthetic breast reduction surgeries in the United States, with men accounting for 40% of them, a record high.
That's
in part because we live in an culture that has thrown the expectations
for beauty that have long been placed upon women onto men as well, which
is a…victory? Not really sure about that. But it's also because science
and technology has made many procures much more affordable, and less of
a time investment due to speedier recovery periods.
I talked to Stafford R. Broumand, M.D., one of the surgeons at 740 Park Plastic Surgery
in New York City, and the former president of the American Society of
Plastic Surgeons, about the changing face of plastic surgery, what types
of things men are getting done now, and what the future hold for the
changing field.
ESQ: Is the term "plastic surgery" still accurate or is it outdated?
Dr. Broumand: The "plastic" in plastic surgery comes from plastikos,
a Greek derivative of "malleable." Skin is malleable; hence the name.
But cosmetic surgery, aesthetic surgery, plastic and reconstructive
surgery: they're all basically the same thing.
Do you see mostly female patients or a good amount of males?
It's a mix. And I guess we're talking now because it's becoming more
prevalent in men of all ages. Some are young men who have a small amount
of breast tissue for whom it's a self-confidence issue. They might have
other areas of fat even though they work out in the gym five times a
week. Or they're in business and don't want to look so stern and
mean-looking, so they have Botox or fillers to soften some folds on
their face, or liposuction on their neck to make them look thinner and
more angular. And as they're getting older they might have extra eyelid
skin.
What are the most common procedures men are getting now?
Eyelid
surgery—blepharoplasty—to get rid of the extra upper eyelid skin, or
getting rid of the bags under the eyes, known as lower-eyelid
blepharoplasty. The latter is extremely common.
Is it an intense procedure?
It's
not. It's a surgical procedure done in the office, and then you go
home. You take three or four days off, you might be bruised when you get
back to work. But it's not painful.
The next thing is neck liposuction, which involves reshaping or
sculpting the neck to get rid of the extra fat. We can do that under
local anesthesia. You come in the office and we're chatting with you the
whole time.
The non-surgical treatments include Botox, which is becoming much more
prevalent among men, to soften the wrinkles of the forehead, or to
eliminate crow's feet around the lateral eyes. Or they get fillers if
they have deep folds. There's a crease from the nose where the cheek and
the lip join that you can have filled. We also have non-surgical
skin-tightening, which is called Ultherapy. It's an ultrasound treatment
that is done with a little sedation that can be done on the forehead,
cheek, or neck region.
What is actually going on there, science-wise?
You
put an applicator or transducer on the skin, and a computer generates
an ultrasound pulse that's diffuse at the skin surface but gets focused
underneath, which transmits to that lower portion of the skin and causes
it to tighten.
What
are some of the other newer things, or looking forward, what are some
things that are being devised now that we may be seeing down the line?
We're
trying to expand the ultrasound skin tightening into the chest and
legs. Other technologies are fat freezing and cool sculpting, and
there's also now laser fat reduction. You apply an applicator to the
skin, and the energy gets transmitted through the skin surface and is
concentrated in the fat area, and it dissolves or burns the fat.
You're freezing the fat?
Either
you freeze it or burn it. With a cold applicator, it ends up looking
like a stick of butter that's frozen and that has to be massaged out.
When it's frozen, 20% of it dies over several weeks and your body
absorbs it. Or you could have the laser treatment where the surface of
the skin is chilled, but the deeper tissues heat up to a certain level
that helps dissolve the fat.
How do you make sure this stuff is safe?
These
are all FDA-approved procedures, and certain offices such as ours test
them out. We enroll patients in studies and gather data, which is then
presented to the FDA for approval.
Where do you see things being five, ten years from now? How far can this field go?
There
will be more technologies such as directional skin-tightening, where
they put these fine needles in the skin, and take out little cores just
like you see in aerated grass, and your skin grows back tighter.
Is cosmetic surgery relatively safe?
My
advice is that you go to a person who's board certified and qualified,
someone who performs these procedures on a regular basis. And when
something doesn't work, they know what to do. We know how to handle
adverse reactions to all of the procedures we do. We're not going to be
surprised and say "we don't know what to do now."
Is such surgery still largely for wealthy people?
No—there's a range of things you can have done. For dissolving fat, for example, we also have an injectable called Kybella.
Is that one of the more affordable options?
Yeah,
you can dissolve the neck fat for $1,500. The Brazilian butt lift is
also becoming more and more requested, and that has a range too,
depending on where you go and how much you have done. That's largely for
women. For men, getting to have neck liposuction under local is cheaper
than having it under general anesthesia. It doesn't break the bank.
Do
you ever see people who don't need the procedure they think they do?
Everyone is insecure, and sometimes we look at our bodies differently
than they actually are.
It
happens all the time. We do not do a procedure without having a
consultation—we have to evaluate our patients before we do or even
suggest anything. We get a better sense of where they're at
psychologically, socially, and physically. Every day we tell people,
that a procedure is not for them, that there are alternatives: weight
loss, exercise, understanding their perceptions might not be the
reality. People see things in print and say they want to look like this
person or that person, and the reality is that those people are
airbrushed, and they may have had procedures done that make them look
abnormal. So we've got to point that out.
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