How do Men Age Differently?
Facial aging is characterized by a myriad of changes that affect the skin, musculature, adipose and skeletal compartments. These include photoaging, wrinkles, ptosis, and volume changes, that together via a complex interplay manifest to an aged face appearance Men have thicker dermis, but matrix degradation during skin aging due to intrinsic (genetics) and extrinsic factors (UV radiation, smoking) generates reactive oxygen species (ROS), leading to the appearance of increased skin laxity or prominent folds around the nasolabial region, periorbital region, and jowl. Moreover, studies have shown that men are more likely engage in lifestyle habits (smoking, less than rigorous use of sunscreen) that aggravate skin aging.
As the face ages, redistribution and descent of facial fat pads contribute to the signature look of being old. Facial fat has been shown to be partitioned between superficial and deep fat, organized in discrete anatomic compartments. The deep fat acts as the structural foundation over which subcutaneous fat lies. Age-related depletion of these fat pads results and loss of their even distribution, leading to predictable change in the appearance of the aged face, where sagging and hollowness persist. Specific areas that contribute to this look include diminishing of the cheek projection, atrophy in the periorbital, forehead, temporal, and perioral areas, leading to sagging due to the relative excess of remaining skin. Although both genders sustain similar age-related changes of the adipose tissues, because men have less subcutaneous adipose tissue, they develop more prominent deep wrinkles rather than the fine lines observed in women
Craniofacial remodeling caused by aging also substantially impacts facial features and overall male aesthetics. Consistent age-related skeletal changes in both genders include an increase in mandibular angle that may cause blunting or loss of definition of the lower border of the face and an increase in the pyriform aperture that can lead to an appearance of nose elongation. Midfacial bone loss may exacerbate the nasolabial old appearance. In men, as the forehead is oblique, the glabella and frontonasal suture are more pronounced, the supraorbital rim is prominent and the mandibular is angular, bone resorption leads to a general look of droopiness in the upper midface areas, and loss of the signature feature of male attractiveness, the strong square chin. It is important to be mindful of the characteristics peculiar to the male facial anatomy and the male aging process. Certain characteristics of the male face have long been recognized and are supported by reasonable scientific evidence, such as the greater bleeding propensity of male facelift patients a result of greater facial vascularity and facial hair, the increased incidence of rhinophyma in male patients, and the decreased incidence of melasma in male patients.
Male Cosmetic Surgery Consultation: Psychologic Aspects
Screening for psychopathology should be a routine component of male aging face consultation. Although cosmetic surgery patients, and men, are significantly more ill from a psychiatric standpoint than normative populations, aesthetic surgeons should still expect to see patients who have mental illness in their practices. Focused psychiatric histories and close observation by the office staff will alert the surgeon to a patient who may need to be referred for mental health consultation.
Thoughtful, targeted questioning can also reveal doubtful motivations for cosmetic surgery and unrealistic expectations regarding the surgical results. Identifying these potential problem patients preoperatively can prevent lawsuit, threats of violence toward the surgeon, and wasted hours trying to satisfy the inherently unhappy patient.
Included in the spectrum of psychiatric illnesses that should be recognized by the aesthetic surgeon is body dysmorphic disorder, an illness that appears to have a higher prevalence in patients seeking cosmetic surgery than it does in the general population. Patients who have body dysmorphic disorder are preoccupied with an imagined or minor physical defect, and their somatic obsession causes significant social and occupational disability. Given the fact that surgery is an ineffective intervention for this disorder, these patients should be sought out and directed to appropriate medical professionals for treatment.
Men’ Consultation in Cosmetic Surgery with Prof. Moawad
In your initial consultation, Prof. Moawad will ask you to explain in detail why you want the procedure and how you hope to look and feel afterward. It’s important to set aside any awkwardness you might feel and speak candidly about the changes you’d like to see. You should feel completely assured that you and your surgeon understand one another. Prof Moawad will also evaluate your health, conduct a physical exam, take preoperative photographs, and explain which surgical techniques are most appropriate for you. You’ll discuss the type of anesthesia to be used, the type of facility where the surgery will be performed, the possible risks, and the costs involved.
Tell him if any part of the consultation makes you uncomfortable, or if you have any special privacy requests. Above all, it’s important to have realistic expectations about your surgery. Remember, Prof Moawad and his professional team at MSI can offer significant improvement, but not perfection. Keep in mind that your age and health may play a role in the quality of the outcome. About a week after surgery. If you get the help and rest you need, you’ll improve your chances of a quicker recovery — and you may see your results a lot sooner.
Good communication between you and your cosmetic c surgeon is essential when planning your surgery. In your initial consultation, you’ll be asked to explain in detail why you want the procedure and how you hope to look and feel afterward. It’s important to set aside any awkwardness you might feel and speak candidly about the changes you’d like to see. You should feel completely assured that you and your surgeon understand one another.
Your doctor will also evaluate your health, conduct a physical exam, take pre-operative photographs and explain which surgical techniques are most appropriate for you. You’ll discuss the type of anesthesia to be used, the type of facility where the surgery will be performed, the possible risks and the costs involved. Medical insurance usually doesn’t cover cosmetic procedures. However, some plastic surgeons offer special financing plans for cosmetic surgery or accept credit cards.
Tell your surgeon if any part of the consultation makes you uncomfortable, or if you have any special privacy requests. Above all, it’s important to have realistic expectations about your surgery. Remember, your doctor can offer significant improvement, but not perfection. Keep in mind that your age and health may play a role in the quality of the outcome.
The world places a high value on looking young and fit, that is why cosmetic surgery is up and men are a big part of the increase. More and more men today are having cosmetic surgery to help them look younger and attractive. Like their female counterparts, they have discovered the benefits of cosmetic surgery not only personally, but also professionally. Men seem to be changing their attitude about several issues that seemed previously to be the preserve of women. Feeling the need to look youthful and appear dynamic well into your 40s, 50s and 60s has led to men re-thinking their attitudes to pills, diet, exercise, face-care products and cosmetic surgery.
In a society that values youth, 50-year-old executives are competing with younger, fitter and more competitive 30-year-olds, who are often willing to work harder, and for less money. One 40-year-old sales executive felt that his baggy eyelids and tired looking appearance affected his peers’ perception of his ability to perform his job. “Every morning I would go to work and someone would ask if I was tired and asked did, I get enough sleep.
In the business world the feeling is if you look tired or don’t take care of yourself, people think you can’t keep up.” But, it’s not just busy business executives in fear of losing their jobs who are filling the cosmetic surgeon’s waiting room. On the home front, men are also finding they want to keep pace with younger-looking wives.
What do Men Need the Most in Cosmetic Surgery ?
Baggy eyelids, receding hairline, wrinkles, frown lines and sagging necks, to name a few. Like women they want trimmer waists and fewer wrinkles and they want more hair. Despite this greater acceptance of men seeking and obtaining cosmetic surgery, a desire for discretion plays a significant part in the type of cosmetic enhancement or surgery that men select. Men come to cosmetic surgeons and dermatologists for many of the same issues, concerns, and problems as women, but cite different reasons.
Women want to ‘‘look less tired’’ or ‘‘look better,’’ because men show work-related reasons for seeking cosmetic surgery; they want to ‘‘increase competitiveness’’ in the workplace. When men present to a cosmetic surgeon, they are usually less familiar with the medical system and less comfortable discussing procedures. Additionally, having spent less time in the medical system, they may not be aware of the downtime that is associated with the procedure that best addresses their concerns.
Men generally present for cosmetic procedures at a later age than women and have usually engaged in behaviors that predispose them to seeking cosmetic surgery, such as not wearing sunscreen and smoking. Men do not usually wear cosmetics, and therefore are more concerned about the post-procedure downtime, as they may prefer not to have recognizable sequelae of healing from a cosmetic procedure.
This may explain why cosmetic nonsurgical procedures, including Botox and microdermabrasion, have increased among the male demographic by more than 300% and 400%, respectively, since 2000. These nonsurgical procedures have minimal downtime and are more acceptable to the male demographic.
Top Cosmetic Surgery Procedures for Men
Hair transplants top the list of the most common procedures, followed by liposuction, nose surgery, eyelid surgery, fillers injections, micro-dermabrasion, chemical peels and breast reduction. Men are also rejuvenating their faces with face, neck and eye lifts, forehead and brow lifts; having lasers and peels to remove the wrinkles and make their skin look younger; re-sculpting their noses and undergoing liposuction and tummy tucks.
These improvements haven’t stopped at the surgeon’s office. Men are also going to hair salons instead of barber shops, having facials and other skin toning treatments, and shopping at cosmetic counters.
What’s new for men In Cosmetic Surgery?
The advent of non-ablative lasers and light-based technology and tissue tightening devices like radio-frequency e offer mini-lifts without surgery and new fillers such as Restylane and Perlane give men more choices to remove lines and wrinkles and fill in deep creases and folds. The power lipo-sculpture, a new liposuction procedure removes double chins, “spare tires” and “love handles” around the waist, large, protruding abdomens and more.
For the first time it allows the Prof. Moawad to be a true sculptor of the human body. Male breasts are another area where power liposuction and sometimes surgical correction can help to improve the appearance of the chest area and restore self-confidence. For many men and women, unwanted hair can be a nightmare. Now men can enjoy the result of Laser Hair Removal process.
Men’s Cosmetic Surgery At MSI
Extensive information about the procedure you plan to have will be provided during your consultation. While going over the steps of the procedure, your doctor will discuss several issues that may influence your surgery. Make sure you fully understand these considerations.
Men Facial Surgery
If you are planning facial surgery or neck surgery, your doctor will evaluate your entire head-face-neck region. Is the hairline receding? How full are the sideburns? Does the beard-growing skin extend up the cheeks or down the neck? Are there facial scars? Is the skin sun-damaged? Is the neck skin loose or drooping? In general, it’s known that male facial skin has a richer blood supply than female facial skin. Male faces bleed more during surgery and are at greater risk for forming a temporary collection or pooling of blood under the skin, called a hematoma, after surgery.
Also, any scarring that may result from surgery may be more difficult for men to hide, since they don’t wear makeup or style their hair toward their faces, as many women do. Hair growth and beard growth may play a major role in the outcome of a facelift. If you are balding or have thinning hair, surgical artistry may be required to hide the facelift incision, especially in the temple area. If the hair-bearing skin of your upper neck is pulled behind your ears during surgery, you may find that you must shave behind your ears or the back of your neck. However, sometimes electrolysis can correct this problem. Be sure to discuss these possibilities with your surgeon.
A fatty area or “jowls” beneath the chin is also a concern for many men. In younger patients, liposuction alone may be enough to correct the problem. Older patients may require a full facelift and neck lift, which may include the removal of excess skin and tightening the platysma muscles, which run down each side of the neck. These muscles are usually thicker in men than they are in women, but do not pose a greater challenge for your plastic surgeon.
Cosmetic procedures such as eyelid surgery, nose surgery and facial implant surgery are performed essentially the same way for men and women. However, it’s important to let your surgeon know if you are seeking a more masculine look to your facial features – a chin with better projection, more prominent cheekbones, a stronger nose.
Men Hair Replacement
The primary consideration for men contemplating hair transplant surgery is the time involved. Natural-appearing hair replacement usually requires multiple surgical procedures, with long recovery intervals. A full regimen of hair transplants may last anywhere from 18 months to 2 years or more. You should be aware that incisions or transplant sites may be noticeable to others, especially in the early stages of the hair transplant process. If your work or lifestyle isn’t compatible with a long treatment period, ask your surgeon about alternatives to hair-transplant options, such as flap surgery or scalp reduction.
Rhinoplasty in the elderly man presents a unique set of obstacles. In addition to the typical forces of healing and scar contracture, the aging nose features the altered anatomy and physiology of aging added to an already complicated three-dimensional structure. The heavier, thicker, and more sebaceous skin of men can exacerbate the loss of support associated with aging, creating a scenario of worse functional issues in men as compared with their female counterparts. Approaching the aging nose requires an appreciation of the nuances of the preoperative, intraoperative, and postoperative phases of the patient interaction. Although functional issues predominate in this population, aesthetic concerns also need to be addressed.
Mend Liposuction and body Shaping
The ideal male body shape is trim and athletic-looking, with broad shoulders and chest, a flat abdomen and a narrow hip-thigh area. However, as men age, areas of fat tend to accumulate around the abdomen, the flanks (“love handles”), the breast area (a condition called gynecomastia) and along the chin and neck. Men sometimes seek liposuction to remove these fatty areas that are resistant to diet and exercise. Men retain their skin elasticity longer than women do, and the areas of fat beneath the skin tend to be firmer and more vascular than those in women. Because of these and other factors, liposuction in men is usually very effective.
Normal-weight and overweight patients need one operative step, in which the fat is removed, and the muscles are sculpted at the same time by using selective liposuction, and if necessary, the fat is repositioned through lipofilling. Muscle-enhancing surgery: In recent years, cosmetic surgeons have developed ways of improving muscle contour with cosmetic implants and “sculpting” techniques.
In all male patients, Prof. Moawad strive to achieve a trapezoid chest and sculpted pectoralis major muscle, pronounced alba and semilunar lines, evident muscular bulk, and adherences in both the abdomen and extremities. Superior results in abdominal contouring using selective lipo-contouring with fat grafting can be achieved. The ex-obese patients need two operative steps: in the first, we perform abdominoplasty with inguinal scar (to remove the excess abdominal tissue and to lift the pubis) and peri-areolar scar (to breast lift and reduction); in the second, we sculpt the muscles and the adherences by selective liposuction.
A full abdominoplasty (or “tummy tuck”) may be chosen by men who have hanging abdominal skin (usually the result of massive weight loss), loose abdominal muscles and/or neglected hernias. It is a major surgical procedure that removes excess fat, tightens the muscles of the abdominal wall and trims the waistline. Men who have a full abdominoplasty are often surprised at the long recovery period. Some patients can’t return to work up to 4 weeks after surgery. Pectoral fat injection performed simultaneously with gynecomastia correction can produce a masculine appearance.
Men after Cosmetic Surgery
The days and weeks immediately following your surgery are critical to obtaining a good final result. Therefore, it’s essential that you follow your plastic surgeon’s orders to the letter.
- Taking adequate time off work
- Wearing bandages or tight compression garments
- Getting enough rest
- Staying out of the sun
- Saying no to alcohol and cigarettes
- Avoiding strenuous activity, exercise, sports and sex
However, cosmetic surgeons understand that it’s sometimes difficult for men, who are programmed by society to be patient, to remain in bed for very long or to accept help from others during recovery. Studies have shown that men often deny their pain and feel foolish about asking for help after surgery. Men who reject help may have an especially difficult recovery if post-operative depression sets in during the weeks following surgery. To avoid post-operative problems, it’s important that you arrange to have a support person available to help you – both physically and emotionally – for about a week after surgery. If you get the help and rest you need, you’ll improve your chances of a quicker recovery – and you may see your results a lot sooner.
Botulinum toxin injection in men :
The classical injection technique does not differ in men, and the basics are like procedures performed in women. However, they often require larger doses. For example, men require larger doses of BoNT-A than women, which is possibly related to their greater muscle mass.
There are also differences in esthetic ideals in men; whereas women require an arched eyebrow, men prefer a lower, horizontal brow. We inject an additional 4 to 5U into a point 1 cm above the supraorbital rim in the mid-pupillary line in men.
It is useful to halve the volume of saline used to reconstitute the vial when treating males, as this technique reduces the injected volume while simply doubling the injected dose.
Refinishing Treatments for Facial Skin:
Shaving must be postponed for about 3 weeks after a skin-smoothing treatment such as chemical peel or dermabrasion. Because these procedures strip away the surface layers of skin, you can expect your face to remain sensitive, swollen and bright pink for several weeks after surgery.
Some men are happy that the beard growth helps conceal the pinkness of their recovering skin – especially if they feel uncomfortable using camouflage makeup.
Men who feel self-conscious about their condition are also advised to give up alcoholic drinks for about 4 weeks. Alcohol causes the areas of treated facial skin to become noticeably red and flushed.
Male Skin Care Needs :
Given the significant benefit in terms of prevention of photoaging and reduction in the incidence of cutaneous cancer, the primary recommendation is avoidance of excessive sun exposure and use of a daily sunscreen.
Avoidance of dry, windy, and harsh environmental exposure and tobacco smoke can further reduce the extrinsic factors related to photoaging.
Use of a daily moisturizing agent can mitigate some of these environmental effects and maintain adequate skin hydration.
In addition, twice-daily use of a gentle facial cleanser can help remove environmental debris, excess oil, and desquamated skin tissue.
For existing photodamage, myriad, expensive treatment modalities are available Data exist to support topical use of tretinoin and tazarotene in prescription strength formulations.
At MSI we have formulated skin care products knowing the need and concern of our male patients. This will include cleansers, moisturizers, and exfoliants.
Fillers Injections for the Male Face :
When performing filler injections in men, some important points need to be agreed upon during the consultation process. Depending on the gravity of the facial aging manifestations and the patient’s goals, the amount of filler and choice of agent are decided.
Hands-on examination including tissue palpation is used to identify anatomic landmarks such as the fat pads, bone and muscle structures, and the folds, wrinkles and creases that need to be treated.
Another gender-related anatomic difference that should be considered when performing filler injections in men is that men have a greater density of superficial blood vessels in the face than women, which makes men more prone to develop bruising. This adverse effect can be circumvented using a cannula instead of a needle, which has been shown to minimize vascular injury and subsequent bruising.
Aside from reversing the signs of aging, fillers can also be used to augment masculine facial features, notably by adding definition in the chin and jaw area or in the upper face to enhance the male forehead prominence by injecting the material into the bony sulcus over the eyebrows.
Typically, men do not want a series of treatments and prefer to see immediate, durable volumizing results. In this sense, new-generation high molecule HA fillers are ideal, as they can volumize the face and last up to 2 years.
Volbella can be used for superficial injections to reduce lines, and more subtle depressions.
Restylane Defyne by Galderma, uses a cross-linking technology called XpresHAn technology, which creates a smooth flexible gel, for natural durable pan-facial augmentation results. This filler is popular with men who show a strong preference for discreet results.
CaHa (Radiesse, Merz) is another filler that can be used for applying the VSR technique in men.
PMMA can be appealing to men, because it is the only permanent filler that provides immediate volumization.