Cosmetic surgery for men is a rapidly expanding field, as operations that were once considered taboo are now more commonplace procedures. Today, men are having liposuctions, facial work, and abdominoplasties (tummy tucks).
As with women, liposuction is the most common cosmetic surgery procedure for men. Areas that are most often addressed are the flanks (love handles) and abdomen. Significant improvements can be made in these areas, which are so difficult to reduce with exercise. Love handles occur as skin laxity increases and fat accumulates over the ligament attachment to the hips. When I attempted to reduce my own moderate love handles by exercise, it required a 12-pound weight loss that took me down to 178 pounds on my 6’1” frame. This felt too thin, so I gained the weight back with exercise and then had those fatty areas liposuctioned. Over the last ten years, I have maintained my weight between 175 pounds and 180 pounds and the love handles have not returned. While it is possible to regain weight after liposuction, the area does not gain disproportionately as it did before when the 100 percent of the fat cells were in place.
In my practice, the most common facial procedure among men involves the neck and can include liposuction alone, suture suspension, and neck lift; the exact type of procedure is determined by the amount of laxity and fat in the neck. As the population ages, people retire later, and our culture continues to place an emphasis on youth, appearance can affect “marketability,” and I feel this is a significant force behind male plastic surgery.
Just as with women, hormonal changes affect the male body. As we age, our estrogen levels go up and testosterone levels go down. This leads to changes in body fat disposition, especially in the breasts. Abnormal breast enlargement in men is called gynecomastia, which involves the disposition of fat as well as an increase in the normal breast tissue that all men have. Gynecomastia can be corrected very successfully with liposuction and surgery. The resection of the breast tissue in my opinion is paramount, as I have found that liposuction alone cannot completely flatten and remove the breast tissue to contour the chest wall.
Recovery to full exercise from most of these procedures is about four weeks with the exception of abdominoplasty, which requires six weeks. In the first two weeks of recovery, activity is first limited and then slowly increased to full activity by four weeks. For liposuction, patients are back to work in about three to seven days according to their ability to tolerate soreness. With facial procedures, most return to work in 7 to 12 days depending upon the amount of bruising. Complications are infrequent and fall into the usual realm of problems such as bleeding or scarring or problems with the skin draping back to the contour.
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