Male Plastic Surgery

Male plastic surgery continues to gain in popularity. Year after year the number of men undergoing elective cosmetic surgery procedures has been increasing. This is because men care about their appearance just as much as women, and men are more willing to admit this now. It’s 2021 and there is less of a stigma surrounding plastic surgery overall and this is helping to fuel an increase in men requesting surgical procedures to improve their appearance. The statistics from the American Society of Plastic Surgery (ASPS) continues to show a steady increase in men requesting elective cosmetic procedures, even though men still make up a very small portion of all plastic surgery patients.

What are the most common cosmetic procedures for men?

The most common cosmetic procedures requested by men include:

How are these procedures different in men?

There is a big difference between cosmetic procedures in men and cosmetic procedures in women. Procedures are often modified to help preserve male characteristics and avoid feminization of the appearance. This is because men in particular, want to look more refreshed, but not different. For example, when performing eyelid surgery on men, the amount of skin removed is often less than the amount of skin we remove in women. This is because a little bit of extra skin on the upper eyelid helps preserve a more masculine appearance. When we do eyebrow lifting in men, we do not lift the brow too high because a lower and straighter brow is seen as more masculine than the high arching brows of women.  Rhinoplasty, or nose reshaping, is another procedure that is modified in men. We tend to keep a stronger, larger nose on the male face. If we were to perform male rhinoplasty the same way we perform female rhinoplasty, the result may be a nose that is too small for the male face.

Basically, if we are performing cosmetic procedures on a man who desires to preserve his masculine features, the surgeon needs to be aware of the normal male anatomy and preserve these masculine features. Of course, if the purpose of the man’s surgical procedure is to create a more feminine appearance, then we would perform the procedure in a manner more common in our female patients.  

Other Considerations for Male Plastic Surgery

Aside from modifications in the surgical technique to preserve a masculine appearance, other considerations for plastic surgery in men include:

  • Incision placement
  • recovery restrictions
  • pain management

 

  • Incision Placement

As plastic surgeons, we always take great care in placement of our incisions. This is because surgical incisions ultimately become surgical scars, and we want these scars to be as hidden as possible. For the most part scars of the face are kept hidden within the hairline. This means that when performing facial plastic surgery on men, we need to consider the male hairline and how it can change over time. For example, a male facelift needs to take it to consideration that men commonly develop receding hairlines or become bald later in life. If a scar is please in same location we would place it on a woman, then this will be a very visible scar in situations of receding hairline for balding.  As you can imagine, hiding face lift scars on men is much more difficult than women with long hair.

Similarly, in the case of a male tummy tuck, the abdominal scar is placed lower and more horizontal in men than in women. This is because we want the scar to be hidden beneath underwear and a bathing suit. In men this requires a lower and straighter scar as opposed to the tummy tuck scars in women that tend to follow a natural curve to their pelvic bones.

  • Recovery Restrictions

Any surgery requires restrictions during the recovery period. Cosmetic plastic surgery is no different. When operating on men, the recovery restrictions often need to be modified. There may be longer restrictions regarding heavy lifting and certain contact sports. Also, in general men tend to be less patient with recovery. This means that men tend to be more unwilling to restrict their activities. Therefore, the surgeon needs to be more specific about what male patients can and cannot do. This is not to suggest that female patients are not impatient sometimes, or that female patients do not engage in strenuous activity and contact sports.  It just means that in general, male patients require more specific instructions and at times are less compliant with these restrictions.

  • Pain Management

Pain management tends to be an issue as well with many male patients. It has been documented now cosmetic surgery to be less tolerant of the pain during the recovery period. This is not to suggest that all male patients are bad with pain and all female patients are good with pain, since everyone is different and it is impossible to characterize peoples pain threshold simply based on gender. However, surgeons need to be aware that male patients overall tend to feel more pain during the recovery. And it is more difficult to control this pain. This means that multiple different medication’s may be required to control the pain.

Choosing your Plastic Surgeon

While the numbers of men requesting cosmetic surgery continues to rise, men still account for only 20% of all plastic surgery patients. This means that plastic surgeons still overwhelmingly have female patients. If you are a man interested in cosmetic surgery, you should be sure to choose a plastic surgeon who is board certified in plastic surgery and is experienced with male patients. This will help ensure that your surgeon will provide you with the most appropriate procedure sense as we discussed earlier, operating on man is very different than operating on women.

If you would like to discuss male plastic surgery with a board-certified plastic surgeon experienced an operating on man, you can contact Dr. Matthew Schulman.

Frequently Asked Questions:

Do men get Tummy Tucks?

Yes. Men get tummy tucks, but a tummy tuck in a man tends to be directed towards excess skin that can accompany weight loss. In women, a tummy tuck is targeting changes associated with pregnancy. However, this is not the case in men. This means that a tummy tuck in men tend to remove excess skin but there is usually not a requirement for muscle repair.

Is it common for men to have chest reduction surgery?

Chest reduction surgery is very common among men. It is designed to remove excess fat and breast tissue that can develop in men. In fact, up to 80% of adolescent boys experience excess breast tissue during puberty. A percentage of these boys do not see regression of this breast tissue and this can become bothersome to them. Male chess reduction is very common among males of varying ages.

What areas of the body can liposuction be performed on in men?

Liposuction can be performed on any part of the body where there is excess fat. In men, it is commonly the lower abdomen flags and lower back which is often referred to as the “spare tire”. But again, if you have excess fat of your neck, thighs, arms, or chest, liposuction may be an option for you.

Is there a procedure to give me a stronger jawline?

Jawline surgery is very common in men. This is because a strong jaw line is considered by many to be more masculine. The specific procedure will depend exactly on what you need done, but jawlines can be strengthened using injectable fillers, implants, or even surgery to move the jawbone.

 

References

Brazilian Butt Lift Safety in 2021

Brazilian butt lift procedures represent one of the most popular procedures in cosmetic surgery today. The number of people requesting this procedure, commonly known as a BBL, has been increasing year after year for the past several years. The procedure involves removing fat via liposuction from the places you do not want it, and then re-injecting that fat into the places you do want it, such as the butt and the hips. The procedure offers the benefit of liposuction in addition to the advantages of fat transfer. The end result is usually a smaller waist with perky butt and rounder hips.

Unfortunately, the Brazilian butt lift procedure has been getting a bad rap in the press over the past several years. It has been called “the deadliest plastic surgery procedure”. There have also been recent Internet clips from a well-known Hollywood plastic surgeon claiming that this procedure is so deadly that it should not be performed. The backlash over this procedure stems from a study that was performed in 2017. This study showed that there was a significant death risk when having a BBL procedure performed. However, this is certainly not the case and evaluation of the actual data shows that this procedure is safer than a tummy tuck.

The 2017 Study

The study was published in 2017 using data from surveys to plastic surgeons. The data study showed there was a 1 in 3000 risk of death after a Brazilian butt lift procedure. This is certainly an extremely high death risk and understandably, this caused great concern amongst plastic surgeons as well as the general public. No plastic surgeon would ever advocate for procedure that carries a 1 in 3000 chance of death. Those of us who have been performing Brazilian butt lift procedures for a very long time and specialize in this procedure, immediately knew that this number just didn’t make sense.

When experts in Brazilian butt lift procedure as well as people knowledgeable about scientific studies looked at the results of the survey, it became apparent that the study was just simply flawed on many levels. There were errors in statistical analysis and study design. But the damage was already done. Global media picked up on this reported death rate of 1 in 3000, and there was an immediate call to ban the Brazilian butt lift procedure. There were some countries in Europe that went so far as to actually prohibit plastic surgeons from for performing this procedure. Additionally, there were some hospitals in the United States that placed this procedure on the list of prohibited operations. During this period of public uproar, there was also criticism of this procedure from other plastic surgeon who, quite frankly, never even performed this operation. It became a very hot topic within the plastic surgery community and caused a great division.

The 2019 Study

Luckily a better designed study was performed in 2019. This study did not have the flaws seen in the original 2017 survey. The results of this 2019 study show that the actual risk of death from the Brazilian butt lift procedure is 1 in 15,000.  This was quite different from the 1 in 3000 death rate that was originally reported. And shows that this procedure is actually quite safe when performed correctly. In fact, for comparison, a tummy tuck procedure carries a death risk of 1 in 14,000. So, this means that the Brazilian butt lift procedure is actually statistically safer than a tummy tuck.

Fat Embolisms

Obviously, there are risks with any surgical procedure. In addition to the usual risks of infection, bleeding, anesthetic reaction, and scarring, the Brazilian butt lift procedure carries a unique risk because of the procedure itself. The procedure relies on injection of fat to fill up areas such as the butt and hips. Injecting fat into the body carries the potential risk of what is called a fat embolism. A fat embolism is when droplets of fat travel through a blood vessel to the heart lung and brain. This is a potentially fatal complication. So how does a fat embolism occur during a Brazilian butt lift procedure? In order for fat to travel through a blood vessel to other organs, fat needs to get into the blood vessel to begin with. When fat is being injected into the buttock, the surgeon needs to be very aware of the location of normal blood vessels in that area as to avoid accidental injection of fat into these vessels. It is these instance of fat embolism’s that are responsible for the majority of unfortunate deaths associated with a Brazilian butt lift procedure.

Ways to Minimize the Risk of a Brazilian Butt Lift Procedure

Regardless of whether or not reported data was flawed, it became quite obvious that the BBL procedure is a procedure growing in popularity and that we need to focus strongly on safety surrounding this procedure. This meant that plastic surgeons created guidelines to help minimize the risk associated with a BBL. These guidelines were extremely important given the increasing popularity this procedure, as well as the increasing number of plastic surgeons who are starting to perform this procedure and may not have many years of experience that the experts have.

The majority of the guidelines focused around techniques during fat injections to minimize the risk of fat injections into blood vessels. This included:

  • improved knowledge of the anatomy of the area so that blood vessels can be avoided
  • patient positioning during the surgery
  • surgical instruments used to inject the fat
  • injecting the fat over the muscle as opposed to in the muscle or below the muscle
  • Rapid recognition of a potential fat embolism

Any plastic surgeon performing Brazilian butt lift procedures needs to be intimately aware of these guidelines in order to keep their patients safe.

How to keep yourself safe during your Brazilian Butt Lift

In addition to plastic surgeons being aware of techniques to reduce your risk during a Brazilian butt lift procedure, there are also things you can do as a patient to reduce your risk. These include appropriately selecting your surgeon who is performing your procedure, and appropriately selecting the facility in which your procedure is going to be performed.

As you are probably familiar, you should always select a board-certified plastic surgeon for your plastic surgery procedure. More importantly though, you want to make sure that your board-certified plastic surgeon is experienced in the Brazilian butt lift procedure. This BBL procedure is very specialized and carries unique risks as described earlier. You want to make sure that they are an expert at the BBL procedure. This means that you should ask your surgeon how many of these BBL procedures they perform per month or per year. You also want to specifically ask what techniques they will use during this procedure. This is because you want to make sure that they are following all safety guidelines in order to reduce your risk of potentially fatal complications. And experience board-certified plastic surgeon will not be offended by these questions. They will recognize that this is a potentially risky operation and they should appreciate your involvement and concern for your safety. If they get offended, then that may be an indication that they are not the right surgeon for you.

 

  • Choosing your facility

All plastic surgery procedure should be performed in accredited operating facility. This means that it could be a hospital, an ambulatory surgery setting, or an accredited office operating room. You want to make sure that wherever you are having the surgery is up-to-date with all safety standards and there is a board-certified anesthesiologist who will be administering your anesthesia and monitoring you throughout the procedure and stay in the recovery room.  As someone who has performed over 5000 Brazilian butt lift procedures safely, I never perform this operation under local anesthesia. I find that general anesthesia is safer, more comfortable for you, and allows me to provide you with a better surgical result.

If you would like to learn more about the Brazilian butt lift procedure and how you can get this procedure done safely, you can contact New York City board-certified plastic surgeon Dr. Matthew Schulman. Dr. Schulman is considered an expert at this procedure having performed more Brazilian butt lift procedures in his career than most other plastic surgeons.

 

References

Choosing Your Plastic Surgeon

The decision to have plastic surgery can be quite daunting. There’s a lot that goes into the decision, including what procedures you want, when to have the surgery, and who to choose as your surgeon. For now, let’s focus on how to properly choose your plastic surgeon for your procedure. This is probably the most important step in the process since a skilled surgeon will be able to properly guide you towards the most appropriate procedure for your needs, and also be able to perform that procedure safely.  While no surgical procedure is entirely risk-free, many of the complications that I have seen over my 15 years as a plastic surgeon could likely have been avoided if the patient had chosen an appropriate surgeon.

Educational Credentials and. Board Certification.

The first place to start when selecting a surgeon is to check their credentials. This includes where they went to medical school, what residency program they completed, and if they have completed and maintained the appropriate certification.  If they have not satisfied this basic level of educational credentials and board certification, then you should immediately cross them off your list of potential surgeons.

Medical School

It may be interesting to know where your potential surgeon went to college and medical school however, this is not as important as you may think. Of course, the surgeons who went to an Ivy League school will proudly post on their website that they are “Ivy League educated”. However, as we all know there are excellent colleges and medical schools that are not Ivy League. What is important however is that your surgeon went to an accredited medical school. All accredited medical schools have standardized curriculums, so as long as the medical school is accredited, you can feel confident that they had the appropriate education. 

Residency Program

More important than where they went to medical school is where they did their residency. Residency training is additional education in a specific field that is completed after medical school. If you are looking to have plastic surgery, you must verify that your surgeon completed a plastic surgery residency program. This residency program is usually 6 to 8 years of training in plastic surgery after medical school. This will help make you more confident that your plastic surgeon has been appropriately trained. It is important to verify that they Indeed completed a plastic surgery residency. It is possible for other doctors who have not completed a plastic surgery residency program to still legally perform cosmetic surgery.

Board Certification

Another important step in choosing your plastic surgeon is to verify that they are board certified in plastic surgery by the American Board of Plastic Surgery. This means that they have completed an accredited residency program in plastic surgery, and have gone on to complete oral testing and written testing to help verify their knowledge and skills. The American Board of Plastic Surgery also requires ongoing education, maintenance of certification with regular testing, and adherance to ethical guidelines of the board. If your surgeon is board certified by the American Board of plastic surgery, it will be proudly displayed on their website, on their office walls, and on their business cards. If you do not see clear display of the fact that they are board-certified in plastic surgery, then they most likely are not. Also, please do not confuse “board-certified” and “board-certified in plastic surgery”. It is possible for someone to be board-certified in another specialty such as internal medicine, cardiology, pediatrics, dermatology, etc., but you would not want them performing your plastic surgery procedure. You want to make sure that your surgeon is specifically board certified in plastic surgery. Again, if they are, they will be screaming it from the mountaintop. You can also check online directories to verify your surgeons for certification, such as certificationmatters.org.

Experience

Next you want to make sure that you are board-certified plastic surgeon is experienced. The fact that they are board-certified should make you comfortable that they are experienced as plastic surgeons. However, you want to make sure that they are experienced in the specific procedure that you are interested in. The field of plastic surgery is very broad. This means that plastic surgeons are trained to treat a variety of conditions and perform a variety of surgeries from head to toe. Many surgeons have gone on to specialize in specific procedures or specific body parts. This means that if you were interested in having a breast procedure, then you want to make sure that your surgeon is experienced and specialized in performing breast surgeries. If you are interested in having a tummy tuck, then you want to make sure that your surgeon performs a lot of tummy tucks. The easiest way to find this out is to ask the surgeon or the office how many of these specific procedures  they perform each month and each year. If your surgeon only performs a handful of the specific surgeries per year, then you may want to look for someone who is more of an expert.

Results

Do you want to make sure that you are familiar with the types of results that your surgeon can offer you. This means that you should look at before and after pictures from your surgeon. These can often be found on your surgeons’ website or other websites that are commonly used. It is more than just looking to see if the results are “good”. You want to make sure that your surgeons aesthetic matches your aesthetic. For example, there are many surgeons who perform a lot of breast augmentations, but their results tend to be larger and less natural looking. If this is the type of lock that you are going for ,then great. However, if you were looking for a more natural result with smaller implants, then you should find a surgeon who commonly offers similar results.

Online Reviews

Another way to help select your surgeon is to look for online reviews from former patients. This is a good way to find out about other people’s experience. You should be careful though when looking at online reviews because online reviews can be manipulated. Some surgeons have found a way to successfully remove negative reviews. Others have found a way to post highly positive reviews written by friends, family, or staff members. I’m not trying to say that online reviews are all fake. But you should keep in mind that some reviews may not be 100% credible. This means that you should find a handful of negative reviews for any surgeon. The presence of negative reviews, does not mean that the surgeon is bad. It is impossible to please 100% of all patients all the time. This means that a busy surgeon who performs hundreds of procedures a year, is likely to have a handful of unhappy patients. This does not mean that the surgeon is a bad surgeon and it does not mean that the surgeon did a bad job. The patient may be unhappy for reasons that the surgeon had no control over. I personally would not trust a surgeon who has hundreds of glowing positive reviews, yet it is impossible to find anything negative.  If I could only name names…….

Speak with Former Patients

Another way to choose your surgeon is to actually speak personally with former patients. Many offices will be able to provide the name and number of former patients willing to discuss their experiences with you. This usually offers a better opportunity to find out information that you will not be able to find out from simply reading an online review. Again, keep in mind that the office will not give you the name of an unhappy patient. But, you can feel more comfortable knowing that the person you were talking to is an actual patient who had an actual procedure with the surgeon.

Have a Consultation

The final step in choosing your surgeon is to have a consultation. This gives you an opportunity to meet the staff, meet the surgeon, and decide if they are the right surgeon for you. You can get to know the surgeon’s personality, and ask them questions about the procedure and their techniques. Choosing a surgeon is like choosing a friend or a partner. Your personalities, and goals need to match.

 

To set up your consultation with Dr. Matthew Schulman, New York City board-certified plastic surgeon, contact us through the website or by phone.

References: