When it comes to the demographic of patients at his practice, Vero Beach, FL plastic surgeon Alan J. Durkin, MD says there is “no question” that more males are coming in across the board—for issues small and large.
“We are seeing a huge uptick in body-contouring requests and nonsurgical interventions for the face,” he says. “The main surgical increase is with upper lid blepharoplasty, which has always been popular amongst male patients. However, over the last year, our volume has increased by 22 percent regarding male upper eyelid lifts.”
While Dr. Durkin categorizes the last 10 years as showing steady growth of the male patient in aesthetics, he says it has clearly increased over the last 12–18 months. “While I cannot prove this, I personally believe that the pandemic and its resolution has accelerated the male desire for aesthetic services. Perhaps it is the ‘Zoom effect,’ perhaps it is from being sedentary for the last year. Personally, I believe it is more of a ‘YOLO effect.’ The pandemic forced all of us to re-evaluate ourselves, men included. Now, with the world re-opening, they have a chance to change something they dislike.”
“You only live once—why not now?”
Mirror, Mirror
Male plastic surgery is also a big focus at Palo Alto, CA facial plastic surgeon Jill L. Hessler, MD’s practice—and she pegs a similar timeline as experiencing the uptick.
“I have seen a significant increase in the number of men seeking cosmetic procedures over the past decade, but especially over the last year. Men have always been less likely than women to have cosmetic treatments, but I think Zoom has had a significant impact on the number of cosmetic treatments people are seeking—and this is particularly true for men.”
Similarly, West Palm Beach, FL dermatologist Kenneth Beer, MD points out that, while it may be a major plus for the telecommunication game, the resolution of these mediums isn’t always so kind to facial flaws.
“I am seeing more men than I have ever seen before,” he says. “They are doing a lot of work from home and, while I don’t see many men who care what their appearance is from the neck down, most do care about what is going on with their face. The men that I deal with are used to looking their best—but may not be ready for high-resolution. For Zoom, FaceTime and Skype, the resolution now is incredible. This means that we see every wrinkle, every freckle and each shadow caused by volume loss.”
Dr. Hessler also notes that Zoom has forced all of us to stare at ourselves in particularly less-than-flattering positions. “Women are quite accustomed to looking in the mirror, but I think men have spent less time reflecting on their own faces. Now, with video-conferencing, men are observing their faces in a whole new light and getting a perspective how others view them.”
The Eyes Have It
Like Dr. Durkin, Dr. Hessler lists blepharoplasty as having the biggest boom when it comes to facial surgery. “I am seeing a dramatic increase in blepharoplasty surgery and necklift surgery. Certain room lighting can emphasize eye bags and lines around the eyes, making one appear tired.”
“There has also been a significant increase in the number of men noticing their neck,” she adds. “There is no lighting or angle that can remove contours of neck laxity—it can only be removed by surgery.”
“I think men are really being forced to stare at themselves on these meetings and calls now, and they don’t like the signs of aging that are represented on their face and neck. Perhaps, they haven’t had time and now with ‘work-from-home’ it is much easier to recover from surgery.”
Encino, CA plastic surgeon George Sanders, MD also gives a nod to the work-from-home formula as driving his uptick in male-focused surgeries, and couples it with a few other factors.
“Initially, at the start of the pandemic, there was a surge of men interested in neck liposuction—and they were motivated by the fat necks they saw when they viewed themselves on Zoom,” he says, adding that neck liposuction for men under 50 is very popular at his practice, as is a necklift for the 65-plus crowd. “The pandemic provided the perfect opportunity to undergo surgery—more free time available, more discretionary income because of less travel/dining/entertainment expenses. Plus, a mask allows for recovery in secrecy!”
Open Discussion
At Nashville, TN plastic surgeon Daniel A. Hatef, MD’s practice, “hair-restoration surgery has absolutely exploded over the past 18 months,” which he says naturally progresses into some other aesthetic surgeries of choice.
“With so many men working from home, they can tolerate the downtime while they await their follicular units to start growing again. Manscaping, ‘Bro-tox’ and male body contouring have all taken off because there is less taboo surrounding these things. Because of that, so many men are now taking great care of their skin and bodies—they want a hairline to match their youthful appearance and vigor.”
Dr. Hessler also believes there has been some “shaking of the stigma” when it comes to men having cosmetic treatments and plastic surgery.
“Many of the less-invasive treatments are almost considered in the category of health and grooming. I am fortunate to live in the Bay Area where there is a strong emphasis on eating well, exercising and being healthy,” she says. “Many people stay extremely fit and active into their 70s and 80s and they want their face to reflect this internal energy. Silicon Valley is also a youth-centered culture and many individuals also want to stay looking young to allow them to work as long as they can.”
“More men seeking cosmetic procedures has been an ongoing trend over the past few years—and it’s no longer shrouded in secret,” agrees New York facial plastic surgeon Konstantin Vasyukevich, MD, who says his male “most-requested list” includes Botox Cosmetic for frown lines, as well as the surgical option of a face- and necklift. “Men feel more and more comfortable with not just getting cosmetic procedures, but also openly talking about it to their friends.”
To that end, Dr. Vasyukevich also calls out a “cultural shift” that he has witnessed over the last decade or two. “People no longer frown upon men who want to look good for their age—there are a lot of men who are willing to undergo cosmetic treatments to achieve that. In part, this is due to women increasingly encouraging their husbands and boyfriends to seek a plastic surgery consultation. The prevalence of social media also plays a significant role in this developing trend. Looking good on social media is just as important for men as it is for women, causing many men to pursue cosmetic enhancements of their look.”
Dr. Sanders says there’s also another social consideration that he sees: the fact that people are simply working longer and retiring later than in previous decades. “It’s no longer taboo for men to dive into appearance-changing operations. Men want to look refreshed and need to do so if they are to remain competitive in the job market and on the dating scene. As men work into their 70s, a refresher procedure is often helpful to secure the best jobs and the best social opportunities.”
By the Numbers
Crediting social media as probably having the biggest pull on increased interest in elective procedures, in general, Los Angeles plastic surgeon Ben Lee, MD says taking a close look at the statistics tells an interesting story.
“For obvious reasons, the total number of aesthetic surgery procedures was down in the United States in 2020. This is in contrast to media reports of a plastic surgery boom during the pandemic, as there were 14 percent fewer procedures reported to the American Society of Plastic Surgeons compared to the previous year. Considering the magnitude of the worldwide health crisis, it is perhaps surprising that so many people took advantage of the downtime to have aesthetic procedures done.”
“Similarly, it has been reported that male plastic surgery has been on the rise, but it has consistently remained at about 8-10 percent of all cosmetic procedures throughout most of the past decade,” he adds. “Reports of a boom in male plastic surgery had been based on a nearly tripling in the numbers of male cosmetic procedures since the late 1990s, when statistics were first recorded. Over the past several years, the proportion of males seeking plastic surgery has remained stable, in the high single digits.”
Nevertheless, Dr. Lee says it is clear that a large proportion of men are interested in cosmetic procedures. “A survey conducted by the American Academy of Facial Plastic and Reconstructive Surgery in 2018 indicated that an astounding 31 percent of men would seriously consider an elective aesthetic procedure. This trend is sure to increase—largely due to social media. It is now acceptable for men to post selfies, and it is increasingly acceptable for men to be concerned with their appearance. With this level of interest, it is inevitable that we will see and increase in male cosmetic surgery in the coming years.”
And, while Dr. Lee does point toward an increased interest in everything-eyes at his practice, he predicts we’ll see an upswing in body procedures as the year rolls out.
“According to the American Psychological Association, 42 percent of Americans reported undesired weight gain over the past year, with the average being an astounding 29 pounds. This has no doubt increased the need for another weight-related problem for men, gynecomastia, or breast enlargement, which is also largely addressed via liposuction.”
Botox Boom
Not surprisingly, Dr. Beer says the nonsurgical option of the neurotoxin is the most-requested treatment for his male clientele—the Aesthetic Society stats report that, in 2019, men accounted for nearly 10 percent of all injectable treatments—but says the use of fractional and fully ablative lasers are “really gaining popularity” as well.
“We are also treating a lot of rosacea with pulsed-dye laser, and filler use has gone through the roof as we have started to see more men coming in for ‘injectable facelifts.’ Overall, it has been an amazing increase. I have also seen an upswing in men who want to do more skin care at home, which may reflect the added time they have from not having to commute,” he says, adding that his skin-care brand, ScientificRx, has had an increased demand for the bamboo exfoliator, the vitamin C and the peptide serum via online sales. “For some products, we have trouble keeping them in stock.”
While Rochester, NY dermatologist Lesley Loss, MD says women still remain the vast majority of her patient population, she concurs that the number of men she sees has had a steady increase.
“The most requested treatments by men are miraDry to eliminate underarm sweat and odor, Botox to soften lines and wrinkles on the face, and CoolSculpting for non-invasive body contouring.”
Also tagging neurotoxins as a top procedure at her practice for men, Bloomfield Hills, MI dermatologist Linda C. Honet, MD categorizes men as “interesting creatures compared to women and make great cosmetic patients” and says she witnesses men being more “results-driven.”
“If they see the improvement and like the results, they will be at your office doorstep on time, every time. They will rarely haggle the cost, and will plan ahead and make their next appointment in a timely fashion.”
Dr. Honet says when it comes to products, men seem to buy in bulk. “They will also buy multiples of the same skin-care product if they like it, so they never run out. I try to keep the skin-care routine simple for men for this reason. More often than not, shopping around is not what men like to do, so when they like what I recommend, they’ll stick to it.”
“All that being said, the last year definitely has brought men out of the woodwork for cosmetic treatments. The top three in my practice have been neuromodulators, platelet-rich plasma (PRP) for hair thinning, and laser hair reduction for body. Dermal filler for tear troughs and jawline have become very popular among men, too.”
The bottom line, she says: Men don’t want anything too labor-intensive to maintain. “They like long-lasting results, they don’t want anything too fussy, and they want to make their significant others happy as much as they want to look and feel great without too much sacrifice. Let’s face it—men want to look good, too. They just go about it a little differently than we women do.”
Coupling Up
Pointing to a somewhat simple explanation for a man to make the personal decision to get plastic surgery, Dr. Hessler explains that she often sees a man care for his wife after a facelift and “he sees how amazing she looks and realizes the procedure wasn’t that bad. Then, they schedule their own procedure.”
Dr. Loss has witnessed a similar segue: “We’ve seen a lot of spouses and partners come in with their female counterpart for cosmetic treatment. As aesthetic treatments have become less ‘taboo’ for women, we’ve seen them sharing with their significant other at home and encouraging them to explore treatment options as well.”
Comparably, Dr. Honet insists that, although it’s very difficult for men to initially pull the trigger to have a cosmetic procedure done, “if they have an emphatic spouse or significant other pushing them from behind the scenes, once they do, they are the most loyal and committed patients I have!”
On the flipside, Dr. Lee says, in his observations, the dating game plays a large role with the “why” behind the decision for a male patient to choose to have an aesthetic treatment.
“To be honest, in prior generations, men simply did not care as much about their appearance, as there is not as much in the way of social rewards for being extremely attractive relative to women. The internet has changed things. Online dating studies have reinforced the belief that 20 percent of the men get 80 percent of the attention, so it pays to invest in your appearance. Platforms such as Instagram and TikTok have made it acceptable to ‘put yourself out there,’ so while it’s still taboo for some men to openly talk about their surgery, there is less of a stigma for a man to have procedures done, as long as they keep it to themselves.”
“Men have much more time on their hands and have money to spend on themselves because they are not traveling, not wearing expensive clothing, not paying for dry cleaning and the job market is competitive,” Dr. Beer says.
“Plus, there are also a new group of men that have realized that, after spending a year with a spouse at home, they may be on the market soon.”