10 Facts About Facial Rejuvenation in Men
3 December 2019 onur
The male demand for facial rejuvenation surgeries is increasing each year. Facial rejuvenation surgeries on male patients are a special area of facial aesthetics. In this blog post, I will share with my dear readers some important points specific to men in facial rejuvenation surgeries.
- Male aesthetics is different from female aesthetics.
One of the existential purposes of aesthetic surgery is the desire of people to have an appealing appearance in the eyes of the opposite sex. You may say, “I’m getting these plastic surgeries done for myself”. I have no objection to that, but it is not possible to distinguish the desire for beautification from the desire for “attraction”, either subconsciously or subconsciously. Beauty in women is often equated with attractiveness. Beautiful women are often found attractive by both their own sex and the opposite sex. This is not exactly the case with men. Men’s attractiveness is not dependent on a “beautiful” face. When you look at many “iconic” men’s faces, it is possible to detect some features that are not beautiful or even clearly flawed. Exaggerated chins, exaggerated skeletal lines, extremely low eyebrows, a forehead too short or too wide, scars, flawed noses, coarse beard, disheveled hair and others… Some key elements of male attractiveness are the features that emphasize this “masculine” character on the face. You may not find an aquiline, big or long nose “beautiful”, but beautifying the noses of acknowledged handsome men like Tom Cruise or Robert Pattinson is enough to reset all the charisma in these men in seconds.
- The principle of “not feminizing” the face
Facial rejuvenation surgeries in male patients have different goals and principles, but the foremost among them is the principle of protecting the masculine character of a male patient at all costs and not making any changes that evoke femininity, that is, “not feminizing” them. The work done may be incomplete and ineffective. It is possible for the patient to say “I do not see much of a change”, but it should never, ever create a feminine expression. It is useful to evaluate the following points in the light of this principle.
- The aging process is good for some men
During the aging process, some men become more “attractive”. Angling of the face, its gaining expression, hard and shadowy facial contours, deepening of the looks, mature/experienced expression brought about by mimic wrinkles, gray hair/beard are likable on some faces. Women who read this post will immediately understand what I am talking about. In the planning process for male patients, it is key to determine these characteristics that suit them and to guide them in maintaining such features.
- A man has low eyebrows
All handsome male figures, without exception, have low eyebrows. Period.
Therefore, brow lift surgeries in men should be performed for very limited indications and to a very conservative extent if they must be done. While forehead lift/brow lift surgeries are one of the important elements of the facial rejuvenation portfolio in female patients, the situation is the opposite in men. One of the most important reasons for the piling up of skin on the upper eyelid in male patients is that the skin, which is normally under the eyebrow, sags and thus appears as if it is on the upper eyelid, due to further drooping of the already-low eyebrows. In male patients, when the upper eyelid skin is removed, the distance between the eyelash and the eyebrow will be shortened, so the eyebrow will droop a little more and the skin pile-up on the eyelid will recur in a short time. In men, upper eyelid surgeries typically open/clean the upper eyelid at a level that is “below expectations” . The reason for this is that while we need to lift the eyebrow to obtain a clearer eyelid fold, we are hesitant to raise the eyebrows due to the “not feminizing principle”. It is very important for male candidates to understand the place of eyebrows in male aging and the limitations of eyebrows.
- Ruddy is the apple, not the cheek
I never associate male patients with chubby cheeks and soft cheek contours. I think it is an aesthetic defect, particularly for a man over the age of 40, to have a full, high, “ruddy-cheeked” face. Therefore, I do not recommend any of my patients to have midface lift / midface fat injection / cheek filler surgeries to increase the fullness of this area. In male patients, in cases where the transition from the undereye to the cheek is really prominent, prostheses that are placed on the bone and give the face a more bony appearance may be preferred to obtain a better appearance. In addition, limited adipose tissue transfers to this area can be an option to camouflage the transition from the undereye to the cheek, but the goal should never be to plump the cheeks, particularly the cheekbones.
- Lower face and neck region are our priority targets
During the aging process, the major changes in the male face occur in the lower half of the face and neck. Happily, these are among the areas that benefit most from facelift surgery. When designing facelift surgery in male patients, I prefer low designs (LowSMAS) that do not move the cheek tissue upwards. The key effect in this surgery is that it allows us to obtain a clearer and sharper jawline and neck contour. The sagging of the lower face and neck in men makes the male face look weak and tired. It is this perception of loss of dynamism that usually bothers patients the most. Lower face and neck lift surgery requires an incision that starts in front of the ear and continues along the hairline behind the ear. This incision scar is the most important surgical handicap for men. If we will work on the neck as well, it may be necessary to make an additional 3-4 cm incision under the chin. Through this incision, we can effectively work on the problems in the midline of the neck as well as accessing the bone structure at the chin. Men with receding or underdeveloped jawbones are particularly affected by aging of the lower face and neck at a much earlier age. Therefore, reviewing the bony support of the chin at the planning stage may distinguish a good result from an average one.
Postoperative camouflaging process
An individual who is not ready to camouflage the scars of facelift surgery cannot have this surgery. Women are lucky because when they untie their hair, the ear area is camouflaged. If they are wearing a headscarf, things are even easier. Even in the early stages of recovery, they can wear makeup for camouflage. In addition, the scars can be camouflaged in the early recovery period with accessories such as headbands and hats. Such an advantage of camouflage allows female patients to resume work and social life in a period as short as 10-14 days. For men, things are a little more complicated. Most of my patients grow a beard to camouflage the scar in front of the ear successfully. After the surgery, you should not choose very short hairstyles if you want to camouflage the back of the ear and the sideburn area. You may shave your beard about 3 months later when the scars become indistinct. Then people will start to react, saying, “Now that your beard is gone, you look younger”, and the perceived change in the face is attributed to the shaving of the beard rather than surgery. If growing a beard is not an option for you, then you can use cosmetic concealer creams/foundations.
- Rebuilding the beard line
On the male face, there is a beardless strip of 1-1.5 cm between the bearded skin and the ear. In facelift surgery, this strip is disrupted and the bearded skin becomes abnormally close to the ear. It may be necessary to reconstruct this beardless strip by regional laser epilation around postoperative month 3 .
- Pay close attention to the lower eyelid
Lower eyelid surgery is one of the operations with the highest complication rate in facial aesthetics. In a nutshell, the lower eyelid may droop and turn outwards postoperatively. Now that’s a mess. Patients cannot go out in public for months. For many years, the scientific literature on plastic surgery has investigated how the complications of this surgery can be prevented, ultimately developing reasonable solutions. In female patients, we routinely fix the outer edge of the lower eyelid to the bone and tighten it. This procedure is called lateral canthopexy. Lateral canthopexy creates a slanting look in the eyes. This slanting appearance remains for 6-12 weeks. Mild slanting is not an issue in female patients. It may even be a source of joy because the patients tend to think they have almond-shaped eyes. In men, however, such long-term slanting is a physical sign that is very difficult to tolerate. Another approach we employ to prevent lower eyelid complications is to lift the midface area and support the cheek tissue and lower eyelid from below. This procedure is also very difficult to tolerate in male patients, as it causes the appearance of filler-applied cheeks. Because of such limitations, classical lower blepharoplasty, which aims to remove excess skin in male patients, is very risky, particularly after the age of 50. Most of the time, in order to stay on the safe side, I just remove the under-eye bags through a secret incision I make on the inner surface of the eyelid and leave the wrinkles on the skin intact. Complication rates are very low in this approach, which we call transconjunctival lower blepharoplasty. In male patients, it is reasonable to accept minimal changes and stay on the safe side, particularly in the plastic surgery of the periorbital area around the eye.
- Gentlemen, you are not alone.
I can feel the uneasiness in all patients who see me for facial rejuvenation: “I wonder if I am violating the norms.” Most of the time, there is no one in the neighborhood that we can take as a reference. That is why it significantly matters to bring male patients together with other patients who have had the same experience. Rest assured, you are not alone. This is the way it goes.
If you want to get detailed information about facial rejuvenation procedures in men, feel free to contact me.
Take good care…
and stay handsome!