Modern Research in Plastic and Reconstructive Surgery

In the last decade, with the rise of social media there has been an escalation of interest and decline in stigma surrounding plastic and cosmetic procedures for men. We sought to highlight the rapidly expanding and increasing role of plastic surgery in men with a comprehensive literature review. Our focus encompassed gender-specific dimensions of procedures such as neuromodulator injections, dermal fillers, liposuction, gynecomastia surgery and hair transplant. We discuss the importance of minimally invasive and discreet procedures; featuring some of the most popular cosmetic procedures amongst men within the last 10 years.

Keywords: Plastic and cosmetic procedures, Men, Appearance, Self-care

Plastic surgery has seemingly been traditionally more favored and accepted amongst women. However, cosmetic procedures for men have continued to increase in popularity. From 2012 to 2022, The American Society of Plastic Surgeons saw over a 24% increase in cosmetic procedures performed in men.^1,2

In a survey done by the American Academy of Facial Plastic and Reconstructive Surgery, they found that the demographic of men receiving cosmetic procedures has not only been getting larger, but younger as well.³ The surge in access and use of social media and the internet within the last decade has played a role in this increasing interest amongst men. Although it is more commonly thought to influence women, studies have shown that men are also affected. Among male patients that received plastic surgery procedures, there was an increased usage of social media.^4,5 With this consistent exposure to the more ideal male body image, there is arguably more emphasis on physical appearance than ever before, bringing along a pressure to attain these idealized standards.⁴ As social media continues to be a prominent part of our lives, so will its effect on interest and demand for plastic surgery.

Over the last 10 years, there has been an increasing interest by men in almost all the various types of cosmetic procedures.⁶ Unsurprisingly, minimally invasive cosmetic procedures exhibited the largest increase, seeing an over 40% rise in men receiving these procedures within the same period. In particular, men tend to choose non-invasive procedures with botox, skin treatments, skin resurfacing and filler being the most sought-after cosmetic procedures by men in 2022.^1,2 This highlights the importance of discreet and natural cosmetic procedures for men. Despite a growing social acceptance of cosmetic procedures for men, there remains the opinion by some that these procedures are emasculating.⁷ This underlying stigma may result in a man’s inclination to perfect certain features as opposed to more significant alterations, with the goal of looking rejuvenated with an overall healthier appearance without signs of recent or profound alteration. Additionally, men seem to prefer procedures with little downtime,^8,9 furthering the growing emphasis on minimally invasive procedures for men.

By far the most popular cosmetic procedure for men in 2022 was the use of neuromodulator injections such as botox, but men are not only after the anti-aging effects of botox. With more men looking to achieve a more youthful look for their age, they are also hoping to alleviate unwanted facial expressions such as looking “grumpy” or “tired”.^9,10 When getting botox, the areas of most concern for men were crow’s feet and forehead lines.¹⁰ Due to the larger facial muscles and harsher fine lines, botox can be especially useful in male patients.¹¹

Dermal fillers are a close second in popularity for men right behind neuromodulators. When receiving facial procedures, men are most fearful of inadvertently developing a feminine appearance and want to attain facial masculinization.⁵ Whether it be due to loss of volume due to aging or a natural looking jawline, filler has become increasingly more popular as a procedure for men.¹¹ With a focus on the lower third of the face such as the chin and jawline, filler can help achieve a prominent jawline which is considered to be a masculine feature, nowadays.

Liposuction was the most common invasive surgical procedure performed in males in 2022. Because men tend to gravitate toward procedures that are easily kept private, liposuction allows men to have discreet fat removal since small incisions are used. Men are most likely to receive liposuction of their breast (gynecomastia), abdomen, flanks, and neck.⁷ Besides traditional liposuction, more minimally invasive approaches have become more sought after by men. Procedures such as laser-assisted liposuction and cryolipolysis⁸ cater to men’s desire for discreet procedures with minimal downtime. Laser-assisted liposuction uses the thermal energy of a laser, while cryolipolysis uses cooling technology to get rid of unwanted adipose tissue.⁸

Traditionally, the goal of liposuction was simply to remove fat to correct lipodystrophy. More recently, there has been a new demographic of younger men who seek out liposuction for a more muscular appearance. High-definition liposuction removes superficial fat that would normally overshadow the muscle below, producing the desired muscular male abdomen.¹² This liposculpting has become increasingly popular especially amongst men. In addition to purely removing adipose tissue for a more muscular appearance, men can also undergo fat grafting. This body shaping technique is used to fill in areas that are lacking such as pectoralis, rectus abdominis, biceps, and triceps muscles to achieve the desired athletic look more men are after.¹³

Gynecomastia surgery, the male version of breast reduction, has remained an attractive procedure for men throughout the last decade and continues to see increased interest. As touched on before, men do not want to appear feminine, and the presence of gynecomastia contributes to low self-esteem and embarrassment.¹⁴ The surgery not only removes the excess tissue but also aims to create a more masculine chest.¹⁵ Liposuction is the most routinely used surgical method in gynecomastia and coincides with the male priority for minimally invasive procedures with little downtime. To capitalize on this, new research and techniques are continually being developed. This includes the pull-through and bottom-up technique which creates nominal scarring with the same cosmetic outcome.¹⁵

Hair transplant is consistently a more sought-after procedure by men than women, considering that almost 50% of men by the age of 50 experience hair loss to some degree.^13,16 Hair loss in men has a significant impact on their emotional and social wellbeing making hair transplant surgery a popular and more permanent option.¹⁷ Although there is medical treatment available for hair loss, it may not produce a desired effect, making hair transplant surgery the mainstay treatment.¹⁶ With new advancement, modern hair transplants are nearly undetectable and can be performed as an outpatient procedure making it a great option for men with hair loss.¹⁸

Now more than ever, men are taking control of their appearance by receiving cosmetic procedures and reaping the benefits of increased confidence and self-esteem. As plastic surgery becomes more accessible, affordable, and accepted, more men have been seeking out procedures and treatments. Within the last decade, we have seen an increase in interest by men in plastic and cosmetic procedures and this trend is set to continue.⁶ This increase in demand for plastic surgery by men is reshaping the field of plastic and cosmetic surgery. The increasing role for plastic surgery in men highlights a significant shift in societal norms and attitudes toward male appearance and self-care.^19-25

None.

This perspective received no external funding.

Regarding the publication of this article, the authors declare that they have no conflict of interest.

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