Cosmetic surgery for men

Nips, tucks, fillers and implants — men across the UAE are turning to cosmetic surgery to tone, trim and tighten what time and nature has distorted.

These days, images of beautiful men sell anything from aftershave to washing machines. In an effort to keep up, the modern man is more likely to exercise, quit smoking and turn to a more health-conscious diet. An increasing number are also willing to pay thousands to improve what genetics, diet or exercise can't.

With the American male grooming market now worth $3.5 billion and sales of male beauty products in the UK growing 560 per cent in the last five years, it seems men across the world are suddenly becoming aware of the way they look. And it doesn't stop at face creams and deodorants.

According to the American Society of Plastic Surgeons, minimally invasive cosmetic procedures for men increased by 44 per cent between 2000 and 2005. In 2003, 15 per cent of all liposuctions and eyelid surgery, 24 per cent of nose jobs and 20 per cent of laser hair removals were performed on men. Currently in the UK, an estimated one in six cosmetic procedures is performed on a man.

Here in the UAE, the worldwide trend continues. Italian brothers Drs Maurizio and Roberto Viel have brought the best of London's Harley Street to Dubai's Healthcare City by opening the London Centre for Aesthetic Surgery last April. “Men make up about 30 per cent of our patients,'' says Dr Maurizio. “Many are married professionals, from all nationalities and usually in the 35 to 50 year age bracket. Cosmetic surgery fits into their growing awareness of wellbeing. Cosmetic surgery is about improving a person's quality of life; gender is becoming less important. Greying baby-boomers sign up for shoulder replacements and cartilage-cell knee transplants rather than give up the sport they love when their bodies start to pack up. Cosmetic surgery is no different.''

Another leading cosmetic surgeon Dr Jaffar Khan claims that feeling the need to look youthful and appear dynamic well into your 40s and 50s is what's behind the acceptance towards men who opt to have ‘a little work' done. “Even if a high-flying career has left you burnt out at 45, you're not supposed to look it,'' says Dr Khan.

“Top tier professionals are being promoted earlier in their careers, especially in such a high-achieving population as Dubai. This puts pressure on the senior guys to keep up. Some men view cosmetic enhancement as a way of positively assisting their career prospects as middle age approaches. The rise in treatments for women is another reason for growing interest in men. About half of my male patients are sent by their wives who have had successful treatments.''

1. BOTOX

What is it? According to statistics from America, wrinkle reducing botulinum toxin (botox) injections among men have increased 233 per cent from 2000 to 2005. In terms of minimally invasive facial rejuvenation, Dr Maurizio claims botox is the single most important innovation of the last decade. He credits this to the fact that doctors are gaining mastery of the technique and are now able to make patients look less frozen and more natural. “Subtlety is important for men; they are more covert about botox than women. They want people to think: he looks good, well rested and healthy. Guys don't want people to wonder who did his Botox.''

The procedure: It's a 15-minute quick-fix, instant treatment that can easily be done over a lunch break. Botox is a purified protein that is injected into the skin to block nerve signals from the brain to the nerve endings. It's sometimes called the Hibernation Treatment since it temporarily puts muscles to sleep, causing wrinkles to relax and soften. The surgeon will clean your skin and then inject small amounts of botox into the area to be treated. You will be asked to frown so the doctor can see the exact pattern of the individual lines on the forehead. “Men more commonly have well developed frown muscles and are more likely to need top-up injections,'' says Maurizio.

Pain-o-meter: It's non-surgical, using a series of fine needles that may be slightly uncomfortable.

Recovery time: Afterwards you may have some tiny red marks where the needle was inserted; lasting up to 24 hours. There will be instant results, but the full effect is gradual over seven to ten days.

Shelf life: It is effective for a period of three to six months, although injections can be topped up at regular three or six-month intervals, or yearly.

Side effects and risks: There is a very small risk of eyelid or eyebrow droop (1 in 800 patients). There may be slight puffiness and occasional bruising following the injections. Older patients with poorer muscle tone may feel heaviness over the eyebrows lasting two to three weeks. There is also a one in 1,500 chance of double vision that will correct itself over time.

Cost: Varies, but one treatment starts at Dhs1,600.

2. LIPOSELECTION

What is it? Liposelection is the new black in body reshaping. The Viel brothers no longer perform liposuction, claiming it's an aggressive surgery that causes bruising, pain and unnecessary downtime.

“Many men come wanting to remove ‘love handles' or stubborn pockets of fat from the chin or abdomen,'' explains Dr Maurizio.

“Liposelection is ideal for these areas. It uses ultrasound technology to precisely remove fat pockets. It is so gentle and specific that it was originally designed to treat brain tumours. We call it the intelligent lipo, because it has the ability to differentiate body fat from tissues that are best left undisturbed — such as nerves, blood vessels and connective tissues. Liposelection targets the less structured fat cells only, minimising pain and bruising.''

The procedure: Local anaesthetic is usually sufficient. On arrival the areas for treatment are marked, followed by sedation. Then the local anaesthetic is administered. Small incisions are made in the skin and a thin tube is inserted into the fat areas to be removed. Surgery may take up to an hour depending on the size of the area treated. It's possible to leave the clinic after two to three hours, although it's a requirement to have someone else drive you. Liposelection is not a treatment for weight control or obesity, and it can't remove cellulite or stretch marks.

Pain-o-meter: You may feel some vibration and friction during the procedure. There may also be a stinging sensation as the cannula moves closer to the muscle.

Recovery time: With liposelection a support garment will need to be worn for up to seven days. Most patients recover quickly and return to normal activities within days. “Expect to be back at the gym in two weeks,'' says Dr Maurizio.

Shelf life: “Your body doesn't replace fat cells in the same area, so the change to your body shape should be long-lasting. If you exercise, eat well and maintain a healthy lifestyle after your operation the procedure should be permanent,'' says Dr Maurizio.

Side effects and risks: It is common to experience some numbness, tenderness and discomfort following liposelection due to trauma of the nerves under the skin. There may be some loose skin, depending on the amount of fat removed.

Cost: Liposelection starts at Dhs30,000.

3. EYELID SURGERY

What is it? Blepharoplasty is eyelid surgery to remove the excess skin above and below the eyes and is one of the most common procedures for men. “Blepharoplasty can refresh a tired or weary appearance by correcting drooping upper lids and puffy bags below your eyes — features that make you look older and more tired than you feel,'' says Dr Maurizio.

“Blepharoplasty won't remove crow's feet or other wrinkles. Neither will it eliminate dark circles under your eyes; although once excess folds of skin are removed the under-eye shadows may be reduced. What is imperative during the procedure is symmetry. The surgery is not difficult but we must be extremely precise. The margins are tiny and there is no room for mistakes,'' says Dr Maurizio.

The procedure: Blepharoplasty is a day surgery using sedation and local anesthetic. The surgeon makes incisions following the natural lines of the eyelids to minimise scarring. For the upper lids, the incision is made in the creases of the eyelid. For the lower, the incision is just below the lashes. The skin is then separated from the tissue underneath, excess fat removed, sagging skin and muscle is trimmed. It takes around 40 minutes for the upper lids and 80 minutes for the lower, two to three hours for both. You will need a ride home after surgery.

Pain-o-meter: Once the anaesthesia wears off, you may feel tightness around your eyelids. Cold compresses help reduce the swelling and bruising. Eye drops may be prescribed to keep the eyes moist as they heal.

Recovery time: There will be bandages for the first few days. Bruising should peak within a week after surgery. Although normal activity can resume after a week, the bruising often limits social activity. Bruising should clear up after ten days. For the first days after surgery you may be asked to keep your head propped up higher than normal while sleeping.

Shelf-life: As long as you lead a healthy lifestyle this surgery should last a minimum of ten years, for many it's permanent.

Side effects and risks: Temporary changes to your vision are not unusual; there may be blurriness, sensitivity to light and your eyes may produce more tears. “Blepharoplasty is relatively low risk,'' says D. Khan. “We focus on the eyelid and as such don't interfere with the visual apparatus.'' As with any surgery there is the risk of infection or reaction to the anesthetic that will be monitored.

Cost: Starting from Dhs24,000 for upper or lower, Dhs34,000 for both.

4. NOSE JOBS

What is it? Rhinoplasty is surgery to reshape the nose, and is one of the most common of all procedures on men. It can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between the nose and upper lip. It may also correct a birth defect or injury, or relieve breathing problems. “It's especially popular here in the Middle East,'' says Dr Khan. “The Arabic nose can be a defining feature. It's an ethnic trait that many men like to modify rather than erase entirely.''

The procedure: The structure of your nasal bones and cartilage, shape of your face, thickness of your skin, age and expectations can all determine the outcome. For closed rhinoplasty an incision will be made within the nostril or in the underside of the nasal strip. Open rhinoplasty separates soft tissue from its underlying structure to re-shape the cartilage and bone. It is mostly performed under general anesthetic and depending on the request it could be day surgery or it could involve an overnight stay in hospital.

Pain-o-meter: As it's performed under general anaesthetic you will feel nothing during the procedure, but recovery after surgery can be uncomfortable. There shouldn't be huge amounts of pain but there will be bruising and swelling. There may or may not be nasal packing which can be uncomfortable for the first few days.

Recovery time: Bandages and a splint need to be worn for a week to ten days. Most people experience black eyes after nose surgery; the bruises may change colour or darken as they heal. Bruising should start to clear up after ten days.

Shelf-life: Reshaping of the nose last a lifetime — although rhinoplasty doesn't defy the ageing process.

Side effects and risks: “Rhinoplasty is a delicate, technically challenging surgery,'' says Dr Khan. “It is important the patient has discussed the risks, weighed them up and is realistic about the outcome. Far too many patients don't ask enough questions and in my opinion there are too many practitioners who are in a rush to get patients on the operating table.'' He suggests clients shop around, ask questions and seek surgeon referrals.

Cost: Ranges from Dhs22,000 to Dhs30,000 and upwards.