Dr. Dirk Lazarus
Plastic Surgeon

Tel: 021 424 1112
Fax: 021 424 1118

86 New Church St
Tamboerskloof
Cape Town, 8001
South Africa

I recently attended my 25th school reunion of the all-boys school that I attended many years ago. It gave me the opportunity to see some aged male faces (some more than others) and men make up about 15% of my cosmetic surgery practice it seems opportune to devote this newsletter to rejuvenation of the male.

Men are different from women. Their psyche does not give them the strength to tolerate surgery in the same way that women do. Men have a low pain threshold. Men have thicker skins and tend to bleed more than women. When men seek cosmetic surgery, they frequently feel the need to justify why they feel the need for surgery, women, like the Nike ad, just do it. The complication rate for men undergoing facelift is significantly higher than for women. These are all well proven in medical studies. It is for this reason that I prefer to advise men to have simpler surgery and to pick operations which are more likely to be winners.

1. Baggy lids: Correction of baggy upper lids is quick, simple and relatively safe. It is definitely one of the winner operations in plastic surgery. It is performed as day case surgery under sedation and local anaesthetic. Excess skin and fat are removed which can rejuvenate the whole face and take years off one's appearance. Bruising and swelling last a week or two. The scar may be a little red for a few months, but it is a good scar and quickly fades to be barely perceptible.

Lower lids, on the other hand, are tricky and can be fraught with problems. Excess fat can safely be removed from behind the lower lid leaving no visible scar. Removal of excess skin by a conventional lower lid blepharoplasty operation is a procedure that is going out of fashion as it leaves a lower lid which is not completely natural looking.

2. Necks, jowls, etc. I frequently consult with men who say: "I don't want a facelift, Doc, but can you get rid of this?" and they grab at their fatty neck and chin. The answer is yes and it is a fairly simple two step procedure, an anterior cervicoplasty. The operation, like for the eyes, is performed as day case surgery under sedation and local anaesthesia. In fact neck correction can be combined with lid surgery and is a very effective rejuvenating combination. Step one is to liposuck the neck. This is done through tiny incisions below the ears which will heal without being noticeable. Fat removal from the neck is effective in re-creating a good chin as skin shrinkage will also occur. Step two is direct excision of any excess turkey gobbler skin. This leave a usually acceptable scar from the chin to the Adam's apple, but this settles in time and is less noticeable than one would believe.

3. Male facelift: The results from facelifts in men are never as dramatic as in women and men often have unrealistic expectations about what surgery can achieve. Certain elements of the facelift can be feminizing, for example a brow lift (look at Burt Reynolds, Tony Curtis) In addition, a conventional facelift can pull part of the sideburn behind the ear and the classic teaching is to warn patients of this. If a male patient is determined to have a facelift, then I prefer to be more conservative just to tighten the cheek skin and jowls.

4. Non surgical treatments: As discussed in my previous newsletter and on my site, Botox is a quick, simple and effective treatment for the upper face. By weakening muscles which cause wrinkles in this area, frown lines, horizontal forehead lines and crow's feet lines can be diminished.

5. Hair transplants are not something which I do, but modern techniques of micrografting are an improvement of what was before. Beware of dishonest advertisers and touched up pictures.

6. Liposuction is another winner procedure for males. Typical areas treated include the tummy, love handles and chest. Although in men much of the fat is deposited around the internal organs and is inaccessible, most men still have a good quantity of fat just under the skin which can be treated. Tense your tummy muscles and you can pinch the fat between your fingers. Of course liposuction is not a method of weight loss as the quantity of fat removed is relatively small, but it is good for reshaping and the fat cells which are removed are done so permanently

Men, although they have their problems, can still be good candidates for aesthetic surgery. I know some of my class reunion mates could have benefited.