Dr. Dirk Lazarus

Plastic, Reconstructive & Cosmetic Surgeon

MBChB (UCT), FCS (SA) Plast & Recon Surg

Male Facial Rejuvenation

Although the male face may exhibit many of the same features of ageing as in women, it is well known that men do not fare as well as women when it comes to a facelift. Men have thicker and more resilient skin which does not lift as well, tend to bleed more, have a lower pain threshold, tend to have a higher complication rate and generally tolerate surgery less well. Men have sideburns which extend down into the beard area. Between the sideburn and the ear is a hairless area which is destroyed by doing a facelift as the sideburn is brought back to the ear. This is a giveaway stigma of a previous facelift in the male patient. Sometimes the sideburn can even be moved so that there is growth behind the ear.

More importantly, the male face has some significant differences from the female face – something usually ignored in treating the aged male face. Men should have low flat brows (women look better with higher, more arched brows) and I therefore need a very good reason to perform a brow lift in men. A facelift elevates the jowls and creates a feminine face which is, broadly speaking, an inverted triangle in form – narrower at the bottom. A male face is more square and jowling is therefore less of a problem for men. A facelift in a man can feminise a previously handsome and rugged male face. Surgery can detract from the maleness of a face. I therefore very rarely consider male faces to be suitable for a facelift and prefer to adopt a simpler and more conservative approach in men. I will analyse each face individually to assess the components of aging and how they can be corrected in a suitable manner.

Surgery that I like to do in men include upper and lower eyelid rejuvenation. This can open the eyes and give a more awake appearance. For many men the neck is a problem and liposuction of the neck is a good operation in men. Some men have additional loose, flabby neck skin (a turkey gobbler or dewlap) which can be treated by simple excision in an operation called an anterior cervicoplasty. Although a scar is left down the middle of the neck, this is not usually a long scar and is situated in the beard area and the shadow under the chin. Most male patients find this to be an acceptable solution. Other procedures that I do for rejuvenation of the male face include fat grafting, fillers and botox.


I think Dirk is really great – the kind of attention which he paid Ethan was really moving and one which I will not forget.