Cosmetic surgery: what are the options for ageing men?

A good haircut, a close shave and a fancy suit might keep a man looking sharp, but can't stave off forever the physical signs of ageing.

Men are increasingly accepting that maintaining a youthful, vibrant appearance lessens the likelihood they'll be perceived as the 'old guy' in the office who doesn't merit further promotion.

While local data is hard to come by, the American Society of Aesthetic Plastic Surgery found the number of cosmetic procedures for men in the US  between 1997 and 2012. Australian cosmetic surgeons report that, on average, about 20 per cent of their clientele is now male.

James Nadin, owner of Sydney's International Centre Cosmetic Medicine, says it's closer to 30 per cent at his clinic. He is reluctant to generalise and points out that motivations for men wanting cosmetic procedures vary. However, he says men working in competitive industries are often conscious of maintaining a youthful visage.

So you've decided you could stand a bit of help, what are the options?

Microdermabrasion

Cost ballpark: $120 per treatment

Why get it done? To remove dehydration lines, stimulate collagen, decongest pores and remove blackheads.

What happens? A diamond tip exfoliation vacuum suction device removes the top layer of dead skin cells.

How much is it going to hurt? Treatments take 45-60 minutes. You'll need six sessions over two weeks then a top-up treatment every four to six weeks. You'll experience some slight tenderness from the suction but this should abate within 15 minutes.

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Botox

Cost ballpark: $175 to $420 per area

Why get it done? Temporarily paralysing the underlying muscle results in more relaxed, less wrinkly skin.

What happens? Botulism toxin is injected into different parts of your face.

How much is it going to hurt? Anesthetic cream can be applied beforehand. Botox's popularity attests to its relative safety but headaches are not unheard of and, rarely, temporarily drooping eyelids or eyebrows can occur if the forehead is over-injected.

Liposuction 

Cost ballpark: $3300 to $4500 (chin, neck and jowls)

Why get it done? Suctioning out the fat around the chin, neck and jowls results in a jawline that's more sharply defined, hence more youthful and masculine looking.

What happens? Small incisions are made, a tube inserted and fat sucked out for 60 to 90 minutes.

How much is it going to hurt? Not much, but you'll need to wear a compression garment for 72 hours. There may be swelling and bruising. Your mouth may droop temporarily. Rarely, a haematoma can develop, requiring drainage. The skin may retract unevenly, especially if it's lax or sun damaged. You'll be back to work in four to five days.

Brow lift

Cost ballpark: $5000 to $7000

Why get it done? Because the curtain above 'the windows to your soul' falls and crumples as the years pass.

What happens? The surgeon cuts away a slice of skin under your hairline, pulls up what's left then stitches you up.

How much is it going to hurt? You're unconscious for the main event but the recovery process involves wearing bandages, applying ice and ointment, and sleeping with your head elevated. You'll need to avoid work or strenuous activities for a couple of weeks. There may be temporary numbness or, more rarely, hair loss or nerve damage.

Neck lift

Cost ballpark: From $4500

Why get it done? To remove that turkey neck.

How much is it going to hurt? It's a 1 to 2 hour procedure done under twilight sedation. You'll have to wear a chinstrap for a week and put up with swelling and bruising for a month. While uncommon, potential downsides include: blood or other fluids building up under the neck requiring drainage, scarring, deep vein thrombosis, and a sensation of the skin being stretched too tightly across the neck.

Mid-face lift (aka cheek lift)

Cost ballpark: $4000 to $10,000

Why get it done? Full cheeks and high cheekbones convey youthfulness.

What happens? Small but deep incisions are made in the face allowing the surgeon to adjust the fat and muscle tissue, smoothing and tightening the skin.

How much is it going to hurt? Surprisingly little. You're unconscious for the procedure and afterwards you'll need to apply ice for a couple of days to keep the bruising and swelling under control. Normal life can resume in 7 to10 days. There's a risk of infection, bleeding, and scarring. There can be puckering around the eyes and, if eyelid skin has been removed, issues around the functioning of the eyelid. 


Facelift

Cost ballpark: $6900 to $30,000

Why get it done? This is the major reno of cosmetic procedures, with equivalent upsides and downsides.

What happens? It depends, but basically the skin on your face is separated from the underlying tissue. Excess fat and skin may be removed and muscles tightened before the skin is then re-draped over the face and sutured into its new position.

How much is it going to hurt? A lot. There will be a drainage tube left in your face to prevent fluid build-up. Your face will be swaddled in bandages and compression garments. You will be in pain and out of action for several weeks. Possible complications are many, include a reaction to the anesthetic, bleeding or infection, (possibly fatal) blood clots, collapsed lung, hair loss, nerve damage, and asymmetrical features.

What to consider first

David Castle, a professor of psychiatry at the University of Melbourne, finds himself in the awkward position of being dispirited by the male cosmetic surgery boom while having to concede those fuelling it are often acting out of rational self-interest.

"I believe society's values are cockeyed in this area. But I also recognise there's abundant evidence that those who look more attractive are more likely to be offered jobs, promotions and pay rises," he says.

"While one might wish society would evolve away from such superficiality, I don't think individuals can be blamed for seeking a competitive advantage.

"If people are making sensible, informed decisions and have reasonable expectations of the outcomes of cosmetic procedures then the research shows they usually do feel better about themselves, at least for a while.

"That noted, if men or women are doing it because of an underlying psychological issue, such as dysmorphic disorder, they are likely to be unhappy with the outcomes."