By: Mariana Bockarova

“When I first started practicing, the feeling amongst plastic surgeons was that if you had a man come see you for plastic surgery, it wouldn’t be a bad idea to send him to a psychiatrist,” says world renowned Canadian Plastic Surgeon, Dr. Frank Lista. As a founder and past President of the Ontario Society of Plastic Surgeons, a member of the Canadian Society of Plastic Surgeons and the American Society of Plastic Surgeons, and the Past President of the Canadian Society of Aesthetic (Cosmetic) Plastic Surgery, Dr. Lista, who operates out of his own clinic, The Plastic Surgery Clinic, observes a new trend, present and growing: Cosmetic surgery amongst men. Recently released statistics from the American Society of Plastic Surgeons (ASPS) show that the number of gynecomastia, or male breast reduction, procedures performed has increased by 8% to over 19,000. Similarly, other procedures that top the list include liposuction, with over 41 000 American patients served in 2011; rhinoplasty at a rate of over 24 000; blepharoplastry, otherwise known as cosmetic eyelid surgery, at 22 905 patients, and facelifts, at just over 10 000. These numbers still pale in comparison to those of women — for instance, liposuction saw 283 669 female American patients last year — but the once-obsolete male market is growing, and fast. With a total of close to 900 000 cosmetic procedures, and a 121% increase in plastic surgery since 1997, it seems the cosmetic surgery amongst men truly is accelerating.

Though these numbers are only reflective of the American market, Dr. Lista notes the similarities: “The single most common thing we see men for is liposuction…then gynecomastia. For some reason, the prevalence is going through the roof…there are papers suggesting the prevalence of gynecomastia (excessive male breast tissue) is at 60%! The other things we see are noses and facial surgeries, like eyelids and facelifts.” Each year, amongst the 1200 major operations Dr. Lista performs, he estimates that a third, or about 400, are for male patients, though he foresees the rate rising to 50%.

Why the increase? As Dr. Lista puts it, “We went from the [visiting a psychiatrist] extreme to now, where almost a third of my patients are men. The reason for that is because I think men are just as concerned with how they look as women are. We used to think that they weren’t, but they are. You can pick up Vanity Fair or Elle, but you can also pick up Men’s Health or GQ or Esquire. Men are just as interested in clothes and shoes and hair and skincare as women are, so that’s been a big, big change.”

Though the ages of male patients Dr. Lista sees varies, starting from an 18 year old, to a 78-year old face lift patient, the gap, however drastic it may seem, according to him, is fairly typical; “If you look at a graph of how old people are when they have plastic surgery it’s a bimodal distribution: You have young patients in their 20s undergoing “type change” surgery [meaning they] don’t like their bodies the way they are and want to change them. Then, nothing happens in childbearing years. Then, we get a second peak in late 30s, early 40s… the “restorative patients,” whose life has changed them, either they have wrinkles or want to improve something.”

And “improve something” they can. With operations ranging from the practical to the extreme, the options are there: A recent trend which has begun to circulate (no doubt partly due to the rise of Movember), is a procedure to help thicken one’s moustache, in which patients undergo ” follicular unit extraction” in order to build a fuller moustache. In this procedure, hair is harvested from other parts of the body (including the scalp), and implanted in the area between one’s mouth and nose.  The moustache has come to symbolize maturity, virility, power and prestige. This particular procedure can also be replicated to help thicken chest hair. Another sign of male virility, a masculine voice, can similarly be created “under the knife”. In a procedure promised to deepen male voice, titled fat injection thyroplasty, men with high-pitched voices can deepen them by having a surgeon inject fat into their vocal cords. Aside from pec and calf implants, abdominal etching is also used to exaggerate a man’s physique. In this procedure, intended for men who have less than 2 centimeters of “pinchable body fat”, patients can undergo liposuction to help create distinct lines (though this is most popular amongst young men).

Regardless of age, Dr. Lista maintains that operating on males, specifically, is an art: “I think the worst thing you can do for a man is to over-operate on their faces. I’ve seen some American celebrities who I’m horrified to see, celebrities who look freakish or feminized. The worst thing you can do is to feminize a male face, give them too much upper eyelid show, make things too tight, and pull their hairline back. The taboo for me is to over operate on people, make them look weird, fake, and tight. My motto is to create plastic surgery that looks natural. I think it’s a success if no one knows you’ve had plastic surgery. If a patient says, ‘everyone thinks I changed my hair color,’ I consider it a success. Good plastic surgery is not detectable. Bad plastic surgery you can see from across the street.”

Though the statistics of male plastic surgery may be up and the taboo down, there are still considerable risks to be aware of if considering plastic surgery. Be sure to see a qualified plastic surgeon and do plenty of research beforehand.