Trading faces: The growing trend of male cosmetic surgery

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17 Jul, 2015 07:00 PM15 mins to read

Having botox or other cosmetic procedures is just a part of a routine for some men now. Photo / 123RF

Botox, facelifts and implants are no longer just for women. Alan Perrott looks at the growing trend of male cosmetic surgery.

Your hair's trimmed, the suit's been pressed and your shoes couldn't be shinier. Not so long ago that meant you were good to go.

Not this traveller, though, or not anymore, anyway. He's Asia-bound for a series of big meetings and has just left a Facebook message for his clinic requesting a top-up before leaving. Nothing major, just a few shots of Botox and some dermal filler should do the trick.

Which is just how it is for a growing number of men. Why go to all the bother of shaving, perfuming and pompadouring when the bags under your eyes leave you looking knackered regardless of how much sleep you've had?

So, having already driven a massive increase in male spending on grooming products since the mid-90s, they're primed and ready for the new generation non-surgical procedures and probably wouldn't rule out eventually going under the knife, either.

If you've got the money you can now do anything from using your own blood to prevent hair loss or reignite erections to kicking back as your love handles are frozen off.

"There's been a real change in attitude to where it's just part of the routine for some men now," says Dr Catherine Stone, owner of the unisex medical spa in downtown's Britomart, and of the phone that that Asian traveller's Facebook message just popped up on.

"In meeting situations it helps when their role and position is reflected in their face. You could say their face has become their calling card," she says.

This is a relatively recent development. For the most part, taking a medical approach to grooming has been the preserve of gay men, but that all changed when the Global Financial Crisis hit in 2007. As the job market raced the dollar to the bottom of the cliff, jobs got harder to hang on to and even harder to find. Men over 40 found themselves sitting in interview waiting rooms alongside fresh-faced young chaps and it didn't matter how good your CV read, your face had you pegged as a dinosaur before your name was even called.

Back when The Face Place opened as a specialist Botox clinic in 2001, men made up less than 10 per cent of the total clientele and almost all were gay. But, come 2007, it had been upgraded to a medical spa and those numbers began rising to where they are now nearer to 30 per cent with a 50/50 gay-straight split.

Ethnically, Dr Stone's mostly dealing with Pakeha, but she has noticed an increase in Chinese and Japanese men looking to lift the bridge of their noses or slim their jawlines.

So she has every reason to be confident of further growth as attitudes toward male cosmetics change.

Opinion, of course, remains divided on whether any of this is a good thing or not: it's not as if the selfie generation needs further encouragement to reflect on its image. But, then again, men looking for extra help with their looks is hardly new - we've all done it to one extent or another.

No? Well, does your toothpaste contain whitener? Does your soap or shaving cream contain a moisturiser? Have you ever dyed your hair? None of those products is about improving your health.

All the same, you can't stop your eyebrows rising when Stone talks of treating a 19-year-old for wrinkles. Really? Botox for teens? "When he first came in, well, I wasn't sure. He'd had lines since he was 17. They were there, but we're always conscious of body dysmorphic disorder (whereby a person considers their body to be in constant need of fixing) so we had several comprehensive chats about what he wanted and what we could do. It was clear that he really was bothered by them and that they were affecting his life, so we went ahead with treatment."

Now Stone knows how you might react to this. It's easy to prejudge old-fashioned vanity as this young man's motivator, which makes him easy prey to an industry that has dined out on the insecurities and egos of fading Hollywood stars. Even Stone's old hospital colleagues thought she was swapping real medicine for facile indulgence when she walked away from surgical training ("You'll be back in six months," they said). But she says such views ignore the true benefits of the work.

"I'm fascinated by the psycho-socio impact of Botox and I've seen, first hand, how even subtle changes in appearance, just little tweaks here and there, change people in major ways. They just blossom. You can never separate the treatment from the person. It's a totally holistic process and often an incredibly emotional one, too."

She's talking about more than a simple ego boost. The Journal of Psychiatric Research recently published the results of a randomised, placebo-controlled study which suggests Botox could become a useful treatment for depression because it relaxes the muscles used for frowning. It seems that maintaining a frown may literally be wearing some people down.

Stone also has high hopes for PRP (Platelet-Rich Plasma), a process in which about 10ml of blood is taken, then spun so that the platelets and plasma can be separated and reinjected. It's your own blood so there is no danger of an allergic reaction as it stimulates the body's repair mechanisms. When applied to the scalp it is supposed to reverse the hair follicle shrinkage that leads to baldness. In the face it rejuvenates old skin and, when injected into the penis (five times) it can improve sexual performance.

The latter she calls the Vampire Priapus (or P) Shot (there is a Vampire O Shot for women as well). While it's only been available in New Zealand since the start of the year Stone has already had about 50 takers with only one failure, a man with a medical condition who felt he had nothing to lose from giving it a go.

If PRP is still only where Botox was 15 years ago, Stone sees huge advances over the next five years or at least until a way is found to get stem cells under control: "They're still a bit scary to me. They may get there, but right now I'm a bit nervous about how safe they and the technology are."

Another possible future can be seen in the United States, where cosmetic procedures have doubled since 2000. Even if men make up only 10 to 15 per cent of the $13 billion US cosmetic surgery industry, the potential windfall has spawned men-only clinics offering everything from coolsculpting (where fat's low freezing point is used to break it down while leaving other tissue unharmed) to fake muscle implants. There are discrete entrances so clients can come and go unobserved.

One such clinic, Marina Manland in Florida, features leather chairs, a cigar room and constantly looping Sports Illustrated swimsuit edition videos in the toilets to keep you preoccupied as you await your "brotox" treatment.

But, regardless of what you get done and how much it costs, every procedure carries the same advisory: it won't last. "Everything [we do] is temporary," says Stone, "because of the simple fact that we all continue to age. Even surgery is temporary. All we can do is slow the process down."

Which isn't an issue if your motivation isn't about stopping the clock. Among all the nose jobs, eye tucks and liposuctions are blokes dealing with physical injuries and disfigurements.

This is when you need someone like Dr Tristan de Chalain, an expat Canadian who worked in American clinics before taking on senior surgical roles at several Auckland hospitals.

He prefers to call his work "aesthetic surgery", a differentiation he makes in response to the comparatively unqualified practitioners entering the cosmetic market.

He also baulks at the more esoteric work now being done, such as the American doctor he met who'd given a Star Trek fan Spock ears and another who granted a patient's request for a manly scar down his cheek.

He sees more to be proud of in a recent case involving a man with a facial growth so large he kept his face hidden, even from his family. After three operations its removal had such an impact his entire family broke down in his Remuera office. "To have someone like that come back into my office and say, 'You have changed my life', there is no better feeling in the world. So, can surgery fix people's lives? Absolutely it can."

Even if it isn't available to everyone, especially those seeking a penis enlargement -a request he gets around once a fortnight.

"I don't want a bar of those guys in my office. I wouldn't touch them with a barge pole."

Not only is such surgery ineffective (they either snip a few ligament attachments so everything drops down or inject fat cells to plump things up a bit. The Men's Health website says, "The results can be visually rather odd"), the desire to meddle in your trouser department labels you a probable "Simon": "He's a Single Immature Male Obsessive Narcissist," says de Chalain, "and they are never happy, have unrealistic expectations and I don't ever want to deal with them. So I make sure I have one, two or three interviews before I ever put knife to skin. If I can't see the problem I'm not doing the work."

Which is pretty much why he's never had any done on himself.

"Men of my generation have more of a 'if it ain't broke don't fix it' mentality. If I needed work I would definitely get it done, but until then I don't mind looking like five miles of bad road.

"But younger men, I think they're more peacock-like, more interested in doing something about their appearance and as the stigma of cosmetic surgery falls away and it becomes more accessible, they will take it up even more."

He, too, noticed a rise in male custom after the GFC, but he's now seeing two more forces at work - women who have had work done and want hubby to get some too, and men who don't think Botox goes far enough.

With the latter group it's men who see their looks as a career barrier even if the remedy comes with downsides. For instance, men are more likely than women to have the "turkey gobbler" fat under their chins removed despite the inevitable horizontal neck scarring. All they want is to look better in a collar and tie. What happens when they're in a T-shirt is irrelevant.

It's because, says de Chalain, men have slightly different expectations to women. He did a facelift for a 79-year-old man who was wanting to get back into the dating game, but wanted to retain enough wrinkles and baggy skin to still look like himself.

"This is the 'like you but better' look, which is one of the most satisfying things I get to do because of the scope for creativity. It's not only about what you're taking out but what you're leaving in."

Now, if you're feeling at all tempted by this but tremble at the cost, here's another advisory: cheap is dangerous.

Dr Tracy Chandler runs a cosmetic clinic in Timaru and is presently preoccupied with repairing an unfortunate patient who went to Thailand to support a friend who was having cosmetic work done. But after getting the hard sell he agreed to the procedures and ended up returning home with facial burns and misshapen eyes, the result of substandard Botox and basic incompetency.

As a result, he's in hiding, unable to work and, as he isn't covered by ACC, is also having to foot the repair bill. Dr Chandler says it's estimated that post-surgery repairs from such overseas expeditions can add another $5800 to your original bill, not to mention the extended period of humiliation and recovery.

Happily, there is yet another solution. Just look after yourself. Dr de Chalain recommends exercise, good nutrition and, if you're lucky, youthful-looking grandparents, while Dr Stone says it's never too early to get sun-smart.

Your skin might be the largest organ in your body, but it's also the last to benefit from a good diet, so crack on with skin products containing vitamins A and C and slap on the sunscreen.

Otherwise, you can always find them on Facebook.

Alan Perrott: The price of vanity

There I was, thinking I was doing okay - nothing spectacular, but in no immediate danger of physical collapse. Which felt just fine until I handed some photos of myself to some cosmetic surgeons and invited them to suggest ways to "fix me".

Now I have issues I didn't even know could be issues. Incipient jowls? A lovely phrase but does this mean I'm on a one-way road to facial saddlebags? Maybe, maybe not, but I did find myself prodding them, post-shave, the other morning to check if they were any more or less incipient than they had been the day before. That's where the madness starts.

And a hanging columella? I'm pleased there's an arrow pointing to the damned thing, because that was a whole new body part for me and who knew they came in good or bad? But I'll hear no more about the dimply chin, I've always been a big Kirk Douglas fan, so if anything I want more dimple not less. And of course I look tired - a trifecta of turning 50, having kids and a bloodyminded attitude to ageing will do that to a bloke.

Still, my smooth forehead came through for me even if I suspect not worrying about it is part of the reason it's holding the line. Well that and the oily skin that cursed my teen years.

Other than all that, it's nice to see the odd press-up is keeping me in check. So, I think I'll just carry on until those jowls finally drop.

After handing photos of myself to cosmetic surgeons I now have issues I didn't even know could be issues. Photo / NZ Herald

The good...

Botox

A 30-year-old Auckland key account manager tells why he has started having cosmetic procedures.

"I have a condition called hyperhidrosis, excessive sweating, and for the last two
years I have been getting [Botox] treatment about two or three times a year to help me in pressure situations, like meetings and presentations, that have always caused me problems. I'd talked to my GP about prescription anti-perspirants but nothing worked. Then this procedure was suggested and while I was apprehensive about the prospect of cosmetic surgery - I mean it felt like I'd be entering a "female domain", which was a little daunting - I looked at it as a remedy to a problem that wasn't going to leave me looking any different. So it was worth a try. All the same I had no expectations - sweating was something I was prepared to live with so the prospect of failure didn't bother me. If I was worried about anything it was simply walking into the clinic and discussing my problem, it just felt a little embarrassing, and having small needles stuck into you is no fun however you look at it. It must have been obvious that I was nervous but they made me comfortable and if the process was a little uncomfortable it wasn't painful. It took a couple of days to kick in but the results were amazing. On a hot day it used to be obvious that I was sweating but after the first treatment there was no sweat patch at all. I find the treatment lasts up to six months with my shirt staying completely dry, so my advice to anyone with a similar problem would be just give it a go.

... and the bad

Cosmetic tourism

A 43-year-old male from Timaru tells his horror story.

I was in Thailand, supporting a friend getting some cosmetic work done. It was available at an affordable price and I had time to heal while on holiday. I had skin fractal laser, IPL laser and dermal fillers under my eyes as I was tired of looking tired. I had three treatments, costing about $900 plus $540 for the dermal filler.

I was relying on an Australian medical tourism agency to manage my treatments and keep me safeguarded. I was told that the treatment I was being given would take only five days to come right. I had no idea I could be burnt and scarred and I had no idea the treatments should never have been given together. I also had no protection, the rights we take for granted here were forfeited overseas.

I was in shock afterwards and didn't leave my room for a day. I was a mess and I have been stared at a lot since then, especially travelling home, which was difficult and humiliating. I was never told that there was a problem with my treatment. Five days became a month (by then the crusting had gone and the scars were revealed). A year later, when I finally went to the doctor, I found out everything I had been told was false and I was highly likely to be permanently scarred.

I have paid money to be badly scarred and I have to live with this on a daily basis. My advice would be not to trust anyone who isn't a qualified doctor and not to take the chance of getting cosmetic work or any other surgery done abroad unless you have comprehensive medical insurance. You pay more in New Zealand for the standards and protection you receive, not to mention the rights and protection if something goes wrong.