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The man factor

Article-The man factor

Dr. StevensJudging by the latest numbers released by the latest American Society of Plastic Surgeons (ASPS), demand among men for cosmetic surgery has gone down since 2000, but men’s desire for minimally invasive procedures has grown in the last 16 years.

Men made up 13% of cosmetic surgery patients last year and 8% of the total in the category of “cosmetic minimally invasive procedures.” But while demand among men for surgery has decreased 45% from 2000 to 2016, their demand for minimally invasive procedures has gone up 74%, since 2000, according to ASPS’s 2016 Plastic Surgery Statistics Report.

Leading the top five minimally invasive procedures among males, according to ASPS: botulinum toxin type A, up 4% from 2015 to 447,000 procedures performed in 2016. Demand among men for botulinum toxin procedures soared 376% from 2000 to 2016.

In May 2017, the American Society for Dermatologic Surgery (ASDS) reported on its 2016 statistics, suggesting, in the last five years, men receiving wrinkle-relaxers has increased 9%, and men using soft-tissue fillers grew from 2% to 9%.

Botulinum toxin and fillers are big aesthetic drivers for men. Still another is noninvasive body contouring with CoolSculpting (Zeltiq Aesthetics), according to Grant Stevens, M.D., founder and medical director of Marina Plastic Surgery, in Marina Del Ray, Calif. Dr. Stevens, clinical professor of surgery at USC Keck School of Medicine, launched Marina ManLand two years ago after his research revealed that men make up more of the gender pie than statistics suggest, and they have very specific needs and desires.

In one study of a series of 528 cryolipolysis patients, 24% were men. But during the study and after the launch of a male-targeted advertising campaign, men made up 42% of those seeking CoolSculpting, according to Dr. Stevens.

“The prime driver [for men] remains nonsurgical body contouring. The number one in that class remains CoolSculpting,” Dr. Stevens says.

The numbers of men acting on their desires to have cosmetic procedures might be only scratching the surface. There are many more who want it, but haven’t yet had it. The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) conducted a survey of 618 men and found nearly a third, 31%, said they are extremely likely to consider a surgical or nonsurgical cosmetic procedure.

NEXT: What Men Want


What Men Want

Dr. RohrerMen are no less vane than women, according to ASDS President Thomas Rohrer, M.D., who practices in Chestnut Hill, Mass., and is clinical associate professor of dermatology at Brown University. However, men are more hesitant to seek cosmetic procedures or talk about having had cosmetic procedures, he says.

“There still seems to be a stigma attached to males having cosmetic procedures,” Dr. Rohrer says.

One stark difference between male and female cosmetic patients is that, for a variety of reasons, men are less tolerant of significant downtime and complications, according to Fred Fedok, M.D., AAFPRS president, who practices in Foley, Ala. AAFPRS’s survey suggests men are, in general, less concerned about wrinkles than they are about their saggy and baggy eyelids, he says.

“The men in my practice seem to like long-lasting interventions than shorter lived and repetitive procedures.  In my practice, there is a call for the use of fillers and fat transfer to improve depressions and midface hollows at least as commonly as the use of Botox [Allergan] for wrinkles. Popular surgical procedures for men are eyelid surgery and facelifts,” Dr. FedokDr. Fedok says.

Common themes among men seeking cosmetic surgery, according to Dr. Rohrer, are that they want to look better, younger and more energetic in the work place. 

“They do not want to be seen as the ‘old man’ in the office,” he says.

In a survey of 300 male patients, Dr. Stevens found men weren’t comfortable in a traditional cosmetic surgery center
designed with women in mind. 

“They did not like couches. They wanted less pain and were less pain tolerant. They wanted total anonymity. They were less time tolerant. They wanted private entrances,” Dr. Steven says.

NEXT: What It All Means


What It All Means

Cosmetic surgeons will likely see more male patients of different ages, according to Dr. Rohrer.

“We have many men in their 30s and 40s coming in to look a little better or to look less tired. These men come in for neuromodulator treatments to relax the lines around their eyes and forehead; [to] have filler injections to fill areas that have started to sink in around the eyes and cheeks; and many for body sculpting,” says Dr. Rohrer. “I have seen several professional athletes who work out every day and are in amazing shape but still have a small pocket of unwanted fat that they want treated. We also have a fair number of men in this age group coming in for tattoo removal. Men in their 50s, 60s and even 70s are coming to have the areas on their cheeks and under their eyes filled back in, neuromodulators to reduce wrinkles, body sculpting, and hair restoration.”

Dr. Steven says that ManLand patients have specific procedure requests in addition to body contouring. Those include: NeoGraft (NeoGraft) for more scalp hair; Ultherapy (Merz Aesthetics) for nonsurgical facial tightening; Miradry (Miramar Labs), to eliminate sweat and odor; and Hydrafacial (Edge Systems) facials. Yes, facials. But those often are done while men are having CoolSculpting treatments.

Facial surgeons are among those who should anticipate the need to change their offices and marketing approaches to accommodate men, according to Dr. Fedok.

“The desire for facial rejuvenation among men mirrors that which we have seen previously in women. The men have just arrived a little bit later,” Dr. Fedok says. “The reasons and causes are multi-factorial. Men are living longer, they are leading more active lives into more advanced ages than previously. They are active in the workforce longer. They want to maintain a vitality, attractiveness and the youthfulness that can be projected from their facial appearance.”

Dr. Fedok anticipates the industry will respond with big changes to what the AAFPRS calls the growing “man”tenance trend.

“Better hair restoration and maintenance for thinning hair could be huge,” Dr. Fedok says.


Dr. Stevens is an investigator for Syneron-Candela, Sientra and Obalon. He is an advisor/speaker for Merz; an advisor for Galderma and Allergan; and founder/shareholder for Strathspey Crown.

Dr. Fedok is a speaker for Rohrer Aesthetics.

Dr. Rohrer has performed recent research for Candela/Syneron and Merz.

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