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    Procedural pitfalls avoidable in the male cosmetic patient population


    Dr. Marten
    Understanding and appropriately addressing the nuances of the male phenotype and how they differ from their female counterparts' are key to achieving good aesthetic outcomes in the male cosmetic patient, according to a San Francisco cosmetic surgeon.

    Though terminology of the numerous cosmetic procedures performed in both male and female patients often is the same, the specific techniques used on males and females can differ, says Timothy J. Marten, M.D., director of Marten Clinic of Plastic Surgery, San Francisco.

    "A male facelift is aesthetically and technically not the same as a female lift, and employing the same techniques one uses on the female face is a commonly made mistake," Dr. Marten says.

    MALE GOALS According to Dr. Marten, understanding the specific cosmetic goals of the male patient as well as male phenotypic characteristics is crucial in achieving optimal aesthetic outcomes.

    "Aesthetically, female beauty is more closely associated with youth than is male attractiveness, and certain aspects of facial aging in men convey an element of strength, power and experience that most men do not wish to completely lose. A surgeon who does not appreciate this or who is not trained in male facelift techniques will perform procedures that are destined to produce suboptimal outcomes," he says.

    A good definition of the neck and jawline is important to both male and female patients, as it gives the patient a youthful appearance, Dr. Marten says. However, achieving this chiseled definition is crucial in males because it will give the patient a fit, athletic, decisive and masculine appearance.

    "A man may appear old, indecisive and befuddled without a good neck and jawline. A long list of negative connotations is associated with a poor neck contour in a man, and if surgery does not produce a good neckline, the facelift procedure will be judged to be a failure," he says.

    According to Dr. Marten, cosmetic surgery in male patients is complex, and a procedure performed on a male patient can be more challenging than when it is performed on a female. Achieving a consistently good cosmetic outcome in men often requires more time, particularly for those surgeons who are less experienced in the nuances of male cosmetic surgery, he says.

    THE EYES HAVE IT When performing cosmetic surgery in male patients, surgeons must try to maintain the masculine characteristics of the male facies, Dr. Marten says, while at the same time achieving a more rejuvenated and natural-looking appearance. One of the most common problems associated with male cosmetic procedures is an overly changed or feminized appearance of the eyes, he says.

    "Surgery on the male forehead and eyes must be done with a very light touch and is complicated by the fact that men are more likely to have lower eyelid laxity and need procedures that correct that. There are distinct aesthetic differences between the male and female eyelids, and if these are not appreciated by the surgeon, a technically successful procedure can be an artistic failure," Dr. Marten says.

    Getting a forehead or eyelid surgery "right" the first time around is also crucial, Dr. Marten says, as aesthetic imperfections can be particularly difficult — if not impossible — to correct.

    FILLERS AND MORE Volumizing and filling hollow areas in the female face using a variety of techniques has become a staple in cosmetic procedures for women. These techniques and their benefits are greatly underappreciated in male patients, however, and as a result, the outcomes of male facial rejuvenation are frequently not maximized, Dr. Marten says.

    "Filling in a man's hollow upper and lower eyelids and cheeks, strengthening his chin and jawline and even subtly filling in his thinning lips with fat injections will result in a more healthy, robust and athletic appearance in male patients. Without filling, a facelift and other traditional procedures often result in a lifted and tighter appearance, but not a healthy and masculine one," Dr. Marten says.

    Disclosures:

    Dr. Marten reports no relevant financial interests.

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