One lift, tuck or suction at a time, cosmetic surgery has been improving appearances and boosting self-esteem for decades. Once seemingly reserved for the rich and famous, retaining youth is now a widespread trend.
And it’s not just boob jobs and facelifts any more.
More men than ever are having cosmetic surgery, and the dim economy is creating buzz about less-invasive, more cost-effective options. Here, three East Coast plastic surgeons discuss these emerging trends and answer important questions those contemplating going under the knife may be asking. And one desperate twenty-something from the West Coast explains why a tummy tuck is more important to him than being tucked into a warm bed.
GOOD, BETTER, BREAST
After nursing two children, “Kelly S.,” 31, of Wilkes-Barre, found her visits to the Victoria’s Secret fitting room to be a struggle — her breasts had lost shape and volume. Finding bras, shirts and bathing suits that fit her properly had become a struggle.
Like millions of women every year, Kelly turned to breast augmentation, still the most sought-after cosmetic procedure, according to the American Society for Aesthetic Plastic Surgery. Kelly had her breast lift and implants done in 2006, and while she knew doctors perform many surgeries like hers each year, she still had her fears.
“I love the end result. It was worth it,” she said. “But I was definitely scared of many things: going through the surgery, how the results would be, the post-surgery discomfort I would have and the healing process. The best way to get through the many feelings I had was doing research and asking my surgeon a lot of questions, no matter how silly it might have sounded.”
Liposuction is the second most performed cosmetic surgery procedure, according to ASAPS.
“Liposuction didn’t exist 30 years ago, but eliminating fat has since become almost the holy grail of our industry,” said Dr. Nathan Mayl, who runs the Fort Lauderdale, Fla.-based Mayl Center for Plastic Surgery & Cosmetic Medicine.
Trends in plastic surgery have come and gone in the past 30 years, too, says Boston-based Dr. Michael J. Yaremchuk, chief of craniofacial surgery at Massachusetts General Hospital and a widely published clinical professor of surgery at Harvard Medical School.
“The tried-and-true operations in plastic surgery are still the mainstay — rhinoplasty, facelifts, eyelid lifts, breast reductions. ....” he said.
ECONOMY SCULPTS NEW TRENDS
Williamsport native Dr. Richard P. Glunk, a surgeon for more than 20 years, says his King of Prussia practice does about a third breast enhancements, a third liposuction and body shaping and a third face and nose. Recently though, he’s seeing an increase in smaller procedures.
“The trend nationally seems to be going away from bigger surgeries,” said Glunk, mentioning Botox and a new competitor filler called Dysport. “They are smaller ticket items (we’re seeing more of) because of the economy.”
According to ASAPS, the number of surgical and non-surgical cosmetic procedures in 2008 decreased 12 percent from 2007, about 11.7 million down to about 10.2 million. The non-surgical numbers are growing: Glunk is seeing more requests for Dermage, a minimally invasive skin-tightening technique using radio frequencies, while Mayl is performing a lot more liquid facelifts.
“The advantages of the liquid lift, other than the lower cost, are no down time,” Mayl said. “It is especially good for the baby-boomers who are neither very young or old, but want to look younger. Additionally, the use of liquid lift doesn’t conflict with any future surgeries. Great for folks who don’t currently have the money or time to do a traditional lift.”
Traditional lifts, however, are still more effective, Yaremchuk explained.
“There’s a lot of hype about fillers and things as an alternative to surgical procedures,” he said. “Fillers have a role in camouflaging wrinkles but one, they are temporary, and two, they are just an adjunct and not an end to itself.”
NOT JUST BOOB JOBS
Women are still having more cosmetic surgery than men, however Yaremchuk explains our youth-driven society is creating more competition in the workplace and on the social scene. For that reason, and because it’s becoming more socially acceptable to be open about cosmetic surgery, more and more men are choosing to retain their youth. One of the most common surgeries he’s seeing is craniofacial surgery. He said many of his male patients wear beards to cover up what they feel is not a masculine face.
“The biggest reason we look the way we do is our underlying facial structure,” said Yaremchuk. “If you change the skeletal contours, you can dramatically change the way people look. Most people associate a strong jaw with a handsome male face. There are certain types of implants that can augment the size of the chin and angle of the jaw, giving a more masculine look and in general, better contours and more angularity.”
Mayl, who now sees about one male patient per week, said men are most interested in liposuction, facelifts and laser work, especially in locations where there is a large gay population. Glunk’s growing male clientele includes male models, marathon runners and athletic middle-aged men all looking for help with their abdomens and love handles.
“That’s a very difficult area, no matter how hard they work,” he said, adding that eyelid lifts are another common request.
Another trend Glunk has been seeing is total body lifts, a common way for someone to remove excess skin after gastric bypass surgery. But that side effect is not limited to weight-loss surgery. People who lose significant weight naturally are also faced with it.
Nick Starr, 28, of San Francisco, weighed more than 250 pounds last year. Through diet and exercise, he shed more than 100 pounds, but he’s left with sagging skin and desperately wants plastic surgery to fix it. Always overweight, he’d wanted plastic surgery as long as he could remember but originally thought liposuction was the answer.
“I realized a tummy tuck was the better procedure for me now, since I have excess skin and fat which won’t go away, no matter how much I’ve worked out in the past year,” he said, adding that his consulting surgeon also suggested love-handle lipo and a breast reduction.
Starr admitted he’s never been good at managing money, so he’s taking an extreme measure to raise $8,000 for his abdominoplasty: becoming homeless.
“I had to change something. I was homeless, living in my car once before,” he explained, adding that now he doesn’t have wheels. “I figure I can do it without the car with a few months while I save up money for the tuck.”
Starr dubbed his journey Nick/Tuck and is chronicling his progress and accepting donations on his blog at www.nickstarr.com.
Like so many others, Starr feels plastic surgery is the solution to finally being happy inside out. Yaremchuk believes strongly that plastic surgery can be life-changing by improving appearance and boosting self-esteem, but he cautions patients that it’s not always the answer to “solve all life’s problems.”
CHOOSING A SURGEON
When choosing a plastic surgeon, it’s important to know the American Board of Plastic Surgeons is the official certifying board for plastic surgeons.
“This is not to be confused with other boards that have ‘plastic’ or ‘surgery’ in (their names). That’d be the first thing (to look for),” Yaremchuk said.
Glunk added that dermatologists, gynecologists, ER doctors and general practitioners are all performing plastic surgery. While these doctors are in fact board certified, it’s most likely not in plastic surgery. Another area of caution is online research. Yaremchuk said, “You have to have a strong filter to know what’s true and what’s not true.”
Mayl agreed that when it comes to plastic surgery, the Internet is filled with misinformation and self-promotion. He suggested people stick to regulated media outlets and make sure they talk with their medical practitioner extensively before having any work done, like “Kelly” did.
“My best advice to anyone seeking cosmetic surgery is do your research, talk about it with loved ones and friends,” said “Kelly.” “Most importantly go to more than one consultation and always ask lots of questions. Take someone with you so you don’t miss or forget important questions or details. Remember, it’s a permanent life-changing decision; take your time never rush into it.
“You always need to ask yourself if it’s right for you and why you want it done. Looking at cosmetic surgery as a glamorous thing may lead you to have a procedure you regret.”
Yaremchuk concluded, “People ought to remember they have one face, one body, and it takes one operation to ruin those things.”
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