Men and Cosmetic Surgery: The Parallels with Women

Men are from Mars, Women are from Venus is a famous self-help book about the psychosocial ramifications of sexual dimorphism between men and women and, in view of this, how to improve communication between the sexes. However, there are many cosmetic issues that affect men and women equally. Feeling or looking old and tired, putting on weight or losing too much weight and losing shape; anxieties about perceived deformities and asymmetry are common for both sexes.

Also, affecting both men and women are concerns about secondary sexual characteristics such as breast size, “man boobs”, the appearance of genitalia as well as facial or nasal proportions that make an individual feel unattractive, self-conscious or too masculine or too feminine. The motivation for cosmetic improvement is also probably very similar too between the sexes.

Presently ten times as many women undergo cosmetic surgery as men. However, I believe that men throughout time have had the same level of concerns about appearance but it is only relatively recently that due to a mixture of social acceptability, technical advances and social media pressure that more men are undergoing surgery. Nationally, for both men and women, liposuction remains the most commonly performed surgical cosmetic procedure. Interestingly the cosmetic statistics diverge after this. The second and third most frequent cosmetic procedures in women are breast enlargements and tummy tucks while for men they are nasal and eyelid surgery. Number four on the list for men is the surgery for gynaecomastia (‘man boobs’) followed by facial surgery (facelift and noses).

When one looks at the age at which surgery is carried out, for both men and women, 40% of all cosmetic surgery is performed between the ages of 35 to 50. On either side of this, the numbers steadily rise from the age of 18 and then diminish significantly after the age of 65. However, I believe that the drop-in procedures for both men and women with age is not necessarily related to the notion that older people start to care less aboutappearance. Recently I was asked to see a very charming 75-year-old man who had some facial asymmetry due to a condition called neurofibromatosis. He had really wanted to look “normal” all his life but only now had the courage to ask whether it was possible!

There are of course some disparities in technique and management of cosmetic procedures between men and women because of anatomical differences such as skin thickness, fat distribution and bone structure. Certain aesthetic expectations will be dissimilar because of the different norms of standard sexual characteristics. For example, for noses there are significant differences in the proportions and landmark angles between men and women and, trans-sexual surgery aside, these benchmarks need to be considered when assessing and treating either sex.

The whole arena of penile size is certainly one of complexity ranging from true disproportion to psychological anxiety with perhaps in some cases are elements of dysmorphia. The same can be said of vaginal labiaplasty in women. So, for all sexes, accurate, experienced and honest appraisal of a cosmetic problem is critical. A broad definition of cosmetic surgery is an operation to change a ‘normal’ form into another one to improve confidence and happiness. It begs the question of what is normal? Which is still a huge area of debate in society and one that currently troubles plastic surgery.

In conclusion, more and more men are having aesthetic surgery. Cosmetic surgery for men and women has strong parallels. Of course, the technical and clinical outcomes will be different but the aims are the same. Happiness for both sexes!