Popular Cosmetic Procedures for Men, Part II

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Men are increasingly receptive to the benefits of plastic surgery. In 2016 there was a 30% increase in men’s cosmetic procedures over the previous year. What explains this trend? An increasing number of men see plastic surgery as a business and personal investment to improve their professional lives and personal attractiveness. –Research shows that men and women who get cosmetic surgery experience impressive long-term satisfaction with their results, seldom regretting having made the investment.

Liposuction for Men

The number of fat cells located between our skin and underlying muscles usually stabilize during the first five or six years of life. The exact distribution of fat moving forward in life depends on a person’s age, sex and genotype. Women tend to have a greater percentage of fat than men do, located mainly in the hips, buttocks and upper thighs. Men, by contrast, have more fat in the abdomen. As men grow older, their fat usually migrates from other areas to inside the abdomen (often under the muscles) and the exterior loins (love handle areas).

Liposuction results in a more youthful body contour. It also permanently removes unwanted fat cells from any area of the body, something diet and exercise can never do. While liposuction is not a method of weight control or treatment for obesity, it is an excellent complement to diet and exercise.

Benefits of Liposuction

  • Liposuction is safe, quick and surprisingly affordable.
  • Downtime is minimal.
  • The fat is permanently removed and cannot come back (though weight gain is always possible because remaining fat cells easily expand when caloric intake exceeds needs).
  • Purged fat can be purified and then ‘fat grafted’ to fill out areas that may have diminished with age like a patient’s tear trough, nasolabial folds, or lips.
  • If you gain weight after liposuction, the fat will be deposited more evenly throughout the body and does not relocate to the areas that underwent liposuction.
  • Finally, men can opt to combine liposuction with other cosmetic procedures at the same time to achieve a more transformational result.

Standard Liposuction Treatment Areas for Men

Though almost any area of the body can be suctioned, the three most popular areas for men are the abdomen, loin (love handle area), and neck. Other target areas include the back, chest (the treatment of choice for excess breast tissue, i.e., gynecomastia), buttocks, arms, thighs, calves, knees, and under the chin. Fat under muscles cannot be removed.

Ideal Candidates

The best candidates for liposuction are men close to their ideal body weight with good skin tone and visible areas of stubborn, localized fat.

Other requisites

  • Despite dieting and exercising, you still have stubborn areas of fat that will not go away.
  • You’re in good health.
  • You understand that liposuction is not a substitute for weight loss. Only 5-10 pounds of fat is removed during this procedure. (However, in some cases, liposuction may be used to jumpstart a weight loss program).

Loose/sagging skin often results from major weight loss or aging. In such cases, removal of the excess skin with or without liposuction is much better than liposuction alone. Options usually include either abdominoplasty (a tummy tuck) or, in some cases, a body lift.

Benefits

Liposuction can change your life for the better in many ways. Patients often report that after this surgery that they feel more athletic and younger. They really do look better, feel more confident and experience significant enhancement in their interpersonal relationships and sex lives.

The Consultation

During your consultation, Dr. Roth will review with you the best liposuction technique for your needs. To ensure you are a good candidate for liposuction, he will review your health history and assess your skin tone, fat deposits, and body contours. Preoperative photos are taken to help evaluate your results.

Dr. Roth is extensively trained and experienced in providing all methods of liposuction and talented at sculpting body contours with artistic precision.

Pre-Op Preparation

Patients should maintain a healthy diet and avoid smoking before surgery. Dr. Roth will provide detailed pre-op instructions once your surgery is scheduled.

Liposuction Surgery

“Traditional liposuction–often referred to as suction-assisted liposuction (SAL), involves removing fat with a cannula attached to a suction apparatus. Power-assisted liposuction (PAL), is similar except that the cannula vibrates to increase efficiency. Ultrasound-assisted liposuction (UAL), incorporates sound wave technology to disrupt fat and in dense, fibrous tissue,” such as the loin and back. The last option is considered the best treatment for gynecomastia (excess breasts tissue in men). –Finally, laser-assisted liposuction (LAP) uses a laser to dislodge fat which is then sucked out with the cannula.

Liposuction is usually an outpatient procedure requiring only local anesthesia. All liposuction surgeries require the injection of fluid to minimize bruising, blood loss and to alleviate postoperative pain. Each region is also infused with an adrenaline solution to prevent bleeding. Antibiotics are administered before, during, and after surgery to prevent infection. When surgery is completed, tiny access incisions are closed with dissolvable sutures.

Patients are fitted with a snug-fitting garment that provides support, helps skin contraction, and enhances final contour. The compression garment is typically worn for six weeks but can be removed beginning the day following surgery to shower.

Patients are usually released within one to two hours after surgery. However, an overnight stay in our surgical facility is advisable after a large volume of fat is removed. Regardless, you’ll need to arrange for a friend to drive you home upon release. They or someone else should stay with you at least that first night.

Recovery

When the anesthesia wears off, you will experience soreness and perhaps some pain for a few days. This is easily controlled with prescription medication. Post-surgery redness and swelling are normal. Your incision sites are secured with dissolvable sutures, healing within two weeks. Because only small incisions are used, the resulting scars are virtually unnoticeable.

Patients may drive and return to work once they discontinue narcotic pain medicine. If surgery is performed on one site, you may only require 3 days of post-surgery recovery. However, if multiple areas are liposuctioned, and other procedures are performed at the same time, it may be two weeks before you can safely and comfortably return to work. Light exercise is encouraged soon after surgery, but strenuous activity isn’t allowed for at least 4 weeks. Follow-up visits will with your surgeon will continue for several weeks.

Patients should engage in regular exercise and a healthy, balanced diet to maintain their liposuction results.

Mastectomy for Men

Men are at relatively low risk of breast cancer (1 in 1,000) compared with women (1 in 8). However, many people will be surprised to learn that over 6,300 men were diagnosed with breast cancer from 2004 to 2011–one percent of all reported cases. Unfortunately, men are often diagnosed at a later stage than women because they are less aware of the symptoms and less likely to seek medical attention when they arise.

Men are at an increased risk for breast cancer if they–

  • Test positive for the BRCA gene mutation (see below).
  • Have a female family member with a history of breast cancer.
  • Previously had radiation to the breast or estrogen therapy.
  • Have reduced testicular function (undescended testis or low testosterone production).
  • Are over 60 years of age.
  • Are obese.

Men with the BRCA mutation have only a 7 percent increased risk of having breast cancer, compared to 87% for women.” Although most surgeons believe prophylactic mastectomies for men aren’t necessary, this procedure is administered twice as often now as in the 00’s. Of course, all men diagnosed with breast cancer should have genetic testing to assess this risk factor

The earlier you’re treated, the better your chances of being cured. If you have a mastectomy, your doctor can perform another surgery afterward to help return your chest to its natural shape.

Types of male breast cancer

Most breast cancers in men begin in the milk ducts of the breast (yes men have milk ducts). Less than 2 percent of breast cancers in men begin in the lobules of the breast. In rare cases, men are diagnosed with non-invasive breast cancer or inflammatory breast cancer.

Treatment

Before the Surgery

During your initial consultation, come prepared with all your questions about the surgery and its possible risks. Dr. Roth will review your medical records and ask you about any medicines you are taking to ensure that you are not ingesting anything that could interfere with the surgery. For example, if you are taking aspirin or any blood-thinning medicine, you may be asked to stop taking them a week or two before the surgery.

You will also meet with the anesthesiologist or nurse anesthetist to discuss the type of anesthesia you’ll receive. This will depend on the kind of surgery scheduled and your medical history.

As with most all cosmetic procedures, you’ll need to quit smoking before surgery because tobacco constricts blood vessels, reducing the vital supply of nutrients and oxygen to tissues.

Surgical Options

Most men with breast cancer have a mastectomy, defined as “surgery to remove all the breast tissue, normally including one or more axillary (armpit) lymph nodes.” This includes glandular excision, liposuction and the complete removal of breast tissue. Surgeries may involve only partial removal of breast tissue if at the inception cancer, though complete removal is the safest option.

There are different kinds of mastectomy. Dr. Roth offers extensive experience and skill in performing all of them, including the following–

  • A simple or total mastectomy removes the whole breast, including the nipple.
  • A modified radical mastectomy removes the whole breast and nipple and many of the lymph nodes under the arm.
  • A radical mastectomy removes the whole breast, lymph nodes, and the chest wall muscles under the breast.
  • A partial mastectomy or lumpectomy removes just the tumor and some of the tissue around it. (This surgery is seldom performed because men have very little breast tissue).

To determine if your cancer has spread you may need–

  • An Axillary Lymph Node Dissection (ALND)—in which your doctor removes 10 to 40 lymph nodes from under your arm. These are then checked under a microscope for signs of cancer.
  • Or–A Sentinel Lymph Node Biopsy (SLNB)—in which your doctor takes only a few lymph nodes from the location cancer is most likely to have spread. A radioactive substance or blue dye is injected into the area around the tumor to locate the nodes. If there are signs of cancer, your surgeon may then perform an ALND.

During Surgery

A nurse will insert an IV line put in your arm to infuse medicines needed during the surgery. Your heart rhythm and blood pressure are carefully monitored throughout the procedure. You’ll get general anesthesia when the procedure is a mastectomy or an axillary node dissection. The length of the operation depends on the type of surgery. A mastectomy with axillary lymph node dissection and biopsy can take from 1 to 4 hours.

Recovery

After the surgery, you’ll wake up from the anesthesia in a recovery room. If all is well, you’ll go home later the same day or the next day.

Your chest will be bandaged and drainage tubes inserted into your breast area or underarm, which will need to stay in place for 1 to 2 weeks after your surgery. Our medical team will give you detailed post-op instructions, including specific guidelines for maintaining, emptying, and measuring the fluid that comes out. You’ll be directed to wait 4 weeks before returning to your normal exercise regimen (weight lifting, running, etc.). However, in most cases, you will want you to start moving the affected arm soon after surgery to prevent stiffness.

Men having a mastectomy and axillary lymph node dissection usually stay in the hospital overnight and return home the next day. However, this procedure is increasingly performed on an outpatient basis, with only a short-stay in an observation unit before going home.

Regardless, you doctor may arrange for a nurse to visit you at home to monitor your progress and provide care.

Men seldom get reconstructive surgery with implants. This is because they normally don’t enhance the shape of a man’s chest. However, your doctor can make the affected breast look more natural and symmetrical and even create a new (often tattooed) nipple.

What to expect after the operation

When you see Dr. Roth after the surgery, he will explain the results of your pathology report and discuss any need for further treatment. If you do require more treatment, he will refer you to a radiation or medical oncologist.

Post-surgery treatment options include–

  • Radiation–High-energy beams that kill cancerous cells.
  • Chemotherapy—Powerful drugs that kill cancerous cells.
  • Hormone therapy—When your cancer was triggered by a testosterone deficiency or other hormonal imbalance.

Possible side effects of breast surgery

Mastectomy is safe, but any surgery has risks. Possible side effects include swelling (a greater risk if lymph nodes have been removed), bleeding and Infection. The buildup of blood in the wound (hematoma) and fluid in the wound (seroma) are also possible.

Long-term prognosis

Men with breast cancer are, on average, 84 percent as likely as men in the general population to live 5 years beyond their diagnosis. The 10-year relative survival rate for men with breast cancer is 72 percent.

Call our office today to schedule your initial consultation! (713) 559-9300