Because of the stiff job competition and the growing number of men postponing their retirement, leading Los Angeles plastic surgeon Dr. Tarick Smaili sees more male patients going to his office to ask for cosmetic procedures.

“Contrary to popular belief, I think men nowadays are as conscious as women in terms of physical appearance.  In fact, a 2010 data from the American Society of Plastic Surgeons (ASPS) has shown that the number of middle-aged men seeking medical enhancement is on the rise,” Smaili added.

Meanwhile, another survey shows men’s growing enthusiasm with plastic surgery.  UCLA has found that 23 percent of US men were interested with the procedure, although only a fraction will push through with their plans.  By contrast, women were about eight times more likely than male patients to go under the knife.

Smaili noticed that many men still view plastic surgery as the last resort to their problems.

“Based on my experience, men will more likely prefer non-invasive procedures such as Botox injection and dermal fillers while women are more willing to go under the knife to achieve the best result possible,” the cosmetic surgeon said.

A significant number of men seeking cosmetic surgery undergo facial rejuvenation procedures such as facelift and eyelid lift.  And with the aging baby boomers who are living longer and healthier, plastic surgeons across the US believe in one thing: more eager patients will fall in line outside their office.

In fact, a 2010 data from ASPS shows that facelift performed on male patients increased by 14 percent.

Aside from employment reasons and Americans’ obsession to looking young, Smaili believes that the increasing number of patients seeking cosmetic procedures is caused by the changing attitude.

“In the past, cosmetic surgery was almost considered taboo, but now, many people would admit it without batting an eyelash.  More men are also open to treatments that would improve their appearance; this is proven by the invention of the term metrosexual, which is used to describe men who spend a lot of time and money for their appearance,” Smaili said.

Aside from facial rejuvenation procedures such as facelift and Botox, Smaili has also noticed an increase in number of male patients seeking liposuction especially in the chest area and abdomen.

In 2010, 13.1 million cosmetic procedures were performed in the country, with about 88 percent accounting to non-invasive treatments.  Meanwhile, almost half of the patients were in their 40s and 50s, a clear manifestation of Americans’ obsession to youthful beauty.

One advantage of non-invasive cosmetic procedures over surgical ones is that they involve no recovery or require little downtime.  However, one consideration is that they often need maintenance so the patients can preserve their youthful appearance; for instance, Botox and collagen injection must be repeated at least every six months.

The International Association for Physicians in Aesthetic Medicine (IAPAM) is expecting that non-invasive cosmetic procedures especially those treating the signs of aging will increase in numbers.  Botox and Dysport, which both uses neurotoxin in small dosage, will continue their popularity.

Dermal fillers such as Restylane and Juvederm will also continue their popularity.  These treatments are used to “fill in” hollowed facial areas such as the cheeks although certain types can also used in lip augmentation.

In addition, non-surgical body contouring procedures such as VelaSmooth and Zerona will continue their popularity.

Over the past couple of years, liposuction has been one of the most popular cosmetic surgeries in the US.  But nowadays, new technologies have made it possible to perform the procedure without using incisions; in fact, some doctors simply inject a concoction of drugs to the fatty areas to melt these away, allowing the body to naturally flush these out.

These are the advantages of minimally invasive procedures over cosmetic plastic surgery:

• The treatments are performed quickly.
• Most procedures are relatively painless or at least the discomfort can be minimized by local anesthesia.
• Bed rest is not required because there is little or no downtime.
• Side effects are minor.  But in case the patients develop some swelling, redness, and bruising, these symptoms will likely subside a day or two.
• The procedures are ideal for patients who do not want the idea of going under the knife.
• Most non-invasive treatments provide instantaneous results because there is little or no symptom such as swelling and bruising.
• The non-invasive cosmetic procedures are much cheaper than plastic surgery.

While many studies have already proven the countless benefits of acupuncture, I am quite doubtful with its effectiveness in terms of removing the wrinkles, fine lines, and sagging skin.  First and foremost, these signs of aging are caused by many factors including sun damage, tissue laxity, and pull of gravity.

But despite some critics, one doctor who offers facial acupuncture still insists that by creating a “little scar formation, it would be possible to lift the sagging skin and address other signs of facial aging.”

Some also claim that the acupuncture needles can encourage the body to produce natural collagen, which is a type of protein responsible for making the skin youthful and plump.

The cost of acupuncture for the removal of facial aging is almost the same, if not more expensive, than most traditional non-surgical facial rejuvenation treatments such as laser, soft tissue fillers, and Botox injection.  Also, patients should consider that it requires monthly maintenance that costs around $150.

Meanwhile, the average cost for the first few sessions of facial acupuncture is $1,000.

Whether facial acupuncture really works—or it is just another media hype—patients should remember that facelift surgery is often the most ideal solution to the signs of aging because it provides a longer lasting effect.  By contrast, non-surgical treatments (e.g., laser skin resurfacing, Botox, and soft tissue fillers) must be repeated every six months to two years in order to maintain the youthful appearance.

But regardless if facelift surgery or non-surgical treatment is used, all facial rejuvenation treatments do not stop the aging process.

Traditional facelift surgery can remove 10 to 15 years off from face, with its result lasting a decade or so.  After this period, a patient may need some kind of revisions such as “isolated” facelift including brow lift, eyelid lift, etc.

With her active lifestyle, the actress said she feels “great and rested,” a complete opposite of what she looked like before having facelifts to correct her sagging jaw line, excess skin around her eyes, and “turkey” neck.

The 73-year-old actress said she did not feel pressure to “maintain a certain look,” and in fact claimed that she is happier nowadays compared to her younger years when she suffered bulimia.

Fonda is just one of the growing number of patients aged 65 years and older who are seeking plastic surgery to look young and rejuvenate.  During the previous decade, most people who opted for facelift surgery were in their middle age.

Dr. Tarick Smaili, a well-known Los Angeles plastic surgeon who did not treat Fonda, said he is seeing more and more seniors seeking facelift surgery and non-surgical forms of facial rejuvenation.

“The growing trend is probably caused by the fact that older people are postponing retirement and they are more socially active compared with seniors during the past decades.  And with the oldest baby boomers reaching their 60s, in my personal opinion the number of seniors opting for facelift will double, if not triple, in the next coming years,” Smaili said.

Meanwhile, the cosmetic surgeon believes that Fonda is a great example of a successful facelift surgery as she looks “rejuvenated” and younger than her real age, in addition to the “natural look.”

“She looks naturally beautiful.  First and foremost, patients should remember that facelift is not all about removing the wrinkles and sagging, but more importantly, its aim is to provide you with a natural look by preserving the fundamental shape of the face,” he added.

Smaili said that the “windswept appearance” usually signals that a facelift is not a success, explaining that it is often caused by removing too much skin and pulling too much tissue.

“Because a facelift can make or break your look, one of the most important things a patient should do is to determine if her doctor is board certified.  If not, this is already a red flag,” the cosmetic surgeon said.

But aside from having a skilled surgeon, Smaili also believes that Fonda’s healthy lifestyle and positive outlook make her look younger.

To remove or at least minimize the signs of aging around the eyes, plastic surgeons use blepharoplasty or what is more commonly known as eyelid surgery.  Depending on the location and amount of excess fats and skin, this procedure may involve the upper or lower eyelid, or sometimes even both.

If the procedure will involve both the upper and lower eyelids, doctors usually work first on the excess, drooping skin in the upper eyelids which in severe cases can even affect the vision of a patient.  This is done by making a discreet horizontal incision along the natural crease of the skin so the scars will not become noticeable.

Through the incisions, plastic surgeons can trim off the excess skin and fats and then tighten the remaining part to eliminate the sagging appearance.  And once the necessary alterations are completed, they will close the surgical wound using tiny sutures.

To remove the fatty deposits and excess skin along the lower eyelid, doctors make a horizontal incision in the lash line.  But if the bulging fats are the only problem, the surgical cut is usually made inside the eyelid that will enable surgeons to remove or redistribute them more evenly.

While the incisions are commonly created by a scalpel or surgical knife, some plastic surgeons use laser beam which is said to be more accurate and safer since it minimizes bleeding.

As a stand-alone procedure, blepharoplasty can make a drastic result, although this is commonly used to complement other facial rejuvenation surgeries such as face lift, neck lift, and forehead lift.

However, patients should remember that this procedure is only designed to remove the excess, loose skin and fats around the eyes but it cannot eliminate or reduce the appearance of wrinkles and furrows.  For this reason, they can ask for complementary treatments such as botox injection, facial fillers, microdermabrasion, and laser resurfacing.

As with any cosmetic surgery, blepharoplasty is associated with recovery and risk of complications, although patients can reduce these by carefully following their doctor’s pre- and post-operative advice which may include avoiding aspirin and other “blood-thinning” medications, quitting smoking, using eye cream to prevent infection, wearing sunglasses to protect the eyes and incision sites, and avoiding activities that may strain their eyes such as reading, using computer, and watching TV.

Perhaps secretary of state Hillary Clinton is the most perfect example of a politician who seems to have had several plastic surgery procedures.  The rumors are hard to ignore as she looks almost 15 years younger today than when she was still the first lady.

Cosmetic surgery expert Dr. Tarick Smaili, who did not treat Clinton, said that she might have undergone eyelid surgery, neck lift, and face lift possibly complemented with Botox injection.  And with her glowing skin, the surgeon added that she had probably resorted to laser skin resurfacing, chemical peel, or dermabrasion.

If you would look Clinton’s previous photos and television appearance, you might notice that she had wrinkles and prominent crow’s feet in the corners of the eyes, and deep creases across her forehead—problems which can be easily treated with soft tissue fillers and Botox injection.

But nowadays, the secretary of state looks more youthful and rejuvenated.  Gone are the sagging skin in her neck and the undefined jaw line, probably due to face and neck lift.

While facial rejuvenation surgeries are enough to erase up to 15 years off your face, skin resurfacing treatments such as laser, chemical peels, and dermabrasion can further make the countenance more youthful by removing or at least minimizing the appearance of sunspots, fine wrinkles, and skin discoloration.  These treatments are also known to correct the leathery, dry skin caused by too much sun exposure and natural aging.

Although good makeup can also do wonders on one’s face, it would be difficult—if not impossible—to achieve the dramatic improvements in Clinton’s appearance.

While some people may think that cosmetic plastic surgery for politicians is superfluous because they are not expected to look just like a celebrity, some may need this “medical enhancement” particularly if their countenance looks haggard or even angry (even if they are not) because of the sagging skin around their eyes and jaw line.

As superficial as it may sound, several studies have proven that our brains judge a person’s traits based on his face—and an angry or tired look caused by sagging skin may not be good to a politician who must appear likeable, competent, and approachable to voters.

To counter the effects of aging in the eye area, plastic surgeons use blepharoplasty or what is commonly known as eyelid lift which typically involves incisions which are placed along the natural crease of the skin, lower lash line, and/or inside of the lower eyelid so the scars are hidden.

In case that blepharoplasty will involve both the lower and upper eyelids, plastic surgeons typically start the procedure by making a discreet incision along the natural crease of the upper eyelid, allowing them to remove the excess fats, muscle, and tissue that partly cover the vision and/or distort the appearance of the eyes.

To address the extra skin and fats in the lower eyelids, doctors create another set of incisions along the lash line.  But in case that the only problem is the fatty deposits and there is not a significant amount of loose skin, most of them would prefer to place the surgical cut inside the lower eyelid in order to remove or redistribute the fats.

Most people who ask for this plastic surgery procedure are between the age of 40 and 60, although some are younger but are genetically predispose to hanging skin and tissue.

While blepharoplasty can serve as a stand-alone procedure, some patients combine this with other facial rejuvenation surgeries such as face lift, brow lift, neck lift, and non-invasive treatments such as botox, facial fillers, and laser resurfacing.

It is important to note that this plastic surgery approach only removes the excess skin, fats, and tissue but not the crow’s feet or the wrinkles in the outer corners of the eyes and furrows between the inner eyebrows.  And because of this reason, some patients ask for botox injection to relax the muscles which in turn prevents wrinkles, laser treatment to treat fine lines, and facial volumizers to plump up the skin.

As with any plastic surgery, blepharoplasty involves downtime which is usually shorter compared to face lift, neck lift, and most facial rejuvenation procedures.  Patients should also expect some pain and discomfort, although they can find relief with over-the-counter or prescribed medications.

During the recovery period, plastic surgeons prohibit their patients to wear contact lenses, read, watch television, and other activities which can strain the eyes or cause dryness.

To date, facelift surgery uses different “isolated” techniques to target the main problem and avoid the dreaded “windswept” appearance which usually happens from over-pulling of the skin.  However, most plastic surgeons believe that this new surgical approach is usually ideal for younger patients than older ones.  (The photo below shows reality TV star Kate Gosselin who had undergone facial rejuvenation surgery to preserve her youth.)

Mid-facelift is one of the most popular “isolated” procedures which is recommended for patients aged between 40 and 50, although some people choose to have this surgery as young as 35 years old.

This new approach targets the mid facial region, the area which usually manifests the first signs of aging, and corrects the sagging lower eyelid, mouth-and-nose lines, downturned lips, and drooping cheeks.

Meanwhile, these are the other common examples of “isolated” facelift surgeries: brow or forehead lift, eyelid lift, lower facelift, and neck lift.  When plastic surgeons combine all these procedures, these are already called as a complete facelift surgery which is the right approach for older patients who need the most correction.

While facelift surgery can remove the excess skin and lift a sagging area, this approach may not be enough to address the other signs of aging such as loss of fats or volume in the face and photo damage from the sun’s harmful rays.  For this reason, some plastic surgery specialists recommend non-surgical treatments to further make the appearance younger.

Examples of non-surgical treatments that may complement facelift surgery are facial volumizers such as natural fats (usually derived from a patient’s tummy), Sculptra, Restylane, Radiesse, and Juvederm.  These fillers can plump up the skin and have been proven for their safety.

To improve the appearance and texture of the skin, plastic surgery specialists also recommend laser treatments, chemical peels, microdermabrasion, and certain creams.  Aside from addressing the leathery skin, these treatments can also remove sun spots, freckles, and skin pigmentation caused by too much sun exposure.

For younger patients who have minimal excess skin, facial volumizers and skin rejuvenation treatments may be an effective substitute to facelift surgery.  But for older individuals, they will benefit more with the surgical approach complemented with these non-invasive procedures.

Plastic surgery specialists today have acknowledged that facial aging not just involves skin sagginess and wrinkles but also loss of volume or fats especially in the temples, lips, cheeks, and upper and lower eyelids; and photo damage manifested by dull and leathery skin, sun spots, freckles, and fine wrinkles around the lips and eyes.

By considering these other signs of facial aging, plastic surgeons not only rely on lifting the muscles and tissues, which if done more than twice, may result to a “windswept” appearance.

Facelift surgery is generally ideal for older patients who have a significant amount of excess skin and tissue which commonly forms in the jaw area (resulting to the appearance of jowls), neck region, and upper eyelids.  For these people, usually the best approach is the complete facelift which uses an extensive incision along the hairline at the temples and continues around the ears to the lower scalp.

Through this long incision, plastic surgeons can trim any excess, drooping skin and redistribute or remove the fats from the jowls, face, and neck.  They also reposition the deeper facial muscles to prevent future sagginess and make sure that the result will last for many years.

For patients with excess skin in their neck region, they will need a second incision placed under their chin to treat the “turkey neck.”  If needed, plastic surgery specialists may also perform liposuction on the area to remove the appearance of “bands.”

While facelift surgery can lift the sagging skin, it does not address the other two signs of aging: loss of volume and photo damage.

There are many ways to treat the loss of facial volume and one of the most common is fat transfer in which doctors collect fats from the tummy or any area where there is a significant amount of fatty tissues, purify these to separate the blood and other impurities, and then inject these to the hollowed areas such as the cheeks, temples, and lips.

But aside from natural fats, plastic surgery specialists also use alternatives to fat injections such as Radiesse, Sculptra, and Restylane.

Meanwhile, photo damage manifested by leathery skin, sun spots, and freckles are usually addressed with chemical peels, microdermabrasion, laser treatments, and other skin rejuvenation procedures.

In 2009, the FDA has approved another wrinkle treatment called Dysport which, like Botox, is derived from a protein produced by the bacterium Clostridium botulinum.  They are both toxin compounds that are reasonably safe if used in small doses.

Just recently, a study conducted by two scientists from the University of California has revealed that Dysport provided better results than Botox particularly in terms of removing the crow’s feet or what plastic surgeons refer to as the “lateral orbital rhytids.”

(Injection Site for Dysport–Medicsi Website)

The study involved 90 patients who received Botox from one side of their face and Dysport from the other.  The respondents and their doctors said that while there was no significant difference between the results of the treatments when the facial muscles were at rest, majority of them stated that Dysport was overall better than its rival.

In 2010, Botox was the most commonly performed non-invasive cosmetic procedure, with about 5.4 millions treatments or 12 percent increase from the previous year. In addition, male patients, who are often reluctant to undergo surgical techniques unlike women, find this particularly appealing, a separate study found.

The researchers used a 5-point scale to evaluate each patient’s appearance.  Meanwhile, the respondents included in the study were asked to squeeze and contract their facial muscles as much as possible and rate their satisfaction from what they were seeing.  According to the finding, about 67 percent said they preferred Dysport results compared to 33 percent who favored Botox injection.

But when the facial muscles were relaxed, the participants and researchers were unable to differentiate the results from both the treatments.

With the findings, the researchers concluded that Dysport “is superior in treating lateral orbital rhytids than Botox,” although “more studies should be conducted in order to compare the two products in addressing other muscle groups in the face.”

Meanwhile, Botox and Dysport are both botulinum toxin which can paralyze and relax the facial muscles, and affect the nerve impulses in order to prevent expression lines.

The researchers said they approached Allergan Inc, makers of Botox, and Medicis Aesthetics Inc., makers of Dysport, for the study’s funding.  Only the latter provided financial sponsorship.