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Cosmetic Surgery and the Modern Man

Background

Although men do not face the same hormonal changes with aging that women do, the male biological clock still ticks, and over time changes in a man’s appearance can lead to a negative self-image, which can take a toll on mental and physical health. Today, men are turning to cosmetic surgery in an effort to help break the cycle of interaction between appearance and negative self-image. Because of this emerging trend, more male patients will be asking their trusted primary care providers for advice in navigating the potentially treacherous world of cosmetic surgery.
Whether in the public eye or leading a more private life, many men put forth energy, effort, and income to maintain a healthy, youthful appearance. Increasing access to more affordable, innovative, and less invasive forms of cosmetic surgery has resulted in more men turning to cosmetic procedures in an effort to look and feel younger. In fact, the American Society of Plastic Surgeons 2010 Report of Plastic Surgery Statistics indicates that of the 12.6 million plastic surgery procedures conducted annually, over 1.1 million were performed on men — a dramatic increase from the 225,009 procedures performed on men in 2000. Demonstrating their cost-effectiveness in these challenging economic times, minimally invasive procedures, such as botulinum toxin injections (Botox) and fillers, were up more than 9% from the prior year in 2010-2011. The more costly operative procedures that men undergo in large numbers include robotic hair transplants, nose reshaping (rhinoplasty), liposuction, cosmetic eyelid surgery (blepharoplasty), and facelifts, as well as surgery to correct male breast enlargement (mastopexy).
The ideal cosmetic plan maintains a life-stage balance of facial and body appearance that allows one to look their best throughout adult life. At earlier stages in life, avoiding excessive sun exposure, toxins from smoking, and recreational drug use will help to stall the progression of environmentally related aging changes. Later, avoiding significant weight fluctuation minimizes the development of loose or flabby skin. Body issues unrelated to such lifestyle factors as diet and exercise are best addressed once bone and soft tissues have reached maturity. For some, a time may come when surgery is considered for body issues unrelated to lifestyle, and plastic surgery may be the best option to help maintain a healthy self-image.
When selecting a plastic surgeon, patients should be sure to consider expertise and board certification. It is important to do the research and be patient with the selection process, because it can take some time. Patients should consider the procedure carefully and discuss with the surgeon whether a procedure is the right step to help meet their goals; this is an important part of the process because cosmetic surgery is not the answer for everyone. Patients should consult with their physician so that they can ask the correct questions in order to move forward appropriately.
A plastic surgeon will help identify patients whose body image goals and objectives may not be met with an operation alone. Postponing surgery with referral to a nutritionist, exercise trainer, or internist may be the appropriate outcome of the initial consultation. For surgery that is entirely elective, all patients should be close to their ideal health before having an operative procedure. If lifestyle choices and habits are not addressed preoperatively, the results of most cosmetic surgeries will be transient and therefore ultimately not worthwhile.
The following is a guide to help men look and feel their best throughout the lifespan.

Men in Their 30s

A man’s circulating testosterone level begins to decrease after age 30 years, with loss of lean muscle mass averaging 1% a year. Because of this, the most important thing a man can do to keep himself looking youthful is to continue building and maintaining his muscle mass. A regular program of cardiovascular fitness paired with weight training is essential to mitigate the natural aging process of decreased muscle mass. Proper hydration and attention to rest and diet are reflected in a healthier, more youthful appearance.
At this stage, age-maintenance procedures that are less invasive and are cost-effective can deliver results that look far more natural than other, more radical surgical choices. Skin care, sun avoidance, and proper use of sunblock are also crucial at this and every life stage.

Men in Their 40s

The use of botulinum toxin injection (Botox) and fillers has become much more common among men in their 40s and 50s, who are beginning to deal with the loss of facial skin elasticity. Because a man’s face has a more robust blood supply than a woman’s face, surgeons performing any personal enhancement treatments on the face must consider such factors as the depth of skin peeling, energy levels for light base treatments, and frequency of past use of topical medications.
The most common aesthetic procedure for men in this age group involves rejuvenation around the eyes. Blepharoplasty (eyelid surgery), when done well, can help revitalize a man’s face in a discreet manner, without announcing to the world that a cosmetic procedure was performed.

Men in Their 50s and Beyond

Men in this age group will typically experience increasing skin accumulation along the jawline and the neck; this is often referred to as “jowls.” Traditional approaches for face and neck lifts do not work particularly well on men because the scars cannot be hidden under the hairline, as with women. To avoid the problems caused by hairline alteration, an alternative operation to a traditional face and neck lift is performed: Using a geometric incision pattern to remove the excess neck skin hides the scar in the area between the bottom of the chin and the Adam’s apple. The presence of hair follicles in the beard also helps camouflage the scar.

Regardless of age, encourage your patients to take a planned, realistic, and conservative approach to achieving their ideal body image. Less favorable cosmetic surgery outcomes among men, such as those seen in Bruce Jenner, Mickey Rourke, and Burt Reynolds, can and should be avoided with the guidance and support of surgeons who demonstrate a clear understanding of what cosmetic surgery options are available, along with knowledge of overarching health concerns.
At the office of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa, we provide a wide range of cosmetic procedures to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Many of these procedures can be combined in order to achieve your desired appearance.  Please call our office to find out more about us at (817) 473-2120 or visit our website at www.MarkBisharaMD.com.

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Eyelid Lifts-Fine Line Between Cosmetic and Therapeutic-by Dr. Mark Bishara, MD

Eyelid Lift Surgery
Drooping eyelids may seem like a common effect of getting older, but sagging eyelids not only age someone’s face, but they can also impair peripheral vision too. Removing the excess skin through surgery can both improve vision and result in a more youthful appearance, but determining whether the procedure is cosmetic or medically necessary has become a point of controversy.  Dr. Mark Bishara, with offices in Mansfield and Southlake, offers eyelid lifts (also known as Blepharoplasty) among his cosmetic services.
Eyelid lifts, called blepharoplasties, are done when the upper eyelid, which usually hangs about 2mm above the pupil, starts to sag. It can be removed for cosmetic reasons or because it starts to block a person’s peripheral vision.

Does Insurance Cover Eyelid Lifts?

An increase in eyelid lift surgeries covered by Medicare has risen. According to the Center of Public Integrity, Medicare can pay $574 to $640 per eye. There are no national Medicare criteria for what determines a functional blepharoplasty. Different Medicare contractors that cover different regions of the country have their own criteria, but were fairly uniform across the country.
For Medicare to cover the surgery, a doctor must perform two vision tests, which measure the degrees to which a person can see peripherally from the horizon. The surgery would have to theoretically improve a patient’s peripheral vision by a specific number of degrees to be approved. The number of degrees depends on what is required by the individual Medicare contractor.
Other private insurance companies often use the same criteria as Medicare to determine if an eye lift is necessary. For example, United Health Group, one of the largest private U.S. health insurance carriers, uses the Medicare guidelines to determine if a blepharoplasty is medically necessary or if it is cosmetic.
A photo of the patient also has to be included to show that he or she has sagging eyelids, and the patient must report additional symptoms, such as headaches from straining their eyebrows or injuries from running into things they can’t see. One common early sign was difficulty reading. At the end of the day, the eyelids might become so heavy they can’t open them.
What to Know Regarding Eyelid Lifts:
As with any type of surgeries, there are risks and complications involved in the procedure. Below are just a few of the risks that are involved and they may, or may not, affect the patient:
• Slow process of recovery
• Visible whiteheads after stitches are eradicated
• Impermanent swelling of eyelids
• Loss of vision or damage to eyes (rare risk)
• Closing the eyes while sleeping might be difficult (normally temporarily)
• Blurred or double vision
• Irregular scarring or healing
People who are considering eyelid surgery should also learn about the medical conditions that make it more risky for them, such as:
• Thyroid problems – Hypothyroidism or Graves’ diseases
• Diabetes
• High blood pressure or other types of circulatory disorders
• Lack of tear production or dry eyes
• Disorders of blood vessels and/or heart disease
People who are opting for eyelid lift surgery have the option of going through a laser eyelid surgery, but the risks and complications are said to be higher than the traditional surgery. It is advisable for patients to research various surgeons and medical centers prior to the surgery. Obtain as much information as possible to avoid any unwanted discrepancies after the surgery. Research can be done via the Internet, which is easy, quick, and informative.
Dr. Bishara provides a wide range of cosmetic procedures, including Blepharoplasties, to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Many of these procedures can be combined in order to achieve your desired appearance. Please call our office for more information at (817) 473-2120.
 

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Eye Lid Lifting by Mark A Bishara M.D. in Southlake and Mansfield Texas

As people grow older, they experience drooping or sagging eyelids and for that reason, eyelid lift surgery has become very popular. You even find certain people who have droopy eyelids from birth and others who have developed myasthenia gravis, which is a disease that cause drooping eyelids. The surgery is normally done while the patient is awake, but he or she will be given medicine to relieve anxiety. The medical practitioner will inject the numbing medicine around the eye, so the patient does not feel any pain during surgery.
Eyelid surgery, also known as Eyelid lift or Blepharoplasty, is carried out by general plastic or facial plastic surgeons. Aside from droopy or sagging eyelids, the procedure is done for those who have dark circles or puffy bags under their eyes. Lower eyelid and upper eyelid surgery procedures are often carried out separately. Another popular eyelid surgery is the double eyelid surgery, which refers to the accentuation or the creation of an eyelid crease. This procedure, known as Asian Blepharoplasty, is often performed on Asian eyes and it is performed to make Asian eyelids look a lot more like Caucasian eyelids by adding a visible fold.
The objective of an eyelid lift surgery is to lift the eyelids and the surgeon will begin the treatment by making tiny cuts into the natural creases of the eyelids. Then, he or she will remove extra loose skin and additional fat tissue. Once the surgeon tightens the eyelid muscles, he or she will place stitches in the area of the eyelid. This type of surgery hardly requires the patient to be admitted and it is usually done in the surgeon’s office instead of an operating room.
As with any type of surgeries, there are risks and complications involved in the procedure. Below are just a few of the risks that are involved and they may, or may not, affect the patient:
• Slow process of recovery
• Visible whiteheads after stitches are eradicated
• Impermanent swelling of eyelids
• Loss of vision or damage to eyes (rare risk)
• Closing the eyes while sleeping might be difficult (normally temporarily)
• Blurred or double vision
• Irregular scarring or healing
People who are considering eyelid surgery should also learn about the medical conditions that make it more risky for them, such as:
• Thyroid problems – Hypothyroidism or Graves’ diseases
• Diabetes
• High blood pressure or other types of circulatory disorders
• Lack of tear production or dry eyes
• Disorders of blood vessels and/or heart disease
Additionally, the risks of anesthesia may or may not include reactions to medicines and breathing difficulties. Other risks are infection and bleeding during and after surgery.
Patients who have undergone eyelid surgery will generally get their stitches removed within three to four days post-surgery, whereas the small pieces of tape are removed within seven days. The patients are able to return to work in the next eight to 10 days, but female patients are advised to use make-up after the eighth day of the recovery period. With the surgeon’s approval and clearance, patients can resume normal activities within three to four weeks.
People who are opting for eyelid lift surgery have the option of going through a laser eyelid surgery, but the risks and complications are said to be higher than the traditional surgery. It is advisable for patients to research various surgeons and medical centers prior to the surgery. Obtain as much information as possible to avoid any unwanted discrepancies after the surgery. Research can be done via the Internet, which is easy, quick, and informative.
 

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Types of Eyelid Surgery (Blepharoplasty)



Eyelid surgery is known in the medical field as blepharoplasty. The surgeon cuts, repositions, or removes the skin, fat, or muscles in the eyelid to give an eye lift effect. Although it is popular for cosmetic reasons, eyelid surgery (blepharoplasty) can also be utilized to treat other conditions.
Eyelid Lift Patient Information: Types of Eyelid Surgery (Blepharoplasty)
There are three major types of eyelid surgery. The first type is called lower eyelid blepharoplasty. As the name indicates, it is done on the lower eyelid and is mostly used for modifying eye bags or improving the wrinkled appearance of skin around the eyes.
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Eyelid Blog



eyelid-procedures
As people grow older, they experience drooping or sagging eyelids and for that reason, eyelid lift surgery has become very popular. You even find certain people who have droopy eyelids from birth and others who have developed myasthenia gravis, which is a disease that cause drooping eyelids. The surgery is normally done while the patient is awake, but he or she will be given medicine to relieve anxiety. The medical practitioner will inject the numbing medicine around the eye, so the patient does not feel any pain during surgery.
Read more

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