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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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Stars Who Admit to Injectables

Game over. Injectables, like Botox and Juvéderm, have officially come out of the closet. Gone are the days of celebrities treating injectables like a dirty little secret for younger-looking skin. Botox is everywhere in Hollywood. And why shouldn’t it be? It’s an easy way to erase wrinkles and lines in minutes—in some cases.
When injectables are done successfully, you get a natural, younger face that still looks like “you” with little to no downtime. Just ask former 90210 star Jenny Garth—she admits that she’s been a fan of Botox since 2008, among many an A-lister who also gets injected. Vanessa Williams says she uses Botox, but sparingly. Jenny McCarthy has been quoted saying she gets Botox injections in her forehead every two months. Singer Kylie Minogue has admitted to using Botox in the past, but recently has been quiet about injections. Kim Cattrall has been quoted saying she uses Botox to get rid of a wrinkles in her forehead. Full House favorite, Lori Loughlin, says the results of Botox are incredible and likens the results to looking like you just got back from vacation. Virginia Madsen is so impressed with how injectables have helped her fight off the signs of aging, she has actually appeared in commercials for Botox and Juvéderm. Daisy Fuentes has been quoted saying that as long as you don’t go overboard with it, Botox has a place, in your face, as you age. Courtney Thorne-Smith, another Botox brand celebrity representative, says she likes it, it works, and it’s just that simple. She’s been a fan of injections for the last 10 years. Lisa Rinna says she uses Botox every three months to ward off the hereditary scowl marks that run in her family.
And remember, if you’re considering injectables, make sure you are seeking treatment from a reputable and experienced board-certified dermatologist or plastic surgeon that uses FDA-approved fillers.
At the office of Dr. Mark Bishara, with offices in Mansfield and Southlake, TX- we offer FDA approved fillers such as Botox and Juvederm.  Our procedures help patients look and feel their best and are designed to improve your appearance. Please call our office to schedule an appointment for Botox or Juvederm at (817) 473-2120 or visit our website at www.MarkBisharaMD.com.
 

 

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Increasing Collagen

We lose a teaspoon of collagen from our faces every year after age 30

There are only a few proven ways to significantly increase collagen in the face to tighten the skin. These methods include laser resurfacing of the face, use of a retinol cream, collagen injections, and hyaluronic acid injections (Juvederm).

Juvéderm® Ultra Plus XC

Juvederm is designed to replenish what natural aging takes away, for a fresher, rejuvenated look. Replenish what’s been lost over time: sun exposure, hormonal changes and aging can all have an impact on your skin’s appearance. Over time, your skin begins to lose hyaluronic acid and collagen, resulting in fine lines, wrinkles and a loss of fullness and elasticity. We can now reverse these signs of aging by correcting the wrinkles and folds and adding volume to sunken skin. Juvéderm is a soft, injectable gel filler that your doctor uses to help replenish and refresh your appearance. It uses hyaluronic acid (a naturally occurring sugar found in your body), which combines with the water in your skin to instantly restore lost volume and reduce lines and wrinkles. Hyaluronic injections have also been shown to stimulate collagen production. Not only that, Juvéderm works to enhance and define lips, cheeks and jaw line.

Juvéderm® Voluma™

JUVÉDERM VOLUMA, the newest facial filler available in the Juvederm family of hyaluronic acid fillers. The first of its kind, JUVÉDERM VOLUMA is a hyaluronic acid facial filler specifically made to restore age-related volume loss in the mid-face (the cheeks, cheekbones and around the chin). JUVÉDERM VOLUMA uses hyaluronic acid, a sugar that occurs naturally in your skin, to instantly restore lost facial volume in the cheeks and contour the chin. JUVÉDERM VOLUMA also combines with collagen and elastin to improve skin structure and elasticity, and create a smooth natural look. The results are instant, natural looking and can last up to 18 months.1 Plus there’s no downtime – most people resume normal activities immediately.
This information is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX

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9 Top Cosmetic Treatments for Aging Skin

1. Retinoid creams

A host of over-the-counter products claim to help fight wrinkles. One option: topical retinoid (derived from vitamin A) creams; look for retinol in the ingredient list. The SkinCeuticals line has products with retinol in them to help fight existing wrinkles . 

2. Over-the-counter peptide creams

Creams containing peptides—short snippets of linked amino acids—can be useful for reducing the appearance of wrinkles and fine lines, but they haven’t been shown to work as well as retinoids. As skin ages, it loses collagen and becomes wrinkled and thin; creams containing peptides are supposed to encourage the skin to make new collagen. Peptides are found in a variety of products, from the inexpensive to the very expensive. There are many SkinCeuticals product that can help.

3. Microdermabrasion

Microdermabrasion uses tiny, fine particles or a very hard diamond-tipped wand to slough off cells from the top layer of the skin and encourage new skin growth. The procedure is usually not painful, though it can be uncomfortable, and it doesn’t require an anesthetic or recovery period; skin heals quickly. But you may require multiple procedures spaced a few weeks apart.

4. Laser skin resurfacing

Laser resurfacing uses high-intensity light to zap and improve the look of wrinkles and scars by tightening loose skin. The effect of your treatment and recovery time vary. There are lasers that can be superficial or intermediate and deep. You may see redness from one day to two weeks, depending on how aggressive the treatment is. 

5. Chemical peels

Used to address mild acne scars, age spots, dull skin texture, skin discoloration, or wrinkles around the eyes or mouth, chemical peels remove the outer layers of the skin and encourage the growth of new, smoother, more evenly colored skin. Depending on the peel’s intensity—which can range from superficial to medium to deep—it may cause reddening and peeling that can last up to several weeks.

6. Botox

Injections of Botox —which also contains botulism toxin and  is approved by the FDA, can paralyze tiny facial muscles, smoothing out the appearance of lines or wrinkles. The cost of Botox will vary depending on location and doctor. The effects of injections may last three to six months, depending on whether you’re a repeat customer.

7. Filler injections

Injections of fillers containing hyaluronic acid can fill in lines and wrinkles and add volume to skin. Hyaluronic acid is a “naturally occurring sugar that gets lost when you age,” and injecting it into wrinkles effectively plumps them up. Juvederm Ultra Plus XC and Juvederm Voluma are the newest and best.

8. Cosmetic surgery

Lifting the skin on the face, neck, eyelids, and forehead can give a tighter appearance. What were once traditionally open procedures—with larger incisions—can now often be done endoscopically, with smaller incisions strategically placed in difficult-to-detect areas, such as under the hairline. The effects of cosmetic surgery are somewhat permanent. 

9. Try prevention

If all this sounds extreme, remember that you can start immediately to prevent any further damage: Start wearing sunscreen every day. Lifetime exposure to the sun can wreak serious havoc. When people were younger…they didn’t think the sun caused any bad signs, but now they’re really feeling the effects of it 30 years later.
This information is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX

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The History of Botox

The history of BOTOX®


BOTOX® (onabotulinumtoxinA) is a type of medicine that is used to treat patients with certain neuromuscular conditions. One of the most researched medicines in the world, BOTOX® treatment is approved for medical uses across the world.

Since its FDA approval for aesthetic treatment in April 2002, the neurotoxin Botox has gone from a somewhat controversial treatment to a celebrity-endorsed wrinkle remedy. Injectables have become the new norm in cosmetic treatment. According to the American Academy of Facial Plastic and Reconstructive Surgery, the most common nonsurgical procedures last year were Botox and hyaluronic acid fillers.
It’s come a long way from its origins as an FDA approved treatment for two rare eye muscle disorders (strabismus and blepharospasm). The original name, Oculinum, doesn’t exactly roll off the tongue, but shortly after Allergan secured that first FDA approval in 1989, the product was rebranded Botox. Once physicians realized that Botox could treat wrinkles, the rest was history.
Botox reached nearly $1.6 billion in sales last year, attributing 51 percent to therapeutic uses and 49 percent to aesthetic uses. It became so successful that it gained its first FDA-approved wrinkle-reducing competitor in 2009-the sincerest form of flattery in the business world. However, Botox continues to evolve as new uses for the product are discovered. Used off-label, it treats a host of concerns such as crow’s-feet, down-turned corners of the mouth and bands on the neck. You may be surprised to learn that it has also been used, off label, to aesthetically treat enlarged pores, droopy eyebrows, a pointy chin and a droopy nose tip. Additionally, it’s an FDA-approved treatment for medical conditions ranging from chronic migraine to excessive sweating. Next up: the company is seeking FDA approval for the treatment of crow’s-feet.

1950s- Scientists discover that botulinum toxin can reduce muscle spasms.
1960s/1970s- Studies explore botulinum toxin as a treatment for strabismus (crossed eyes).
1988- Allergan researches other medical uses of botulinum toxin.
1989- Allergan introduces BOTOX®, the first botulinum toxin approved by the FDA to treat blepharospasm (eyelid spasms) and strabismus.
2000- FDA approves BOTOX® therapy for cervical dystonia to reduce the severity of abnormal head position and neck pain.
2002- FDA approves BOTOX® Cosmetic (onabotulinumtoxinA), the same formulation as BOTOX®, with dosing specific to moderate to severe frown lines between the brow.
2004- FDA approves BOTOX® for severe underarm sweating when topical medicines don’t work well enough.
2009- 20-year anniversary of BOTOX®
2010- FDA approves BOTOX® therapy for increased muscle stiffness in elbow, wrist, and finger muscles with upper limb spasticity.

2011- FDA approves Botox for detrusor overactivity associated with neurologic condition
2013- FDA approves to improve symptoms of overactive bladder in adults
BOTOX® is the first medicine to be studied and then approved by the FDA specifically for the prevention of headaches in adults with Chronic Migraine who have 15 or more days each month with headache lasting 4 or more hours each day in people 18 years or older.
Compared to other cosmetic procedures, BOTOX® offers patients many benefits with its convenience, effectiveness and affordability. The entire procedure takes about ten minutes to perform, and patients can go home and return to regular activities immediately after. The results of BOTOX® injections are visible within the next few days.
At Dr. Bishara’s office we have weekly Botox specials in our Mansfield and Southlake office locations.  Please call our office at (817) 473-2120 to find out more about our weekly Botox specials or visit our website at www.MarkBisharaMD.com.
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