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15 March 2004

Men try a little nip and tuck

Liposuctions, facelifts, even breast reductions: They're not just for women anymore.

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Liposuctions, facelifts, even breast reductions: They're not just for women anymore.

Nowadays, record numbers of men are seeking cosmetic surgery as a quick fix for everything from beer bellies to big noses.

The number of men in the United States having cosmetic surgery has grown 48 percent since 1992, to 107 575 last year, according to the American Society of Plastic Surgeons. Men now make up about 11 percent of the more than one million people who have cosmetic surgery each year.

And nearly one-third of the men are asking for liposuctions to slim down their abdomens.

Some men even are asking for abdominal "etching," where the surgeon removes fat in a way that results in a "six-pack" stomach - the kind often seen on sculpted male models on magazine covers.

Some experts, however, worry that the trend signals a potential problem - that men are starting to fall victim to the same unrealistic body images that have plagued women for years.

Last year, nearly 30 000 men had liposuctions, a 33 percent increase from the year before and a five-fold increase from 1992.

After liposuctions, most-asked-for procedures by men include eyelid surgeries, nose reshapings, facelifts and breast reductions.

Excess breast tissue, which creates a condition called gynecomastia, sent about 9 000 men last year to cosmetic surgeons seeking help. Hormonal changes, medications or genetics can cause gynecomastia, experts say.

The stigma is fading

To plastic surgeons, the increase in men seeking to improve their appearance using everything from cheek implants to forehead lifts to collagen injections is simply a sign that the stigma associated with cosmetic surgery is lifting.

"Women are no longer alone in their desire to look and feel younger," says Dr Paul Parker, a New Jersey plastic surgeon. "And our society is much more accepting about the use of aesthetic or cosmetic surgery to assist in looking and feeling our best."

Still, having cosmetic surgery remains something some men don't want to advertise.

KT, a 64-year-old New Jersey man who did not want to be named, is among them.

Two years ago, he had blepharoplasty - otherwise known as eyelid surgery - to remove excess skin and fat from his upper and lower lids. As he aged, KT says, his eyelids began to droop so badly that eventually he lost some peripheral vision.

Insurance paid for the procedure, he says, but not for a second, different one he had a few months ago. This time, KT spent $7 000 for a facelift to reduce jowls in his neck and slackness in his cheeks. Having once modeled men's clothing, KT wants to get back into the business. As the population ages, he says, some retailers are looking for older models - but not too old.

"My wife talked me into it," KT says. "She's 15 years younger than me, and she said, 'It will make you look younger, younger, younger.' I didn't do it for the sake of vanity."

Some see trouble with the trend

But others see male cosmetic surgery as a troubling trend.

Roberto Olivardia, a clinical psychologist at Harvard Medical School, says he is seeing more men who are fixated on wrinkles, sagging skin and other perceived body flaws - a similar preoccupation with appearance that causes many women to suffer.

"We are a very youth-obsessed society," Olivardia says. "Not only do you have to have the perfect body, you also have to look young."

"Being young is very, very important, especially in today's 'dot-com' business world," Olivardia adds. "Men believe, in order to stay competitive, you have to look good. And that means looking young."

Since baby boomers started crossing the 50-year-old threshold, cosmetic surgery for 51- to 64-year-olds has risen 47 percent, according to the plastic surgeons' group.

For both men and women, the most frequent reason they give for having cosmetic surgery is to improve self-image, says the American Academy of Cosmetic Surgery.

For women, becoming single again, either through divorce or the death of a spouse, is the next most-common reason for plastic surgery. But for men, it's to enhance their career.

In recent years, Olivardia says he's also seen an increasing number of men with "body dysmorphic disorder," a pathological preoccupation with being muscular and an unfounded fear of being "too small." These men are prone to depression, use of anabolic steroids and excessive weightlifting, he says.

And for some men, their unhappiness leads them to cosmetic surgeons, seeking procedures like pectoral or calf implants, he says.

"I have spoken to countless men who think the solution is not that they need to think of themselves differently, but they need to go to a cosmetic surgeon," Olivardia says. "And with every procedure, they are more and more dissatisfied."

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