While more women than men undergo facelift procedures, men still make up about 15% to 20% of the facelift population. Men are almost exclusively bothered by a ‘neck waddle’ and usually consider a facelift at an older age than women when this waddle is more significant.
One of the keys to facelifting in men is not to overdo it. I have see many men who have had a facelift and they look a little unnatural at best and some even look more effeminate. I am certain this is not what they were seeking from the procedure. A subtle improvement for men is much better than an overdone dramatic one. Men, understandably, are particularly skiddish about being known as having had a facelift.
From a planning and technical standpoint, the male facelift patient differs from the female in one significant way….hair. Both the amount and style of scalp hair and the presence of beard skin changes several aspects of the operation. The placement of the incisions and their eventual obscurity is of critical importance. Like all facelifts, the first and most important goal is to have scars that are difficult to find. No matter how great the neck and jowl result is, or how long the result may last, poor and visible scarring will make that all irrelevant. I have yet to find a patient who wants to advertise that they have had a facelift. (although some results that you have seen scream that they have!)
Men have beards which provide both an advantage and a disadvantage. The upward-disappearing sideburn that can occur in women with a facelift (the tuft of hair in front of the ear gets higher) is not an issue for most men. When their existing sideburn gets higher after surgery, they simply start shaving lower regaining the lost sideburn. Most men should even start before facelift surgery in growing longer sideburns so they will be at a normal level after surgery. The diadvantages are that the incision in front of the ear must stay…in front of the ear. It can not be placed partially inside the ear as in women (known as retrotragal) because beard skin will drawn up into the ear which is both a nuisance and not natural looking. In addition, because of the direction of pull behind the ear in a facelift, some beard skin will end up behind the ear necessitating shaving this area. As long as men are advised of this possibility and after surgery requirement, I have not seen it to be a problem.
One final thought on male facelift results…..men do not usually get a particularly dramatic result. Their skin often stretches more than a woman’s making it difficult (and unnecessary) to create a super sharp neck angle. They are also prone to more settling or some ‘relapse’ after surgery due to their thicker heavier skin. As already mentioned, however, men are usually not interested in spectacular changes but prefer less obvious ones. This may be the most important key to the male facelift patient.
Dr. Barry Eppley
Indianapolis, Indiana