Neo-Adonis

Rapidly changing cultural mores have influenced the popularity of cosmetic surgery among men.

Real men don’t eat quiche—or do they? I can never remember. But real men do get cosmetic surgery. They’re altering their noses, erasing double chins, and having breasts made smaller, calves larger, pecs rounder, and bellies and love handles stealthily sucked away. New hair is being grown on formerly bald pates, while pelts of body "fur" are being banished forever by the laser. The seemingly linear relationship between the burgeoning popularity of cosmetic surgery among men and the graying of baby boomers is hard to ignore. For years doctors offered a vast menu of improvements to women as their counterparts stoically watched it all happen. There was no seismic discovery or revolution in technique that made cosmetic surgery suddenly acceptable to men. It is true, however, that methods have required a bit of retooling to best serve the anatomy and mindset of men. But all this evolved naturally as interest grew. Here, some popular procedures deconstructed.

Dr. Gerald Imber is a leading New York plastic surgeon and the author of Absolute Beauty (HarperCollins, 2005).

Neck

Deep nasolabial folds from the nose to the corners of the mouth, along with jowls and the loose turkey-gobbler neck, are usually the enemy. Tightening skin and underlying musculature does the job without erasing character. Redundant upper-eyelid skin is trimmed more conservatively for men, and under-eye bags are removed via an incision beneath the lashes. From $4,500

Hair Transplants

Before the shaved head became popular, hair transplants were a balding man’s best alternative. Virtually undetectable ones are done as individual micrografts—a far cry from the unsightly stand of trees produced by the old techniques. The catch? It requires several sessions and lots of money. From $15,000 a session

Facial Surgery

The goals of facial surgery for men are different from those for women. Often less invasive, it concentrates on making a man’s loosening skin fit neatly, rather than eliminating wrinkles. Male skin is generally thicker, with an extensive blood supply nourishing the hair follicles of the beard. Add the excellent exfoliation of daily shaving and wrinkles are rarely a problem. Men also tolerate smile lines or crow’s-feet so long as skin is taut. From $10,000

Breasts

Male breasts (gynecomastia) are mostly fat surrounding enlarged breast tissue. To achieve a flat, firm, masculine chest, surgery is performed via a small incision in the areola to remove the fat and, when necessary, glandular tissue from above the pectoral muscle ($12,500). At the other end of the spectrum, the current interest in working out and bodybuilding has left a number of men dissatisfied with anything short of bulging pecs. This look is achieved with silicone implants inserted beneath the muscle, usually through the underarm ($10,000).

Abdomen

Creating a six-pack abdomen by what is euphemistically called liposculpture is neither simple nor predictable. To my eye the results are not impressive enough to warrant the risk. Gone wrong, there is little available to reverse the damage. I tell my patients to watch their diets and start doing sit-ups. From $5,000

Liposuction

The single procedure that seemed to open doors for men was liposuction. Pioneered in France in the late seventies, it was soon introduced in the States. By the late eighties it had evolved more or less into what the procedure is today. For men the idea of a little suction to reduce a bit of girth settled around the middle, love handles, or double chin breaks no barriers. From $7,500

Calves

Silicone implants that mimic the feel of soft tissue may be inserted beneath the gastrocnemius muscle to produce round, muscular-looking calves. Complications, including pressure on the nerves, has dampened the enthusiasm for this procedure among most surgeons. From $10,000