The Patient's Question: I've got prominent forehead wrinkles, along with under eye bags and loose skin under the chin. They all age me way beyond my years!
Dr. Freund's Response: Before discussing your concerns, here's a little background on men and plastic surgery. Most men do not have the same support structures available when deciding to have plastic surgery. My women patients will come in for a consultation with friends, or armed with information about what. Men will typically come to my office alone and will be less likely to have discussed their concerns with friends and significant others.
This makes any decision to undergo surgery more difficult for the patient and the doctor, as it's difficult to assess a patient's expectations. To set the record straight, about 1 out of 9 plastic surgery patients are male. Men have the same procedures as woman, but they are always more concerned about minimizing downtime and eliminating any telltale signs of plastic surgery.
Now, your issues.
Forehead Wrinkles -- Can be treated in two ways: 1) a browlift stretches out the wrinkles as the forehead is lifted. This is similar to smoothing out the wrinkles on a bed, as the sheets are pulled taut. While this may be a fine choice for a woman, men must be more concerned about incisions in the scalp and scars if they begin to lose their hair. Today, most men opt to treat forehead wrinkles with a muscle-paralyzing agent (Dysport or Botox), which relax the muscles that cause wrinkles. This treatment is safe and easy and has little or no downtime. Cost $500-800.
Fat Under Chin -- The neck structures that contribute to the bulge under your chin can include: 1) excess skin, 2) too much fat surrounding the the neck muscles, 3) weakening of the neck muscles or 4) genetics ("everyone in my family has that!"). Since your skin appears tight and the muscles appear to be intact I'd guess you have excess fat. This is a test I perform with my own patients to evaluate if the muscles need tightening: I ask to look in a mirror and use the muscles of the lower lip to pull the lip downward to expose the lower teeth. If this movement creates two vertical bands on the neck, then muscle tightening may also be needed. If your muscles are intact, I would advise liposuction. The procedure has a great success rate and most people return to work in 2-3 days. Cost $3,000 to $5,000.
Bags Below Eyes -- What you call bags (indicated by the letter "A") are more likely a depression called the tear trough deformity. This is the border between the muscle of the lower eyelid and the upper the cheek. As the cheek sags with age, this depression becomes more obvious. The best way to treat this is with fat injections, which transfers fat from your own body to fill this depression. The techniques are better than they were in the past and they are performed under local anesthesia. Downtime is 2-7 days. Cost $2,500.
These three treatments will limit your downtime, maximize your long-term results and leave no signs of plastic surgery. If you would like a more complete description of the procedures and treatment options please refer new book, "A More Beautiful You - Reverse Aging Through Skin Care, Plastic Surgery or Lifestyle Solutions."
Best of Luck,
Robert Freund, MD, FACS
The health or medical information in this article is for informational purposes only and is not intended to be used as a substitute for professional medical advice, diagnosis or treatment. Please consult your doctor or a qualified healthcare provider with any questions.