More men going under the knife

To friends and colleagues, Frank Lococo's furrowed brow made him appear angry and confrontational. Not exactly personality traits you want as an advertising executive.

So the 37-year-old Milwaukee man opted for cosmetic surgery, joining the growing number of men willing to go under the knife — or for some, under the needle — in an effort to make themselves look younger and, hopefully, improve their careers.

"Being in advertising and marketing, there is a lot to how you look," said Lococo, of Milwaukee. "How you dress, what you drive, it all makes an impact on the overall presentation of you."

According to the American Society of Plastic Surgeons, in Arlington Heights, Ill., 1.1 million men underwent cosmetic surgery in 2007, a 9 percent increase from 2000. Of those procedures, 884,000 were minimally invasive such as Botox, microdermabrasion and laser hair removal, while 233,000 were surgical such as rhinoplasty, eyelid surgery and liposuction. Botox treatments are the most common minimally invasive treatment for men, with 296,012 done in 2007 — a 215 percent increase from 2000.

Anecdotal interviews of physicians at local hospital systems including Milwaukee-based Columbia St. Mary's and Aurora Health Care, Wauwatosa-based Froedtert Hospital and Glendale-based Wheaton Franciscan Health Care revealed local doctors are seeing more male patients too, especially those who are interested in Botox and eyelid surgery.

Last year, Lococo had Botox injections done at Froedtert & the Medical College of Wisconsin Plastic Surgery Center to soften his furrowed brow and above his eyes. The results were immediate, and he's setting up a second appointment. Lococo plans on having the same injections, and possibly a few more around his eyes.

He compares Botox to putting a toe in the water before deciding to jump in the pool. Depending on how he ages, Lococo said he would consider more complex cosmetic surgery.

One treatment of Botox costs an average of $2,000 and lasts about a year. Compared with the $8,000 to $10,000 for facelifts, Botox has become a popular and economically sound choice for many, said Dr. David Larson, chairman of plastic surgery at Froedtert & the Medical College of Wisconsin.

Dr. Jolene Andryk, a plastic surgeon with Aurora Advanced Healthcare, said despite the increase in male patients, she doesn't market her business to them because cosmetic surgery still carries a stigma for men.

Most of Andryk's male patients have been referred by wives or girlfriends, she said.

"I'm seeing more of the business professional group coming in," she said. "I (recently) had a consult with a man in his late-50s whose coworkers kept telling him he looked tired. He was looking for a more youthful, energetic appearance. There are subtle ways for men to look refreshed and refined in the business world and they are seeking them out."

Andryk, who does reconstructive surgery in addition to cosmetic, estimates 15 percent of her cosmetic base is men, up about 5 percent from five years ago.

Fourteen percent of Botox injections, 15 percent of all liposuction and eyelid surgeries, 20 percent of laser hair removal and 24 percent of nose jobs are carried out on men, according to the American Society of Aesthetic Plastic Surgery in Los Alamitos, Calif.

More patients

Larson has seen an increase similar to Andryk's in his male patient business as invasive procedures and so-called "liquid facelifts" become more popular.

Larson estimates about 10 percent to 12 percent of his business is male patients, making up 5 percent to 8 percent of his gross income.

"As word passes from their wives to them, I'm seeing more men," Larson said. "For invasive procedures such as liposuction, nose surgery and removal of excessive eyelid skin, men see great results and those operations have really gone up."

According to the American Society of Plastic Surgeons, the top five male cosmetic surgery procedures are nose reshaping, eyelid surgery, liposuction, breast reduction and hair transplantation. The top five minimally invasive procedures are Botox, microdermabrasion, laser hair removal, chemical peel and laser skin resurfacing.

Dr. Terrence Wilkins, a plastic surgeon with Columbia St. Mary's, said when he started 20 years ago, male patients were less than 10 percent of his business. Today, about two in 10 patients are men.

"The procedures men have are a little different here, than the national statistics," Wilkins said.

Wilkins said that nationally, the most common procedure for men is liposuction, but in the Milwaukee area eyelid surgery is the top procedure, followed by rhinoplasty.

Andryk said a man's professional status, income and education level normally coincide with his interest in plastic surgery. Cosmetic surgery is not typically covered by insurance companies.

"It's a sign of our times," she said. "Fifty is the new 30, so nobody wants to be 50 and look like they are 70."

Latino Immigrants to Europe Use Plastic Surgery to Fit In

File under self-hatred a lo Europeo. Plastic surgeons in Spain are reporting a barrage of requests from Central American and South American immigrants wanting to undergo plastic surgery to make themselves look "more European". According to doctors around 2500 immigrants submit themselves to procedures such as rhinoplasty (nose jobs) and other types of surgery to modify their faces.

"What they want is for people not to recognize them as foreigners and go unnoticed," explains plastic surgeon José María Palacín.

The surgery is said to cost around 5000 euros (around $7800) and 20 Minutos reports that the majority of immigrants that request the surgery are Ecuadorian and Colombians living in Madrid.

This is of course a terrible thing, but it also makes me stop and think: what is happening in Madrid that makes immigrants feel the need to go to these lengths to "go unnoticed"?

New Rhinoplasty Technique Preserves Ethnicity

Plastic surgeon, Dr. Oleh Slupchynskyj, has revealed in a new study that African Americans can have nose jobs without changing their ethnic look. According to a study recently published in the Archives of Plastic Surgery, a three-tiered surgical procedure can produce a natural-looking nose job without loss of racial identity. This procedure, Dr. Slupchynskyj states 'improves the equilibrium of the nose and face by reducing nasal flare, increasing the dorsal height of the nose and refines the look of the tip of the nose'.

 

Dr. Slupchynskyj noted that the three-tiered approach was significant since "African American patients are not looking to change their ethnic features; they seek satisfaction from a nose that is in harmony with the remainder of their facial features."

 

The study of 75 African American rhinoplasty patients found that most of them were satisfied with the result and indicated that their self-esteem was also increased.

GORE-TEX appears to be safe alternative for rhinoplasty

NEW YORK (Reuters Health) - For patients who undergo plastic surgery on the nose (rhinoplasty), GORE-TEX implants are a safe and inexpensive alternative to using tissue grafts taken from another part of the patient's body, according to the results of a 17-year review of more than 500 patients.

For initial and subsequent rhinoplasty procedures in patients with enough internal nasal tissue and external soft tissue coverage, "GORE-TEX should be strongly considered for major and minor corrections of the nasal wall and bridge in properly selected patients," Dr. Krzysztof Conrad and colleagues, from the University of Toronto, advise.

The review, which was conducted at a teaching hospital, community hospital, and private facial cosmetic surgery center, involved 521 patients who were followed for up to 17 years. A total of 685 GORE-TEX implants were placed, all by one surgeon.

The new findings appear in the Archives of Facial Plastic Surgery.

The implants, which were 1 to 10 mm thick, showed "excellent stability and tissue tolerance." Complications requiring implant removal developed in only 1.9 percent of patients and included infection, swelling, and cases in which the implant moved or partially came out.

"The unlimited supply and natural feel of the GORE-TEX implant," the authors comment, and the "excellent blending" with the contour of the nose, plus the minimal operating time, "outweigh the disadvantage of occasional complications, all of which can be treated successfully as long as they are not neglected," Conrad's team concludes.

SOURCE: Archives of Facial Plastic Surgery, July/August, 2008.

Allergan Smoothing Out Wrinkles

Allergan, Inc. (AGN) has been expanding into new therapeutic areas through acquisitions over the past few quarters. We believe these acquisitions will provide the company with the opportunity to drive growth in its existing business and to expand into new areas of business even in the face of slowing U.S. consumer spend. The Inamed acquisition, in particular, should help strengthen Allergan's position as a specialty pharmaceutical company.

From a fundamental standpoint, we are enthusiastic about the future of Allergan. The company possesses a strong blockbuster product in Botox wrinkle treatment and a slew of innovative new products in the eye and skin care markets. We were pleased to see Allergan receive the Food and Drug Administration approval for Juvederm dermal fillers several months ahead of expectations. Both Botox and Juvederm should help the company strengthen its position in the dermatology and plastic surgery market. We were also pleased to hear about the U.S. approval of silicone breast implants.

We expect 2008 to be a strong year for Allergan and the company's impressive pipeline should help drive growth in the next decade. The stock currently trades at 19.8x our 2008 estimate of $2.59. Several issues are likely to keep a lid on the share price in the near-term. Allergan shares have been under pressure lately due to safety concerns surrounding the use of Botox. Allergan also received a subpoena from the Department of Justice, U.S. Attorney's Office for the Northern District of Georgia, related to promotional, educational and other activities for Botox. We maintain a Hold rating on the stock with a price target of $56.