Health & Fitness

Men are nipping and tucking more than ever

James Provencher, 30, a Miami Beach resident, gets a dermal-filler injection from Dr. Lisa Grunebaum, a plastic surgeon at UHealth — the University of Miami Health System.
James Provencher, 30, a Miami Beach resident, gets a dermal-filler injection from Dr. Lisa Grunebaum, a plastic surgeon at UHealth — the University of Miami Health System. FOR THE MIAMI HERALD

Leaning back against the pillow, James Provencher closed his eyes and took a deep breath. He wasn’t nervous about the half-inch, 27-gauge needle that Dr. Lisa Grunebaum was about to plunge into his face. In fact, he likened the whole Botox experience to a pedicure.

“It’s very relaxing,” said Provencher, 30, who, sitting in Grunebaum’s treatment room at UHealth — the University of Miami Health System, received a cheek-plumping injection called Voluma and a wrinkle-preventing Botox injection.

Over the past 10 years, he has had approximately 15 cosmetic procedures.

While Provencher, who lives in Miami Beach, may appear too young to have undergone multiple plastic surgery procedures, he’s part of a growing trend in the world of cosmetic surgery: Men who are having their facial lines filled, “love handles” removed and chins firmed.

According to the American Society of Plastic Surgeons, the number of men who have undergone minimally invasive cosmetic procedures — think Botox — spiked 67 percent from 2000 to 2014, the most recent statistics available. Indeed, more than 1.2 million cosmetic procedures, both surgical and minimally invasive, were performed on men in 2014.

Over the last several years, Dr. Leslie Baumann, a Miami cosmetic dermatologist and Miami Herald columnist, has noticed a growing number of men coming to her for facial injections to “fill” or plump up their chin and jaw lines. Men alone make up 80 percent of the patients she treats to dissolve chin fat using a product called Kybella, a man-made form of a substance that occurs in the body that, when injected, breaks down and recycles fatty acids.

According to Baumann, the side effects are minimal — which makes the procedure more inviting than it did years ago when “it was really hard to get away with it without people knowing,” she said.

That brings up another commonality she’s seen among her male clients: Men more than women tend to want to keep their plastic surgery procedures quiet. With these types of injections, while you won’t want to attend a black-tie event or schedule any important in-person meetings for the first two weeks, the main side effect is swelling “like you just had a little too much salt.”

Baumann, who performed research trials for the FDA approval of Kybella four years ago (the agency approved it last June), said the jaw line is very important in how men perceive their own attractiveness.

Another popular procedure is called Ultrashape, which firms out the flanks and removes “love handles” and Gynecomastia surgery, which reduces a condition commonly called “man boobs.” (Breast reductions in men were up 5 percent in 2015 to 27,456 procedures, the American Society of Plastic Surgeons reports.)

“We have seen amazing results. The body whips into place in about four to six weeks,” she said.

The downtime and side effects for a non-invasive treatment called CoolSculpting, a machine that freezes and kills fat cells, were so slight that Dr. Carlos Wolf, a partner in Miami Plastic Surgery who is board certified in facial plastic and reconstructive surgery and otolaryngology, said he rode his bike 40 miles the day after he had his “love handles” removed. Wolf, who writes a column for the Miami Herald, experienced some numbing, but suffered no pain, he said.

“It’s a nonstop procedure: You don’t have to stop anything you normally do,” he said. Wolf underwent the procedure on a Friday and returned to work Monday. That was 3 1/2 years ago and his love handles have not returned.

Wolf considers this type of technology the “ultimate procedure” for him: You pay $3,000 to $5,000 to look and feel better without anesthesia or a hospital stay. Because Wolf has been a plastic surgeon for about 30 years, the Kendall resident has seen a world of plastic surgery disasters. His advice: Don’t scrimp on doing the research.

“The unfortunate thing about the explosion of non-invasive procedures is you have morons who have the money to set up a business and hire doctors and pay them double, and the doctors don’t know what they’re doing because [all they did was take] some weekend course,” he said.

Like Wolf, Baumann considers plastic surgery something that balances out one’s health, not an obsession of the vapid. Still, there are people who don’t know when to stop — Baumann calls it the “red carpet syndrome,” alluding to Hollywood celebrities who look stretched, perpetually surprised or downright unrecognizable.

So, while it may be a bit of a “cheat” to pay $2,000 for something that allows you to minimize your waistline without killing yourself at the gym, if it brings happiness that leads to confidence, that can improve overall quality of life.

Back in Grunebaum’s office, the plastic surgeon eyed Provencher’s 30-year-old face and injected his cheeks with a gel called Voluma. A doctor doing it right knows not to inject men too high, she said, because you don’t want to feminize them.

“It’s such a quick and easy thing that can do so much,” Provencher said. “A week after these treatments you look really fresh.’’

Other frequent plastic surgery clients are people who work out vigorously. Fitness aficionados often lose weight in their face, which makes them look older, she said.

Grunebaum doesn’t want patients walking out of her office looking like “Wow, what’d you do!” She wants you to look like you, just a less tired you.

Another aspect of plastic surgery that Provencher likes is the new habits his face has formed when he reacts emotionally to something.

“When I smile now, my eyebrows don’t go up,” he said, as Grunebaum quipped that that will help ward off future wrinkles. Plastic surgery patients lose the habit of contorting their faces in ways that most commonly cause wrinkles. In fact, they actually can’t move certain parts of their face.

Case in point: Grunebaum, holding the Botox needle between Provencher’s eyebrows, asked him to “squinch your face like you’re mad” in preparation for the procedure.

And while it may come naturally to a doctor to mimic the motion she wants her patient to perform, both Grunebaum and Provencher shared a laugh: Neither of them could actually squinch.

Top five minimally invasive cosmetic procedures for men:

▪  Botox: 411,913

▪ Laser hair removal: 191,816

▪ Microdermabrasion: 157,285

▪  Chemical peel: 98,629

▪  Soft tissue fillers: 92,949.

Source: 2014, Plastic Surgery Statistics Report from the American Society of Plastic Surgeons

Top five cosmetic surgical procedures for men in 2014:

▪ Nose reshaping: 54,680

▪ Eyelid surgery: 29,402

▪ Breast reduction: 26,175

▪ Liposcution: 24,327

▪ Facelift: 11,851

Source: 2014, Plastic Surgery Statistics Report from the American Society of Plastic Surgeons