Making Over Middle-Aged Men

When he was young, Steven Goldgram thought plastic surgery was a uniquely female pursuit. "I remember going to high school and girls were getting nose jobs all the time," says the 57-year-old interior designer. "But guys didn't get their noses done back then."

In fact, most men didn't get any type of cosmetic procedure done "back then"--or, if they did, they sure didn't talk about it. But that's changing now, thanks in part to baby boomers like Goldgram who are increasingly turning to surgeons to lift faces, tuck tummies, and, yes, even nip noses, as they settle into middle age. In 2006, nose reshaping, liposuction and eyelid and face-lifts were all among the top 10 cosmetic surgery procedures for men.

"A lot of baby boomer men are at the age now when changes are more significant, and there's a greater acceptance of plastic surgery," says Dr. Michael McGuire, a vice president at the American Society of Plastic Surgeons (ASPS), who has seen the percentage of male patients in his practice in Santa Monica, Calif., double to nearly 20 percent in the last few years. "People start telling them they look tired, and what they are really saying, of course, is, 'You're looking old'."

That's what prompted Goldgram to rethink his stance on surgery. Earlier this year, he noticed in photos that the lower half of his face was starting to droop. "I'm pretty energetic, and pretty young inside," he says, "but I didn't feel that looking at myself." Goldgram, who lives in Saratoga Springs, N.Y., ended up getting a lower face-lift and, yes, a nose job, too. "I can't deny that I'm a little vain," he says "I just wanted to look better."

He has plenty of company. In 2006, men underwent more than 1.1 million surgical and nonsurgical procedures (women accounted for nearly 9.9 million--or 90 percent). Though that is slightly less than in 2005, it's an 8 percent increase from 2000. And there are early indications that men made up an even larger percentage of procedures last year. Surgeons interviewed for this article say they've experienced a notable jump in the number of male patients over the past year, especially among baby boomers (the oldest of whom are now in their 60s). A recent survey of ASPS members in southern California found that men made up 20 percent of the market for that area in 2007. (National figures for the year won't be released until late next month.)

Dr. Foad Nahai, president of the American Society for Aesthetic Plastic Surgery (ASAPS), says he's seen a similar increase at his practice in Atlanta: men made up between 15 and 20 percent of the patients he saw in 2007. "It's just in the last year that we've really seen that change," says Nahai, who attributes much of the growth to aging boomers and the acceptance and array of nonsurgical wrinkle remedies. "Even four years ago, I could recite the names of every man who came in for Botox. Not anymore."

Botox remains the most popular nonsurgical procedure for both men and women. But the ASPS and the ASAPS also report large increases in the number of men getting microdermabrasion treatments, as well as Restylane, Radiance and other wrinkle fillers over the past few years. The number of microdermabrasion procedures performed on men more than doubled between 2000 and 2006, when more than one in five patients was male. Wrinkle fillers were introduced more recently, but surgeons report that the number of treatments given to men increased by more than 66 percent between 2005 and 2006. Many who start with those end up getting surgery eventually, according to surgeons. Ron, a 64-year-old business executive at a food manufacturing company in Los Angeles, had a laser peel in April. Then he decided to have eyelid surgery and a neck lift. Now, he plans to kick off 2008 with a face-lift. "I didn't think I'd do this when I was younger," he says. "But I'm more mature now, and I want to feel better about myself." (Ron didn't want his last name publicized; so it seems there's still some stigma for men who get plastic surgery.)

Wrinkles used to make a man more "distinguished," while a little extra weight around the middle seemed a rite of passage for married middle-aged men and a sign of a well-fed husband. Not so in today's youth-oriented, age-defying society. "Men are now feeling the pressure that women were feeling before," says Nahai. "They think, `Unless I look young, I won't be able to compete in the marketplace'."

That was the case for Alan Horowitz, a 59-year-old residential realtor from Morristown, N.J., who considered his $20,000 mini-face-lift an investment. "When you feel good about the way you look, it changes your whole personality, your whole outlook on life, and how people perceive you," he says. "You have two minutes to connect with a client. You want to look as sharp and good as you can."

Whether that requires a cosmetic procedure is debatable: though the number of male patients has risen, only a small percentage of all adult American men went under the knife or needle in 2006. Still, as baby boomers age, there's a good chance there will be many more men like Goldgram and Horowitz who decide cosmetic procedures are no longer just an option for the fairer sex.