Facelift for Men

Facelift surgery can be successfully performed in men who are seeking facial refreshment. The aim is to reposition loose tissue, restore facial volume and improve on jawline definition and neck contours. Respecting the gender-specific anatomy and the more discreet aesthetic changes required, will ensure a well-balanced masculine rejuvenation.

The male face has a number of gender-specific anatomical characteristics which must be taken into consideration when selecting the appropriate surgical strategy. These include: (1) a distinct craniofacial architecture (large jaws, square lower face and a strong malar-midface), (2) prominent facial muscle mass, (3) flat and angular cheeks with little subcutaneous fat, (4) low positioned brows, (5) thick, dense and heavy skin with a rich composition of hair follicles, blood vessels and seborrhoeic glands.

The physiological process of facial ageing is also more gradual in men and occurs later in life, as compared to women who often experience an acceleration around the time of menopause.

Changes in the facial skeleton (bone reabsorption), appear particularly in the orbital, maxillary and mandibular areas. This corresponds with the common aesthetic concerns relating to a softer jawline definition and progressive hollowness under the eyes. The age-related soft-tissue changes in men include gravitational descent (ptosis), loss of facial volume (atrophy) and accumulation of fat in the neck (fat hypertrophy). These events are usually associated with an undesirable heaviness and skin laxity in the lower face and neck. In addition, the upper portion of the face may experience simultaneous hollowness in the temporal, infraorbital and upper mid-face regions.

Male facial rejuvenation

The male face requires a surgical approach which is both conservative and also emphasises the natural masculine features. Techniques used are different from those of the female facelift, as the importance is placed on preserving the angularity of the craniofacial architecture, whilst at the same time restoring soft-tissue contours.

Special considerations for the man undergoing facial rejuvenation

1. Incision placement

Shorter hair styles generally offer less possibility for scar camouflage. For this reason hair-preserving incisions parallel to hair shafts and scar-minimisation techniques are important components of a male facelift. For men with naturally good neck contours and little skin laxity, a 'short-scar' type of facelift will offer the advantage that no scarring will be evident along the retroauricular hairline (behind the ears).

The distribution of facial hair follicles (beard and sideburns) will generally determine whether the incision will follow the natural skin lines in front of the ear (pre-tragal incision), or inside the ear (tragal incision). Both are discreet. The pre-tragal incision is the traditional solution, as no hair-bearing skin is transposed inside the ear. However, It is also possible to remove unwanted hair follicles during surgery (or postoperatively using a laser), thus allowing a tragal incision to be used for men who will benefit from this approach. Dr Sorensen will advise during consultation.

2. SMAS modification

The tendency for gravitational descent of soft-tissue and the associated heaviness in the lower face and neck, makes modification of the SMAS layer an essential component of the male facelift. This surgical manoeuvre provides the best possible tissue repositioning, without skin tension and determines the degree to which facial contours are restored.

Although there are several approaches to modifying the SMAS layer, the two techniques listed below, are in Dr Sorensen's opinion the most successful in rejuvenating the male face:

●  Lateral SMASectomy: particularly effective in improving the neck and lower facial contours in men. This technique complements the shape of the craniofacial architecture, thereby enhancing natural masculine projection and angularity.

●  High SMAS facelift: indicated when age-related soft-tissue changes are present uniformly throughout the face. It is the treatment of choice for men with sunken midfacial contours, prominent nasolabial folds and hollowness under the eyes.

Both procedures can be combined with additional modification of soft-tissues in the neck if further contouring to this area is required. This includes fat removal (lipectomy), muscle tightening (platysmaplasty) and skin adjustment.

3. Restoration of facial volume

Significant changes in the thickness of the male facial tissue occurs in the fourth and fifth decades of life. For this reason, a conservative volume restoration should always be included as part of the facelift procedure.

Men usually experience pronounced soft-tissue atrophy in the infraorbital region. The resulting hollowness under the eyes, in conjunction with herniation of fat from within the orbit (eye bags) and loose eyelid skin, magnifies the appearance of facial ageing.

Fat transfer treatment will replenish the lost volume throughout the face, including the infraorbital area and upper mid-face. It complements the SMAS facelift procedure, as it provides structural support to soft tissues, counteracts gravitational descent and improves overall skin quality.

The grafted fat may also be used to subtly augment certain areas of the face which will benefit from more definition and projection. This typically relates to the chin, jawline, mandibular angle and cheek bones.

4. Complementary procedures

The status of the eyes should always be considered when planning a facial rejuvenation. Men are naturally prone to loose skin and fat herniation on both upper and lower eyelids. Restoration of eyelid tissue using a tissue-sparing upper blepharoplasty and transconjunctival blepharoplasty, will provide a significant refreshment with relatively little surgery.

A defined jawline is considered an important masculine feature by many men. Although a facelift will improve on jawline definition, it will not add projection to a receding chin or compensate for age-related bone reabsorption. A subtle chin augmentation can be achieved with fat grafting alone (usually 2-3mm), whilst a chin implant will offer a more prominent and square projection (usually 5-10mm).

Individualised surgery

A facelift is the only procedure which can effectively restore a more youthful contour of the male face and neck, redefine the jawline and correct loose skin. During consultation, Dr Sorensen will examine the facial tissue, measure facial proportions and discuss individual requirements and goals, in order to formulate an effective treatment plan.

A collaboration with our skin specialist/aesthetic team may also be recommended to correct sun-damaged skin and optimise skin health.

Postoperative recovery is usually faster in men than it is for women, due to their thicker skin and increased vascularity and which promotes good healing. Most men return to work after two weeks and sports activities after six weeks.