The face of plastic surgery is more masculine than it has ever been before. Plastic surgery has long been perceived as the woman's domain, but more men are taking advantage of better technology and changing attitudes and reaching for a new image created by a surgeon's scalpel.
Some local plastic surgeons say the number of their male patients has doubled in the past five years.
While women may choose plastic surgery because of societal pressures, men are looking to boost their status in the workplace.
In general, plastic surgeons say their male patients believe a more youthful and energetic appearance is career-enhancing. A drooping face, with sagging eyes and brows can give the appearance of being tired.
During a recent post-operative visit, one man told Dr. Leo McCafferty, a plastic surgeon associated with Mercy Hospital and other hospitals: "I feel like you've given me an additional 10 years [in the workforce]."
"I don't know whether that's true or not, but that's the perception," McCafferty said.
"A middle-aged professional wants to stay youthful because he perceives himself to be competitive in the work environment if he seems more youthful," said Dr. Guy M. Stofman, chief of plastic surgery at Mercy Hospital.
And this aesthetic goal is reflected by the procedures local surgeons say they most often perform.
Liposuction, particularly of the "love handles" area of the abdomen; rhinoplasty, or nose jobs; or eyelid surgery and male breast reduction top the list for local procedures.
Nationally, the No. 1 procedure on men is hair transplantation. In 1997, more than 50,000 men sought this procedure, making up 83 percent of all hair surgeries performed. The second most popular procedure was nose reshaping, followed by liposuction, according to the American Society for Aesthetic Plastic Surgery Inc.
Although hair transplants are popular across the country, it's hard to gauge their popularity locally.
McCafferty said the ongoing, expensive treatments often do not meet patients' expectations. Other surgeons said hair transplants are still popular here, but are performed by a diverse group of physicians, including dermatologists.
But the number of men in Pittsburgh seeking plastic surgery seems to be in sync with the rest of the nation. According to the plastic surgery society, men accounted for almost 14 percent of the procedures performed in 1997. Local plastic surgeons estimated that men make up between 10 and 15 percent of their practices.
"Men have not had the same social pressures as women to look their best at all times," said Dr. Dennis Hurwitz, director of UPMC Health System's Aesthetic Plastic Surgery Center.
Hurwitz also said that, historically, Pittsburgh's traditional image as a blue-collar laborer's town has made plastic surgery taboo - an attitude that is changing as plastic surgery becomes more common for people in all income brackets.
"There's been a disdain for concerns about appearance," he said.
The popularity of certain procedures for men varies by region. For example, pectoral and calf implants might be popular on the West Coast, which has a milder climate, but they aren't catching on here.
Some procedures also go hand-in-hand for men. For example, chin implants often go with nose jobs to create a more chiseled look by toning down a prominent nose and bringing out a recessed chin.
Stofman said he often performs liposuction or removes excess skin on men who have lost weight and want to finish off remaining fat exercising won't burn.
Male plastic surgery also presents a challenge to doctors who must avoid feminizing male features and work around concerns such as men who have less hair and don't use makeup to hide scars.
Advances in technique and technology, however, are solving these problems. Smaller incisions and endoscopic surgery mean less scarring and recovery time.
"This whole image in the'90s of living health is not only corresponding to living well, but also looking well." Stofman said. "The man of the'90s is starting to appreciate that."