January 21, 2025 • 37 mins
While men may not call it “beauty,” they’re still focused on their appearance and the image they project. Many want to recapture how they looked when they had more time for the gym or before genetics started making changes.
New York plastic surgeon Dr. Douglas Steinbrech, a specialist in male plastic surgery, joins Dr. Bass to discuss what procedures men want most, how their approach to plastic surgery differs from women’s, and why techniques must be tailored to male anatomy.
Dr. Steinbrech’s game-changing body banking technique uses your own fat, removing it from unwanted areas and adding it to areas that need volume. Unlike traditional lipo, body banking avoids visceral fat buildup and doesn’t require extreme diet changes to maintain results.
Find out:
-
Why tailored incisions that complement a man's natural face and neck contours are essential
-
How Dr. Steinbrech developed scarless abdominal sculpting
-
Why compression garments are crucial for recovery
-
How social media shapes men’s self-image
About Dr. Douglas Steinbrech
Dr. Douglas Steinbrech specializes in minimally invasive aesthetics, blending this approach into both surgical and non-surgical techniques. Named one of America’s Top Plastic Surgeons by the Consumers’ Research Council of America, he’s known as the go-to surgeon for men. Using advanced techniques tailored to the male body, a large portion of Dr. Steinbrech’s practice is dedicated to enhancing natural masculine features.
Learn more about New York plastic surgeon Dr. Douglas Steinbrech
Follow Dr. Steinbrech on Instagram @drsteinbrech
About Dr. Lawrence Bass
Innovator. Industry veteran. In-demand Park Avenue board certified plastic surgeon, Dr. Lawrence Bass is a true master of his craft, not only in the OR but as an industry pioneer in the development and evaluation of new aesthetic technologies. With locations in both Manhattan (on Park Avenue between 62nd and 63rd Streets) and in Great Neck, Long Island, Dr. Bass has earned his reputation as the plastic surgeon for the most discerning patients in NYC and beyond.
To learn more, visit the Bass Plastic Surgery website or follow the team on Instagram @drbassnyc
Subscribe to the Park Avenue Plastic Surgery Class newsletter to be notified of new episodes & receive exclusive invitations, offers, and information from Dr. Bass.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:01):
Welcome to Park AvenuePlastic Surgery Class,
the podcast where we explore controversiesand breaking issues in plastic
surgery. I'm your co-host, Summer Hardy,
a clinical assistant at BassPlastic Surgery in New York City.
I'm excited to be here with Dr. LawrenceBass, Park Avenue plastic surgeon,
educator and technology innovator.
The title of today's episodeis Male Plastic Surgery.
(00:24):
We know women love to thinkabout beauty, but what about men?
Are they part of the explosionin plastic surgery as well?
To bottom line it? Theanswer is definitely yes.
Both the numbers of procedures andthe percentage of procedures in
men is growing, but it's stilla small minority of the total,
(00:45):
according to The AestheticSociety statistics as well as those from the American
Society of Plastic Surgeons,
the percentage was aroundfive to 6% in 2022.
That's the last year for whichstatistics are available.
Still, this small number reallyunderstates the importance of
(01:06):
appearance to men.
Men don't think about personalbeauty exactly the same way as women,
but they are still very concerned withtheir and the image they project to
others. Appearance is a huge part of that.
That makes sense. So what canyou tell me about this Dr. Bass?
(01:27):
Well, let me turn to ourguest to discuss this issue.
Today we have with usDr. Douglas Steinbrech.
He's a board certified plastic surgeonwho trained at the Institute of
Reconstructive Plastic Surgeryat NYU where I trained.
And he is really amaster of body contouring
(01:49):
and minimally evasiveapproaches in plastic surgery.
He's been especially active indefining plastic surgery for men,
including editing the seminaltextbook on the subject entitled
Male Aesthetic Plastic Surgery.
He was gracious enough to ask me towrite a chapter in that textbook on cheek
(02:10):
augmentation. Dr. Steinbrech, welcome.
Thank you. It's a pleasure tobe here. Thanks for having me.
I think it's a great topic.Topic I'm a big fan of.
Welcome Dr. Steinbrech. Solet's get right into it.
What are the aesthetic issuesthat men pursue most often?
Yeah, it's really a variety of things,
but what I see a lot is with aging,it's a couple of things for face,
(02:37):
the men are concerned withtheir neck and really the
jawline or the jaws and the point of,
as Dr. Bass said, the point of wherethe cheek is when it comes to body,
they're more concerned about being fit.
We're currently in a wave wherewe're inundated with Instagram
(02:58):
and media and everyone's watchingeveryone and everyone's actually putting
everything that they have onthe internet or on their phone.
And so people are seeing a lotmore, they're comparing a lot more.
They're seeing a lot more skin.
So this has sort of shiftedpeople's interest in fitness and an
interest in looking good.So from a body perspective,
(03:22):
a lot of men are coming inasking for improved body
contour.
They're interested in more dramatic
fit appearance, and particularlyin those areas that are stubborn,
everybody's going back to the gym,
but the areas that thegym can't quite cover,
(03:42):
that's where we come in.
And then the other thing that we couldtalk about later is how much massive
weight loss and evenmoderately weight loss with
GLP-1 copy cats
or Ozempic and these sortof weight loss drugs,
how much that's really shifting thelandscape in terms of body contouring
(04:05):
for men.
Okay, that's really interesting. Youtouched on this a bit in that answer,
but separate from what men areactually looking to address,
are there differences in how most menapproach or think about plastic surgery
compared to most women?
Yeah, I think men, they're interested in,
like I said before,
(04:25):
they're interested in looking like theyused to look when they had more time
to invest at the gym andbefore there were changes
with their genetics. Andthat's what we see a lot.
We see a lot that men want to be backwhere they were when they were in
their twenties before thetestosterone change went down a little
(04:49):
bit and before work andfamily responsibilities
really came into play. The otherthing is about how men and women,
and when I say any of thesethings I try not to generalize,
and I'm definitelytrying not to be sexist,
I just find that people havedifferent approaches and a lot of
(05:10):
times men tend to not want to chaperone.
They tend to want to dothe research, look online,
see who looks like theyspecialize in this area,
and sort of like they know that theyknow that they've done well this year and
they know that they want to go out andif they do really well at work that
(05:33):
they're going to get themselvesthat BMW or the Mercedes. They walk
into the Mercedes shop knowingthat this is what they want.
And so instead of shopping around toa bunch of different car lots, they
know where they want to be.
So they've already done the researchwhen they've come to me and instead of
(05:55):
asking a lot of questions and comparingwhat I say to another doctor and going
up and down Park Avenue,
they usually feel like they've done theirresearch and they treat me more like a
consultant. They hire me for my expertise,
for my ideas of what I have. Theylisten to what I have to say,
and then they
(06:17):
usually allow me to execute theirplan. So from that standpoint,
I really enjoy working with men because,and a lot of women are this way too.
Again, I don't want to generalizeit, I don't want to be sexist,
but I just find a lotof men when they come,
they've already made their decision.
It's just where they want to know whatis the best way and they seek my advice
(06:39):
as an advisor. As a consultant.
Got it. Okay.
So if we look at procedures thatmen are specifically focused on,
what are some of the differences in howthose procedures need to be performed?
Yeah, so well,
one of the things isfor women, we see a lot.
I always say women areinterested in four bumps,
(07:02):
which means two bumps in front and twobumps in the back in general, again,
this is in general wejust want to have fun,
but men are interested ina lot of different bunks. So it could be a six pack,
an eight pack delts, anteriorlateral, posterior delts traps,
chest biceps, calves, triceps.So all of these areas,
(07:23):
and we accomplished those ina couple of different ways.
One is using your own,I call it body banking.
It's using your owncells, your own fat cells,
taking them out of the bad areas andthen moving them into good areas.
So that's what we call body banking.
It's taking all those cellsand transplanting it into a good aesthetic area.
So by subtraction and thenaddition, we can completely,
(07:46):
like a artist uses clayto create a more artistic
or athletic result.I could do the same thing with my clay,
which is a patient's owncells, their own fat cells.
So we find it does a couple ofdifferent things, first of all,
it gives them a better artistic result.
Then just throwing the fatand putting it in a bucket,
(08:09):
I think that's a complete waste of time.
You wouldn't imagine a clay sculptor just
removing the clay and throwingit away. That's complete waste.
He takes some and then he adds itto other areas. So that's what I do.
But then the second thing about itis we're just starting to understand
(08:29):
a couple of the rulesor the dynamics of fact
grafting or lipo celltransfer and what it means.
So I've kind of studied thisand I've looked at this,
and what we find is that if patientsjust have liposuction and they throw away
the fat,
that they can get what we callrebound fat. So that's fat
(08:52):
showing up in otherundesirable for our locations.
So let's say if you have a dudethat comes in and you do lipo,
I used to do this all the time.I used to do all the liposuction,
really make his abs look great,really make his flanks look great,
throw the throw away the fat,
and then they would come back and ifthey didn't increase the caloric burn
(09:14):
or decrease the caloric intake,
they're still getting excesscorid excess calories and they're
developing, they're feeding thosefat cells. Well, guess what,
if I didn't bank any fatcells on the outside,
then then it's going to come back.If I threw it all in the bucket,
the only fat cells left over arevisceral fat cells. That's belly fat,
(09:36):
fat inside behind yourabdominal wall. I see it.
So when they come back nine monthslater, after they're all healed,
they come back nine monthspregnant. Now that we get smarter,
now that we bank things, Ibank things in your shoulders,
trots chest into the glutes, intothe calves, wherever we put it,
they can relax with their diet. Maybethey can have bread with dinner,
(10:01):
right? Can you imagine or evenhave dessert? You don't have to
live a life without pleasure. And nowwhen they do it, the doctor sent to do it,
they get more upper volumecleavage or upper chests volume,
their traps pop and their shoulderswiden. So this is what our patients find,
and they're really, really not only happyabout their abs, improving their abs,
(10:24):
but now they have all this great volumeand other desired errors and they look
great at the beach, at the pool,
but they also look greatplaying golf with a pull-on.
And as you get older,
mother nature plays a couple oftricks on you. She turns down for men,
she turns down the testosterone, she turnsup the estrogen. So as she does this,
as you move into your forties, fifties,sixties, seventies, and as this happens,
(10:46):
instead of all those fat cells gettinglarger around your belly or inside your
belly, if you had liposuction,what happens is it increases in size relatively.
There is the got banked,the desires that we put in.
So I always tell my patients to writeme a thank you note in 25 years if I'm
still around.
But we immediately had peoplea year or two that are really,
(11:10):
really pleased. And so that'sthe other advantage of it.
I think that's a really important point.
Liposuction started as thistreatment for people back 40,
50 years ago who were idealbody weight with very focal
areas of extra fat.
And if you do liposuctionon someone like that,
(11:31):
a 25-year-old with a teeny bit of fat inthe love handle area or something like
that, that's great,
but we've really,
really broadened the applicationto people who are older,
people who are not obese. It'snot a treatment for obesity,
but for people who are overweight,which is almost all of us Americans.
(11:54):
And when you're treating that population,
the fate of the body when you takethe fat away becomes different
as Dr. Steinbrech described,
because that visceral fat ismore metabolically active,
it's bad fat,
and if you're in a weight gaining stage of
(12:16):
life, unless you radicallyalter your lifestyle,
then liposuctioning out subcutaneous fat,
which is not as metabolicallyactive and consequential in a bad
way for you,
is more likely to get you in trouble where
taking that fat and putting itsomeplace where you need it is
(12:41):
protective and aesthetically useful.So it's a win-win, isn't it, Doug?
Absolutely.
And just for the women out there thatare listening and not believing this
before we did BBLs or now we say glutealaugmentation or a buttock augmentation
but we say Brazilian buttlifts. Before we did that,
Dr. Bass and I used to just do liposuctionon women and then we do a tummy
(13:06):
tuck and I would do my verybest to suck out all the fat,
but we threw it in the bucket.We didn't know any better.
We never put in theglutes or anybody cells.
What happen is the patientsreally wouldn't be great about going to the gym and
wouldn't be really great aboutdecreasing their post caloric
intake. And so they would get thisrebound fiber, what I call catch fat,
(13:28):
compensatory atrophiccellular hypertrophy,
which just means cells in otherareas compensator enlarge,
unless you do change how much you takein or how much you put out. But what
would happen is six months later,
I would have these women come in andthey would look like a truck because
what I took out, we didn't bank anywhereelse. I didn't put in the glutes.
(13:52):
We didn't really do BBLs then, we justthrew all the fat away. And they would
come back looking
like Spongebob Squarepants and they wouldhave a lot of visceral fat almost like
they were pregnant.
You'd have an unhappy patientand an unhappy puffing.
But now to illustrate the point,
(14:13):
everyone sucks it out and they put evenmaybe less than a couple of years ago,
but puts something somewhere else.
And usually it's in the buttock forwomen and now they come back six months.
"You're a genius doctor. You're agenius." The husband is in love with you.
The patients are in love with youbecause guess what? They went home.
They did not change how much they ate.They did not change how much they burn,
(14:34):
but instead of comingback as visceral fat,
it came back in their backsideand the husbands otherwise were
in love with you. So that justfurther illustrates the point.
This is a really interesting discussion.I hadn't thought of any of this before.
Is this just a differentaesthetic endpoint then,
or are the actual techniques different?
(14:56):
The techniques are different as well.
And also the philosophy is differentand the postoperative care is
different. And I'll tellyou why. Postoperatively.
Well, also preoperatively,
I put people on a slightly elevatedcarbohydrate diet so that their
cells are a little bit larger so thatmore of them survive the transfer
(15:18):
postoperatively. And then postoperatively,
we keep them on a high carb diet and ahigh protein diet for really high carb
diet for 28 days to make sure all thoseless cells that we put in their new
location actually survive.
Because we really don't want someone tobe in starvation mode because your body
prioritizes the most important thing.
What's going to be the mostimportant thing to heal up,
(15:40):
not to keep any exogenousfat cells or transplant.
It's really not your body's priority.
Your priority is heal up the surgery thatjust got done. So we want to give them
extra carbs to keep everything there.And that's really sort of a change.
A lot of times surgeons don'tstress or emphasize or higher
(16:00):
carbohydrates postoperatively, and it'ssaying to get to patients to do it,
they came to haveliposuction to get lighter,
to really tell peoplethat you need to do this,
that that's something that you haveto massage with patients as well.
And the other thing about whatI do is a lot of postoperative
(16:21):
molding. We use a lotmore foam with procedures
and we spend extra timereally talking about
compression wear to make sureeverything heals as easily as possible,
as polished as possible,but also to make sure that
the transition zones from what we'vesubtracted to what we've added,
(16:43):
our nice and smooth, our aesthetic, ourmixed sense, and our natural appearing.
So then where thetechniques are different,
does that mean that theinstruments are different as well?
Yeah. Well,
one thing that I have and I'vedeveloped is a scar abdominal healing.
And you may see summerwhen you go to the beach
(17:04):
or the pool,
you may see some guys that have hadabdominal sculpting or abdominal etching
and their abs, their stomachlooks like a tic-tac toe board,
and they have six different incisionsright on the skin, right visible,
God forbid if they were alittle bit darker complected,
maybe we call it Fitzpatrick scale andit's scaled from lightness to darkness.
(17:28):
But if it might be a patientthat may be a patient of color
or a patient of a thicker dermis,
one of these guys that may be Latinoor black can have problems with
hypertrophic scarring or keloids.Those are those bad scars.
So if you are giving them a scar that'sright on their abdomen and it scars
poorly, sometimes they look ritualistic,
(17:52):
they're going to have scars thatobviously show that they've had abdominal
sculpt.So I tell everyone that we need to have,
and I have curved cannulasso that I can hit all the
points from two small incisions underneathyour swimsuit or through the belly
button or a little nick throughthe nipple that nobody ever sees.
So I can hit all those siteswithout any scars on your abdomen.
(18:14):
So we developed this in 2017,
it's called scarless abdominal
sculpting, and I alwaystell the residents,
and I tell when I'm speaking,
I have to speak in Cartagenanext down in Columbia,
and then we're going Greece and thenAustralia. So when I talk to people,
(18:36):
I had these conferences,
I always tell patients I've never hadto apologize for an incision that I did
not make. Right. If you don't makethe incision, you don't need to do it.
And frequently I'm at a conference andI'll talk about this and I'll sort of
beat on people about this,stop making these incisions.
(18:57):
We have the tools of thetechnologist not to have that.
And then the next doctor that gets upand gives his abdominal sculpting talk
showed make sure there's incisions Ijust told everyone in the audience not to
make. So it's kind of tricky.
Yeah, I think that's a lessonfrom the whole field of minimally
invasive surgery andplastic surgery as well,
(19:19):
that the smaller the incision is,the further away the incision is,
the more it becomes critical tohave exactly the right instrument
that empowers you todo what you need to do.
And if you try to do it withjust a conventional instrument,
you try to struggle, you'renot in the right position,
the instrument's not configured properly.
(19:42):
So that contribution thatyou made of developing
instrumentation that enablesthis whole process was really
one of the tremendous steps up foraccomplishing this in a way that keeps the
entire abdominal area lookinggreat instead of a jigsaw
puzzle of a bunch of littleincisions, as you're saying.
(20:03):
And I've always tried to tilttowards the absolute minimum of
liposuction incisions offat grafting incisions,
and there are some surgeons that gowith very short cannulas and make
many incisions every four inches or so.
And I've just never understood thatapproach. So I think you're right on.
(20:25):
Yeah, frankly, that's one of the problemswith a lot of these new technologies.
The companies are moreinterested in making money,
so they make all the probes very short,
so they can't use the body in prob forthe neck group or anything like that.
And by making them short, inherentlypeople just have to make more incisions,
which means more scars.The patient, unfortunately,
(20:49):
I dare say that for thecompany sometimes the
priority isn't the patientor the patient's scars.
The priority is how many of these thingscan they sell sometimes, unfortunately.
Yeah. I mean that's the thing.
We often use a few differentliposuction cannulas in terms of what
the apertures look like,
(21:10):
the holes that actually shear offthe fat or in terms of the curve
of the cannula or the lengthof the cannula or the diameter.
And as soon as you go toan energy based technology,
either applicator or cannula,
you can't really buy more than onefor a case, which means by definition,
(21:32):
you're using one disposablecannula rather than
your, I mean,
I've had a lot of cannulas for 20 yearsand we just put them in the sterilizer.
They're steel, they getcooked, they're sterile,
and we use them and use them and use them.
But I can pull on that familyof cannulas for whatever exactly
(21:53):
I need in that instant toget the shaping I want,
which you lose when youtransition to a single cannula
approach. Right. That's an interestingpoint. I didn't think of that.
So I'd like to kind of focusin a different direction
from body,
(22:14):
and you mentioned that neck and jawlineare one of the big things for men
because it does give them a worn,
tired outlook and nobodywants to look that way,
especially if you don't feel that way.But this is also a procedure of course,
that women do commonly.
How do you approach faceliftor neck lifting for men?
(22:37):
How are your incisions different?
How is it different what you're doingunderneath with your connective tissue
layers? What's yourthought process for this?
Sure. Well, men are a littlebit different than women.
And neither for men or women do.
I like to do the old fashionedsurgeons really in the
(22:58):
sixties, seventies, and eighties,
which was kind of wait until everythingfalls apart and then they get these Park
Avenue matriarchs and they puttheir foot up on the table and pull
as much as they can. So thatpatient is very wind swept.
So a couple of things that we dofor the men is men would rather
have A, not look feminizedand B, not look overdone
(23:22):
or look like they did have surgery.So for the men, they'd rather,
and this is one thing I remember,
I had this lady from Texas whenI started out my practice, "doc,
I want to be pulled so tightthat I only have one line and I
want to be sitting on it." AndI just thought it, first of all,
it was very clever, but mendon't want that. And for men,
(23:46):
what we want is I always talkabout something that looks,
some lines are character and there'snothing that looks more artificial for me
than to see a man that doesn't have onesingle wrinkle, one single anything.
I think that a few lineshere or there are sexy.
We just don't want to lookold or older than our age.
(24:08):
So number one priority for men rather,
they'd rather have less done.And I always tell my patients,
I get in the same sig with them,
you come to me because you want to staylooking masculine and you don't want to
look like you had surgery and want tolook like you don't look like an alien or
a woman. So for my guys,
I know I say if there's anythingthat you're going to be displeased,
(24:30):
it's because there's a little, youwanted this to be completely gone.
I never say gone. In my practice,
I always say improve after I speak with'em and they realize that they don't
want to look overdone or over pulled,God forbid. They do understand that,
and it's about setting those expectationsthat makes 'em happy. In terms of
technical differences for the women,what we do is we take their skin,
(24:51):
we put it all the way behind the dragus,behind and into the ear. For the men,
I don't do that becausethey have hair bearing.
They have that beard or bring it rightup to that little line that everyone has.
We call pretragal that ithas in front of the ears.
But what I do is I do something different.What I do is I make sure I see some,
and in fact, I went to a laser show,
(25:12):
I don't want to get too specificbecause it's going to reveal the person,
but really fantastic lasers vicepresident could have gone to
anyone that he wanted to,
but I could see when he had his faceliftwith incision, went straight down,
it was about a half inch in front of theear and then came back dead giveaway of
someone who's had surgery,
is a poor match.There was a straight line. What I do,
(25:36):
what I do is different is I make sure Igo around each and individual and most
good plastic surgeons do this,
but I still do see some guys when I goout to South Anthem and go to dinner and
I see the guy at the club that hasan incision that came straight down.
So we always blended in with thenatural structures of the ear.
When my mother was putting togetherwallpaper in the dining room,
(25:59):
her floral wallpaper,
she would painstakingly cutaround every fruit and every
flower so that there were no seams inthat wallpaper. And I did the same thing.
So you don't see it in men. Theother thing with men for the neck,
we start with injectables.
So we can go a long way witheven removal of fat with
(26:21):
Kybella, and that's just an injectable.Or I can do liposuction
with neck fat, which is radial frequency.
Next step up from that is we make anincision and bring the platysma muscles
together, with a platysmaplasty,
redrape the skin along with removeof fat and tightening of the skin.
Next step of that is short scar neck lift.
(26:45):
It just comes around the earand that improves the neck,
but won't take care of the jawline.
If we really want to take care ofthe jawline from a non-invasive
way or an injectable way, I can dowhat I call my male model makeover,
which is more into the cheekbone, more along the jawline.
Have a special way that I do it to makesure that you don't look like a mobster
(27:06):
with which you've seen several people dobecause they're injecting in the wrong
place,
but I inject it a certain wayso they have a more stronger,
more defined jawline.And then when it comes to surgery,
if we want to improve thejawline in the cheekbone,
a little bit of the nasal labelfold is do a full neck and phase
(27:28):
for the gall. So that's prettymuch the entire realm. Oh,
one more thing is what I sortof call is the Clint Eastwood
neck work, which is somebody that says,
we have a lot of guys that comein in their sixties, seventies,
maybe even eighties, who say, "doc,just get rid of the Turkey neck.
(27:48):
Get rid of the Turkey neck." And forthose people, I can do it under local.
We can remove the skin directly.
But the reason why I say Clint Eastwoodis because it's got to be a certain
patient that says weathered skin,
a lot of natural sun aging,
a lot of creases,
crevices and crags so thatwhen you do directly size
(28:12):
that the resulting scarcan hide quite well
under that weathered skin.
But it's really not something that wedo and a younger person or a person that
doesn't have a lot ofskin damage, that's it.
Yeah. So there's thisbig range of options,
and I think those are allreally important points. I mean,
one thing about face and neckoperations is they're not just
(28:37):
loose skin operations,they're shaping operations.
And so by definition,
a male face shape is differentfrom a female face shape,
and it's really,
really important to reinforce themaleness of the shape in a man
and not feminize the face or the eyelids.
(28:57):
And I see that all the time from peoplewho just have one approach and one
approach isn't even good for one gender.
You obviously have to customizeyour approach based on what's
going on in that individualpatient stage of aging.
But it's really important to do that withthe goal of reinforcing a male facial
(29:18):
shape.
And that incision location andtailoring in is just part of that
good plastic surgery training thatwe got at NYU and Summer watched me
making that kind of incisionlast week on a very nice
77-year-old gentleman whostill works full time. And
that kind of incision worksbetter than trying to pull that
(29:42):
thickened weathered cheekskin over the tragus,
the little button in front of theear that's going to look poorly
matched and not hiding theincision right in the crease in
front because you're worried aboutthe hair bearing and non hair bearing
areas of the face, likewise isgoing to leave you with a giveaway,
(30:04):
which is essentially avoidable.
So these technical details really makea critical difference in preserving
a natural look, which isalways the goal for men.
I think you said a mouthful when yousaid that because that is a hundred
percent what the job is about.
(30:25):
If a man comes out lookingnatural, younger, fresh, or rested,
then it's a success.
And if you make any kind of alteration,
it's really a bad day.
Absolutely. Couldn't agree anymore.
The other thing I wouldtouch on is the support
(30:48):
and bony support,
and that's the other thing that we haveto think about because just like you
said, this is just not just looseskin surgery. If it was loose skin,
you would just bring it up.And the problem is men age.
I always tell my patientswhen they're in their teens,
one of the reasons why guys look sogreat in their early twenties is they
(31:12):
may stop growing when they're 18, 19, 20,
but the jawline continuesto grow until around your
27th birthday is it starts to
recede. So if you took the mandible,
the skull mandible froma 27-year-old and then
a 72-year-old, we're goingto flip the numbers there,
(31:35):
you're going to see a lot ofresorption of that bony area.
So if you bring up theskin and you've lost a
significant amount of your mandible,
the actual actual bonypush in the mandible,
you're not going to look right. You'regoing to look forrshortened and lack
projection, and you're goingto lose that masculinity,
(31:56):
and you're not going to look like youlooked in those pictures that you brought
from 20, 30, 40 years ago.
So one of the things thatwe do have to do is replace,
but what we need to dois we need to recreate
that extra fullness, and I can do that
(32:16):
during the neck lift or facelift.Usually after is better,
we reset the tissues afterthe reset and healed.
I go back in and I give that extravolume of that bone with injectables.
I can do it with fat or I cando it with hyaluronic acid,
which are injectables off the shelf.
And that not only makes a patienthave a more chisel, more masculine,
(32:39):
more defined jawline,
catches a light and throws a shadowthat gives that really straight,
strong masculine look.
But it also makes you look more like youlooked like when you were 27 years old
because we recreated your jawlineyou had when you were 27 years
old, so you look younger as well.
(33:00):
Wow. That was a lot of smalldetails that I hadn't considered,
but are clearly really important whenconsidering plastic surgery for men.
So as we prepare to wrap upthis episode, Dr. Steinbrech,
what takeaways do you wantto share with our listeners?
I think the key thing is when you'relooking for men's plastic surgery,
what you want to do is do yourresearch, right? You want to go to,
(33:21):
anybody can, a lot of people do,they buy the Google terms for male
plastic surgery, New York's bestmale plastic surgeon, or they'll say,
Phoenix best male plastic surgeon.But then when you go to the website,
it's nothing but orchids andbutterflies, right? And then really,
it's when you go to the gallery andyou're trying to find one man in their
(33:44):
gallery of their before and after photos,
and all you see are hundredsof breast augmentations,
and you're really not lookingfor a breast augmentation.
So it's to do your research.
And then the other thing is to alsomake sure that they're a member of,
they're board certifiedin plastic surgery.
And even higher than that,
(34:04):
a higher level is that they're amember of The Aesthetic Society.
So those I think arereally important things
when you're choosing your plasticsurgery for male plastic surgery.
And what are your takeaways, Dr. Bass?
Well, we've talked about some ofthese things before on the podcast,
but the way plastic surgeryprocedures are done, the parameters,
(34:27):
the measurements and metrics aredifferent for men and for women.
We've kind of scratched the surface heretalking about body banking and talking
about face and neck shape,
but for every procedure, it's goingto be different for men and women,
the aesthetic interests ofmen and women go head to toe,
(34:50):
but there are certain aesthetic issuesthat are more commonly of concern
based on gender.
We're limiting the discussion in thisepisode to individuals that identify in
one of these two simplebaskets of men or women.
But we must acknowledge,as Dr. Steinbrech did,
(35:10):
that there are individuals that don'tfit into one of these simple categories
based on how they identify orbased on their aesthetic goals.
So for that reason,
it's really important for patients intheir surgeons to discuss the aesthetic
goals and the aesthetic
sense of beauty ahead of timeto come closest to producing the
(35:33):
patient's vision of beauty in reality.
In summary,
men are definitely interested in plasticsurgery and increasingly interested.
The procedures have improvedto match men's needs,
and that's in part due to excellentinstruction in how to customize these
procedures for men from leadersin male plastic surgery like
(35:57):
Dr. Steinbrech,
there are a lot of subtle featuresand some very obvious features that
say male or female,
and it's critical to understandboth the big and little features and
build them into your plasticsurgery procedures if you want a
nuanced natural looking result.
(36:20):
So I'd like to thank Dr.Steinbrech for joining us today.
It's been a lot of fun to talkthrough this topic with you.
Absolutely. Thank you for havingme. I really, really enjoyed it.
Some great questions,
and I really hope that people goout there and explore it more.
Thank you, Dr. Steinbrech for sharingyour extensive expertise in this area.
(36:43):
Thank you for listening to the ParkAvenue Plastic Surgery Class podcast.
Follow us on Apple Podcasts,
write a review and sharethe show with your friends.
Be sure to join us next time to avoidmissing all the great content that is
coming your way. If you want tocontact us with comments or questions,
we'd love to hear from you,
send us an email atpodcast@drbass.net or DM us on
(37:05):
Instagram @drbassnyc.
Welcome to Park AvenuePlastic Surgery Class,
the podcast where we explore controversiesand breaking issues in plastic
surgery. I'm your co-host, Summer Hardy,
a clinical assistant at BassPlastic Surgery in New York City.
I'm excited to be here with Dr. LawrenceBass, Park Avenue plastic surgeon,
educator and technology innovator.
The title of today's episodeis Male Plastic Surgery.
(00:24):
We know women love to thinkabout beauty, but what about men?
Are they part of the explosionin plastic surgery as well?
To bottom line it? Theanswer is definitely yes.
Both the numbers of procedures andthe percentage of procedures in
men is growing, but it's stilla small minority of the total,
(00:45):
according to The AestheticSociety statistics as well as those from the American
Society of Plastic Surgeons,
the percentage was aroundfive to 6% in 2022.
That's the last year for whichstatistics are available.
Still, this small number reallyunderstates the importance of
(01:06):
appearance to men.
Men don't think about personalbeauty exactly the same way as women,
but they are still very concerned withtheir and the image they project to
others. Appearance is a huge part of that.
That makes sense. So what canyou tell me about this Dr. Bass?
(01:27):
Well, let me turn to ourguest to discuss this issue.
Today we have with usDr. Douglas Steinbrech.
He's a board certified plastic surgeonwho trained at the Institute of
Reconstructive Plastic Surgeryat NYU where I trained.
And he is really amaster of body contouring
(01:49):
and minimally evasiveapproaches in plastic surgery.
He's been especially active indefining plastic surgery for men,
including editing the seminaltextbook on the subject entitled
Male Aesthetic Plastic Surgery.
He was gracious enough to ask me towrite a chapter in that textbook on cheek
(02:10):
augmentation. Dr. Steinbrech, welcome.
Thank you. It's a pleasure tobe here. Thanks for having me.
I think it's a great topic.Topic I'm a big fan of.
Welcome Dr. Steinbrech. Solet's get right into it.
What are the aesthetic issuesthat men pursue most often?
Yeah, it's really a variety of things,
but what I see a lot is with aging,it's a couple of things for face,
(02:37):
the men are concerned withtheir neck and really the
jawline or the jaws and the point of,
as Dr. Bass said, the point of wherethe cheek is when it comes to body,
they're more concerned about being fit.
We're currently in a wave wherewe're inundated with Instagram
(02:58):
and media and everyone's watchingeveryone and everyone's actually putting
everything that they have onthe internet or on their phone.
And so people are seeing a lotmore, they're comparing a lot more.
They're seeing a lot more skin.
So this has sort of shiftedpeople's interest in fitness and an
interest in looking good.So from a body perspective,
(03:22):
a lot of men are coming inasking for improved body
contour.
They're interested in more dramatic
fit appearance, and particularlyin those areas that are stubborn,
everybody's going back to the gym,
but the areas that thegym can't quite cover,
(03:42):
that's where we come in.
And then the other thing that we couldtalk about later is how much massive
weight loss and evenmoderately weight loss with
GLP-1 copy cats
or Ozempic and these sortof weight loss drugs,
how much that's really shifting thelandscape in terms of body contouring
(04:05):
for men.
Okay, that's really interesting. Youtouched on this a bit in that answer,
but separate from what men areactually looking to address,
are there differences in how most menapproach or think about plastic surgery
compared to most women?
Yeah, I think men, they're interested in,
like I said before,
(04:25):
they're interested in looking like theyused to look when they had more time
to invest at the gym andbefore there were changes
with their genetics. Andthat's what we see a lot.
We see a lot that men want to be backwhere they were when they were in
their twenties before thetestosterone change went down a little
(04:49):
bit and before work andfamily responsibilities
really came into play. The otherthing is about how men and women,
and when I say any of thesethings I try not to generalize,
and I'm definitelytrying not to be sexist,
I just find that people havedifferent approaches and a lot of
(05:10):
times men tend to not want to chaperone.
They tend to want to dothe research, look online,
see who looks like theyspecialize in this area,
and sort of like they know that theyknow that they've done well this year and
they know that they want to go out andif they do really well at work that
(05:33):
they're going to get themselvesthat BMW or the Mercedes. They walk
into the Mercedes shop knowingthat this is what they want.
And so instead of shopping around toa bunch of different car lots, they
know where they want to be.
So they've already done the researchwhen they've come to me and instead of
(05:55):
asking a lot of questions and comparingwhat I say to another doctor and going
up and down Park Avenue,
they usually feel like they've done theirresearch and they treat me more like a
consultant. They hire me for my expertise,
for my ideas of what I have. Theylisten to what I have to say,
and then they
(06:17):
usually allow me to execute theirplan. So from that standpoint,
I really enjoy working with men because,and a lot of women are this way too.
Again, I don't want to generalizeit, I don't want to be sexist,
but I just find a lotof men when they come,
they've already made their decision.
It's just where they want to know whatis the best way and they seek my advice
(06:39):
as an advisor. As a consultant.
Got it. Okay.
So if we look at procedures thatmen are specifically focused on,
what are some of the differences in howthose procedures need to be performed?
Yeah, so well,
one of the things isfor women, we see a lot.
I always say women areinterested in four bumps,
(07:02):
which means two bumps in front and twobumps in the back in general, again,
this is in general wejust want to have fun,
but men are interested ina lot of different bunks. So it could be a six pack,
an eight pack delts, anteriorlateral, posterior delts traps,
chest biceps, calves, triceps.So all of these areas,
(07:23):
and we accomplished those ina couple of different ways.
One is using your own,I call it body banking.
It's using your owncells, your own fat cells,
taking them out of the bad areas andthen moving them into good areas.
So that's what we call body banking.
It's taking all those cellsand transplanting it into a good aesthetic area.
So by subtraction and thenaddition, we can completely,
(07:46):
like a artist uses clayto create a more artistic
or athletic result.I could do the same thing with my clay,
which is a patient's owncells, their own fat cells.
So we find it does a couple ofdifferent things, first of all,
it gives them a better artistic result.
Then just throwing the fatand putting it in a bucket,
(08:09):
I think that's a complete waste of time.
You wouldn't imagine a clay sculptor just
removing the clay and throwingit away. That's complete waste.
He takes some and then he adds itto other areas. So that's what I do.
But then the second thing about itis we're just starting to understand
(08:29):
a couple of the rulesor the dynamics of fact
grafting or lipo celltransfer and what it means.
So I've kind of studied thisand I've looked at this,
and what we find is that if patientsjust have liposuction and they throw away
the fat,
that they can get what we callrebound fat. So that's fat
(08:52):
showing up in otherundesirable for our locations.
So let's say if you have a dudethat comes in and you do lipo,
I used to do this all the time.I used to do all the liposuction,
really make his abs look great,really make his flanks look great,
throw the throw away the fat,
and then they would come back and ifthey didn't increase the caloric burn
(09:14):
or decrease the caloric intake,
they're still getting excesscorid excess calories and they're
developing, they're feeding thosefat cells. Well, guess what,
if I didn't bank any fatcells on the outside,
then then it's going to come back.If I threw it all in the bucket,
the only fat cells left over arevisceral fat cells. That's belly fat,
(09:36):
fat inside behind yourabdominal wall. I see it.
So when they come back nine monthslater, after they're all healed,
they come back nine monthspregnant. Now that we get smarter,
now that we bank things, Ibank things in your shoulders,
trots chest into the glutes, intothe calves, wherever we put it,
they can relax with their diet. Maybethey can have bread with dinner,
(10:01):
right? Can you imagine or evenhave dessert? You don't have to
live a life without pleasure. And nowwhen they do it, the doctor sent to do it,
they get more upper volumecleavage or upper chests volume,
their traps pop and their shoulderswiden. So this is what our patients find,
and they're really, really not only happyabout their abs, improving their abs,
(10:24):
but now they have all this great volumeand other desired errors and they look
great at the beach, at the pool,
but they also look greatplaying golf with a pull-on.
And as you get older,
mother nature plays a couple oftricks on you. She turns down for men,
she turns down the testosterone, she turnsup the estrogen. So as she does this,
as you move into your forties, fifties,sixties, seventies, and as this happens,
(10:46):
instead of all those fat cells gettinglarger around your belly or inside your
belly, if you had liposuction,what happens is it increases in size relatively.
There is the got banked,the desires that we put in.
So I always tell my patients to writeme a thank you note in 25 years if I'm
still around.
But we immediately had peoplea year or two that are really,
(11:10):
really pleased. And so that'sthe other advantage of it.
I think that's a really important point.
Liposuction started as thistreatment for people back 40,
50 years ago who were idealbody weight with very focal
areas of extra fat.
And if you do liposuctionon someone like that,
(11:31):
a 25-year-old with a teeny bit of fat inthe love handle area or something like
that, that's great,
but we've really,
really broadened the applicationto people who are older,
people who are not obese. It'snot a treatment for obesity,
but for people who are overweight,which is almost all of us Americans.
(11:54):
And when you're treating that population,
the fate of the body when you takethe fat away becomes different
as Dr. Steinbrech described,
because that visceral fat ismore metabolically active,
it's bad fat,
and if you're in a weight gaining stage of
(12:16):
life, unless you radicallyalter your lifestyle,
then liposuctioning out subcutaneous fat,
which is not as metabolicallyactive and consequential in a bad
way for you,
is more likely to get you in trouble where
taking that fat and putting itsomeplace where you need it is
(12:41):
protective and aesthetically useful.So it's a win-win, isn't it, Doug?
Absolutely.
And just for the women out there thatare listening and not believing this
before we did BBLs or now we say glutealaugmentation or a buttock augmentation
but we say Brazilian buttlifts. Before we did that,
Dr. Bass and I used to just do liposuctionon women and then we do a tummy
(13:06):
tuck and I would do my verybest to suck out all the fat,
but we threw it in the bucket.We didn't know any better.
We never put in theglutes or anybody cells.
What happen is the patientsreally wouldn't be great about going to the gym and
wouldn't be really great aboutdecreasing their post caloric
intake. And so they would get thisrebound fiber, what I call catch fat,
(13:28):
compensatory atrophiccellular hypertrophy,
which just means cells in otherareas compensator enlarge,
unless you do change how much you takein or how much you put out. But what
would happen is six months later,
I would have these women come in andthey would look like a truck because
what I took out, we didn't bank anywhereelse. I didn't put in the glutes.
(13:52):
We didn't really do BBLs then, we justthrew all the fat away. And they would
come back looking
like Spongebob Squarepants and they wouldhave a lot of visceral fat almost like
they were pregnant.
You'd have an unhappy patientand an unhappy puffing.
But now to illustrate the point,
(14:13):
everyone sucks it out and they put evenmaybe less than a couple of years ago,
but puts something somewhere else.
And usually it's in the buttock forwomen and now they come back six months.
"You're a genius doctor. You're agenius." The husband is in love with you.
The patients are in love with youbecause guess what? They went home.
They did not change how much they ate.They did not change how much they burn,
(14:34):
but instead of comingback as visceral fat,
it came back in their backsideand the husbands otherwise were
in love with you. So that justfurther illustrates the point.
This is a really interesting discussion.I hadn't thought of any of this before.
Is this just a differentaesthetic endpoint then,
or are the actual techniques different?
(14:56):
The techniques are different as well.
And also the philosophy is differentand the postoperative care is
different. And I'll tellyou why. Postoperatively.
Well, also preoperatively,
I put people on a slightly elevatedcarbohydrate diet so that their
cells are a little bit larger so thatmore of them survive the transfer
(15:18):
postoperatively. And then postoperatively,
we keep them on a high carb diet and ahigh protein diet for really high carb
diet for 28 days to make sure all thoseless cells that we put in their new
location actually survive.
Because we really don't want someone tobe in starvation mode because your body
prioritizes the most important thing.
What's going to be the mostimportant thing to heal up,
(15:40):
not to keep any exogenousfat cells or transplant.
It's really not your body's priority.
Your priority is heal up the surgery thatjust got done. So we want to give them
extra carbs to keep everything there.And that's really sort of a change.
A lot of times surgeons don'tstress or emphasize or higher
(16:00):
carbohydrates postoperatively, and it'ssaying to get to patients to do it,
they came to haveliposuction to get lighter,
to really tell peoplethat you need to do this,
that that's something that you haveto massage with patients as well.
And the other thing about whatI do is a lot of postoperative
(16:21):
molding. We use a lotmore foam with procedures
and we spend extra timereally talking about
compression wear to make sureeverything heals as easily as possible,
as polished as possible,but also to make sure that
the transition zones from what we'vesubtracted to what we've added,
(16:43):
our nice and smooth, our aesthetic, ourmixed sense, and our natural appearing.
So then where thetechniques are different,
does that mean that theinstruments are different as well?
Yeah. Well,
one thing that I have and I'vedeveloped is a scar abdominal healing.
And you may see summerwhen you go to the beach
(17:04):
or the pool,
you may see some guys that have hadabdominal sculpting or abdominal etching
and their abs, their stomachlooks like a tic-tac toe board,
and they have six different incisionsright on the skin, right visible,
God forbid if they were alittle bit darker complected,
maybe we call it Fitzpatrick scale andit's scaled from lightness to darkness.
(17:28):
But if it might be a patientthat may be a patient of color
or a patient of a thicker dermis,
one of these guys that may be Latinoor black can have problems with
hypertrophic scarring or keloids.Those are those bad scars.
So if you are giving them a scar that'sright on their abdomen and it scars
poorly, sometimes they look ritualistic,
(17:52):
they're going to have scars thatobviously show that they've had abdominal
sculpt.So I tell everyone that we need to have,
and I have curved cannulasso that I can hit all the
points from two small incisions underneathyour swimsuit or through the belly
button or a little nick throughthe nipple that nobody ever sees.
So I can hit all those siteswithout any scars on your abdomen.
(18:14):
So we developed this in 2017,
it's called scarless abdominal
sculpting, and I alwaystell the residents,
and I tell when I'm speaking,
I have to speak in Cartagenanext down in Columbia,
and then we're going Greece and thenAustralia. So when I talk to people,
(18:36):
I had these conferences,
I always tell patients I've never hadto apologize for an incision that I did
not make. Right. If you don't makethe incision, you don't need to do it.
And frequently I'm at a conference andI'll talk about this and I'll sort of
beat on people about this,stop making these incisions.
(18:57):
We have the tools of thetechnologist not to have that.
And then the next doctor that gets upand gives his abdominal sculpting talk
showed make sure there's incisions Ijust told everyone in the audience not to
make. So it's kind of tricky.
Yeah, I think that's a lessonfrom the whole field of minimally
invasive surgery andplastic surgery as well,
(19:19):
that the smaller the incision is,the further away the incision is,
the more it becomes critical tohave exactly the right instrument
that empowers you todo what you need to do.
And if you try to do it withjust a conventional instrument,
you try to struggle, you'renot in the right position,
the instrument's not configured properly.
(19:42):
So that contribution thatyou made of developing
instrumentation that enablesthis whole process was really
one of the tremendous steps up foraccomplishing this in a way that keeps the
entire abdominal area lookinggreat instead of a jigsaw
puzzle of a bunch of littleincisions, as you're saying.
(20:03):
And I've always tried to tilttowards the absolute minimum of
liposuction incisions offat grafting incisions,
and there are some surgeons that gowith very short cannulas and make
many incisions every four inches or so.
And I've just never understood thatapproach. So I think you're right on.
(20:25):
Yeah, frankly, that's one of the problemswith a lot of these new technologies.
The companies are moreinterested in making money,
so they make all the probes very short,
so they can't use the body in prob forthe neck group or anything like that.
And by making them short, inherentlypeople just have to make more incisions,
which means more scars.The patient, unfortunately,
(20:49):
I dare say that for thecompany sometimes the
priority isn't the patientor the patient's scars.
The priority is how many of these thingscan they sell sometimes, unfortunately.
Yeah. I mean that's the thing.
We often use a few differentliposuction cannulas in terms of what
the apertures look like,
(21:10):
the holes that actually shear offthe fat or in terms of the curve
of the cannula or the lengthof the cannula or the diameter.
And as soon as you go toan energy based technology,
either applicator or cannula,
you can't really buy more than onefor a case, which means by definition,
(21:32):
you're using one disposablecannula rather than
your, I mean,
I've had a lot of cannulas for 20 yearsand we just put them in the sterilizer.
They're steel, they getcooked, they're sterile,
and we use them and use them and use them.
But I can pull on that familyof cannulas for whatever exactly
(21:53):
I need in that instant toget the shaping I want,
which you lose when youtransition to a single cannula
approach. Right. That's an interestingpoint. I didn't think of that.
So I'd like to kind of focusin a different direction
from body,
(22:14):
and you mentioned that neck and jawlineare one of the big things for men
because it does give them a worn,
tired outlook and nobodywants to look that way,
especially if you don't feel that way.But this is also a procedure of course,
that women do commonly.
How do you approach faceliftor neck lifting for men?
(22:37):
How are your incisions different?
How is it different what you're doingunderneath with your connective tissue
layers? What's yourthought process for this?
Sure. Well, men are a littlebit different than women.
And neither for men or women do.
I like to do the old fashionedsurgeons really in the
(22:58):
sixties, seventies, and eighties,
which was kind of wait until everythingfalls apart and then they get these Park
Avenue matriarchs and they puttheir foot up on the table and pull
as much as they can. So thatpatient is very wind swept.
So a couple of things that we dofor the men is men would rather
have A, not look feminizedand B, not look overdone
(23:22):
or look like they did have surgery.So for the men, they'd rather,
and this is one thing I remember,
I had this lady from Texas whenI started out my practice, "doc,
I want to be pulled so tightthat I only have one line and I
want to be sitting on it." AndI just thought it, first of all,
it was very clever, but mendon't want that. And for men,
(23:46):
what we want is I always talkabout something that looks,
some lines are character and there'snothing that looks more artificial for me
than to see a man that doesn't have onesingle wrinkle, one single anything.
I think that a few lineshere or there are sexy.
We just don't want to lookold or older than our age.
(24:08):
So number one priority for men rather,
they'd rather have less done.And I always tell my patients,
I get in the same sig with them,
you come to me because you want to staylooking masculine and you don't want to
look like you had surgery and want tolook like you don't look like an alien or
a woman. So for my guys,
I know I say if there's anythingthat you're going to be displeased,
(24:30):
it's because there's a little, youwanted this to be completely gone.
I never say gone. In my practice,
I always say improve after I speak with'em and they realize that they don't
want to look overdone or over pulled,God forbid. They do understand that,
and it's about setting those expectationsthat makes 'em happy. In terms of
technical differences for the women,what we do is we take their skin,
(24:51):
we put it all the way behind the dragus,behind and into the ear. For the men,
I don't do that becausethey have hair bearing.
They have that beard or bring it rightup to that little line that everyone has.
We call pretragal that ithas in front of the ears.
But what I do is I do something different.What I do is I make sure I see some,
and in fact, I went to a laser show,
(25:12):
I don't want to get too specificbecause it's going to reveal the person,
but really fantastic lasers vicepresident could have gone to
anyone that he wanted to,
but I could see when he had his faceliftwith incision, went straight down,
it was about a half inch in front of theear and then came back dead giveaway of
someone who's had surgery,
is a poor match.There was a straight line. What I do,
(25:36):
what I do is different is I make sure Igo around each and individual and most
good plastic surgeons do this,
but I still do see some guys when I goout to South Anthem and go to dinner and
I see the guy at the club that hasan incision that came straight down.
So we always blended in with thenatural structures of the ear.
When my mother was putting togetherwallpaper in the dining room,
(25:59):
her floral wallpaper,
she would painstakingly cutaround every fruit and every
flower so that there were no seams inthat wallpaper. And I did the same thing.
So you don't see it in men. Theother thing with men for the neck,
we start with injectables.
So we can go a long way witheven removal of fat with
(26:21):
Kybella, and that's just an injectable.Or I can do liposuction
with neck fat, which is radial frequency.
Next step up from that is we make anincision and bring the platysma muscles
together, with a platysmaplasty,
redrape the skin along with removeof fat and tightening of the skin.
Next step of that is short scar neck lift.
(26:45):
It just comes around the earand that improves the neck,
but won't take care of the jawline.
If we really want to take care ofthe jawline from a non-invasive
way or an injectable way, I can dowhat I call my male model makeover,
which is more into the cheekbone, more along the jawline.
Have a special way that I do it to makesure that you don't look like a mobster
(27:06):
with which you've seen several people dobecause they're injecting in the wrong
place,
but I inject it a certain wayso they have a more stronger,
more defined jawline.And then when it comes to surgery,
if we want to improve thejawline in the cheekbone,
a little bit of the nasal labelfold is do a full neck and phase
(27:28):
for the gall. So that's prettymuch the entire realm. Oh,
one more thing is what I sortof call is the Clint Eastwood
neck work, which is somebody that says,
we have a lot of guys that comein in their sixties, seventies,
maybe even eighties, who say, "doc,just get rid of the Turkey neck.
(27:48):
Get rid of the Turkey neck." And forthose people, I can do it under local.
We can remove the skin directly.
But the reason why I say Clint Eastwoodis because it's got to be a certain
patient that says weathered skin,
a lot of natural sun aging,
a lot of creases,
crevices and crags so thatwhen you do directly size
(28:12):
that the resulting scarcan hide quite well
under that weathered skin.
But it's really not something that wedo and a younger person or a person that
doesn't have a lot ofskin damage, that's it.
Yeah. So there's thisbig range of options,
and I think those are allreally important points. I mean,
one thing about face and neckoperations is they're not just
(28:37):
loose skin operations,they're shaping operations.
And so by definition,
a male face shape is differentfrom a female face shape,
and it's really,
really important to reinforce themaleness of the shape in a man
and not feminize the face or the eyelids.
(28:57):
And I see that all the time from peoplewho just have one approach and one
approach isn't even good for one gender.
You obviously have to customizeyour approach based on what's
going on in that individualpatient stage of aging.
But it's really important to do that withthe goal of reinforcing a male facial
(29:18):
shape.
And that incision location andtailoring in is just part of that
good plastic surgery training thatwe got at NYU and Summer watched me
making that kind of incisionlast week on a very nice
77-year-old gentleman whostill works full time. And
that kind of incision worksbetter than trying to pull that
(29:42):
thickened weathered cheekskin over the tragus,
the little button in front of theear that's going to look poorly
matched and not hiding theincision right in the crease in
front because you're worried aboutthe hair bearing and non hair bearing
areas of the face, likewise isgoing to leave you with a giveaway,
(30:04):
which is essentially avoidable.
So these technical details really makea critical difference in preserving
a natural look, which isalways the goal for men.
I think you said a mouthful when yousaid that because that is a hundred
percent what the job is about.
(30:25):
If a man comes out lookingnatural, younger, fresh, or rested,
then it's a success.
And if you make any kind of alteration,
it's really a bad day.
Absolutely. Couldn't agree anymore.
The other thing I wouldtouch on is the support
(30:48):
and bony support,
and that's the other thing that we haveto think about because just like you
said, this is just not just looseskin surgery. If it was loose skin,
you would just bring it up.And the problem is men age.
I always tell my patientswhen they're in their teens,
one of the reasons why guys look sogreat in their early twenties is they
(31:12):
may stop growing when they're 18, 19, 20,
but the jawline continuesto grow until around your
27th birthday is it starts to
recede. So if you took the mandible,
the skull mandible froma 27-year-old and then
a 72-year-old, we're goingto flip the numbers there,
(31:35):
you're going to see a lot ofresorption of that bony area.
So if you bring up theskin and you've lost a
significant amount of your mandible,
the actual actual bonypush in the mandible,
you're not going to look right. You'regoing to look forrshortened and lack
projection, and you're goingto lose that masculinity,
(31:56):
and you're not going to look like youlooked in those pictures that you brought
from 20, 30, 40 years ago.
So one of the things thatwe do have to do is replace,
but what we need to dois we need to recreate
that extra fullness, and I can do that
(32:16):
during the neck lift or facelift.Usually after is better,
we reset the tissues afterthe reset and healed.
I go back in and I give that extravolume of that bone with injectables.
I can do it with fat or I cando it with hyaluronic acid,
which are injectables off the shelf.
And that not only makes a patienthave a more chisel, more masculine,
(32:39):
more defined jawline,
catches a light and throws a shadowthat gives that really straight,
strong masculine look.
But it also makes you look more like youlooked like when you were 27 years old
because we recreated your jawlineyou had when you were 27 years
old, so you look younger as well.
(33:00):
Wow. That was a lot of smalldetails that I hadn't considered,
but are clearly really important whenconsidering plastic surgery for men.
So as we prepare to wrap upthis episode, Dr. Steinbrech,
what takeaways do you wantto share with our listeners?
I think the key thing is when you'relooking for men's plastic surgery,
what you want to do is do yourresearch, right? You want to go to,
(33:21):
anybody can, a lot of people do,they buy the Google terms for male
plastic surgery, New York's bestmale plastic surgeon, or they'll say,
Phoenix best male plastic surgeon.But then when you go to the website,
it's nothing but orchids andbutterflies, right? And then really,
it's when you go to the gallery andyou're trying to find one man in their
(33:44):
gallery of their before and after photos,
and all you see are hundredsof breast augmentations,
and you're really not lookingfor a breast augmentation.
So it's to do your research.
And then the other thing is to alsomake sure that they're a member of,
they're board certifiedin plastic surgery.
And even higher than that,
(34:04):
a higher level is that they're amember of The Aesthetic Society.
So those I think arereally important things
when you're choosing your plasticsurgery for male plastic surgery.
And what are your takeaways, Dr. Bass?
Well, we've talked about some ofthese things before on the podcast,
but the way plastic surgeryprocedures are done, the parameters,
(34:27):
the measurements and metrics aredifferent for men and for women.
We've kind of scratched the surface heretalking about body banking and talking
about face and neck shape,
but for every procedure, it's goingto be different for men and women,
the aesthetic interests ofmen and women go head to toe,
(34:50):
but there are certain aesthetic issuesthat are more commonly of concern
based on gender.
We're limiting the discussion in thisepisode to individuals that identify in
one of these two simplebaskets of men or women.
But we must acknowledge,as Dr. Steinbrech did,
(35:10):
that there are individuals that don'tfit into one of these simple categories
based on how they identify orbased on their aesthetic goals.
So for that reason,
it's really important for patients intheir surgeons to discuss the aesthetic
goals and the aesthetic
sense of beauty ahead of timeto come closest to producing the
(35:33):
patient's vision of beauty in reality.
In summary,
men are definitely interested in plasticsurgery and increasingly interested.
The procedures have improvedto match men's needs,
and that's in part due to excellentinstruction in how to customize these
procedures for men from leadersin male plastic surgery like
(35:57):
Dr. Steinbrech,
there are a lot of subtle featuresand some very obvious features that
say male or female,
and it's critical to understandboth the big and little features and
build them into your plasticsurgery procedures if you want a
nuanced natural looking result.
(36:20):
So I'd like to thank Dr.Steinbrech for joining us today.
It's been a lot of fun to talkthrough this topic with you.
Absolutely. Thank you for havingme. I really, really enjoyed it.
Some great questions,
and I really hope that people goout there and explore it more.
Thank you, Dr. Steinbrech for sharingyour extensive expertise in this area.
(36:43):
Thank you for listening to the ParkAvenue Plastic Surgery Class podcast.
Follow us on Apple Podcasts,
write a review and sharethe show with your friends.
Be sure to join us next time to avoidmissing all the great content that is
coming your way. If you want tocontact us with comments or questions,
we'd love to hear from you,
send us an email atpodcast@drbass.net or DM us on
(37:05):
Instagram @drbassnyc.
Popular Podcasts
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.