Male Facelifts: Customized Incisions are Key

NEW YORK, NY (July 16, 1999) — In performing facelift surgery, proper placement of incisions is crucial to achieving natural-looking results, and special criteria apply to male patients. A distinguished panel of board-certified plastic surgeons discussed the nuances of customized facelift incisions in an article appearing in the May/June issue of Aesthetic Surgery Journal, an official publication of the American Society for Aesthetic Plastic Surgery (ASAPS).

The "traditional" location for the upper portion of the facelift incisions is within the hair in the temple region and within the natural contours in front of and behind the ear. "In choosing where to make the temple portion of the facelift incision, the position of the hairline as well as the amount of skin needing to be removed must be carefully considered," says board-certified plastic surgeon Timothy J. Marten, MD, of San Francisco, Calif. "If there is a great amount of excess skin, this could shift the sideburns to a noticeable degree." Men may have a difficult time camouflaging sideburn displacement since they generally do not have many options for styling their hair. When there is significant excess skin, the incision may be placed along the edge of the temporal hairline rather than behind it.

Sometimes an incision may be placed in an existing crease in front of the ear, but another option is to place the incision just on the margin of the tragus (the tiny projection of cartilage at the opening to the ear canal). "I find that an incision on the tragal margin is less conspicuous than a pretragal incision in men due to the color and texture differences between the tragal skin and the cheek skin," says Dr. Marten.

The primary difference between a male and a female facelift is management of beard shift in men. Beard shift onto the tragus often can be prevented by destroying the beard follicles with a needle-tip cautery at the time of surgery. This is easier if the patient is asked not to shave for two days before surgery. "I tell male patients who desire an incision along the margin of the tragus that they may require electrolysis later," says board-certified plastic surgeon John William Little, MD, of Washington DC.

Beard shift behind the ear may occur as facial skin is pulled back. "Shaving behind the ear generally is not a problem for men, but shaving right up against the ear lobe may be difficult," says Dr. Marten. "That’s why I leave a slightly larger cuff of skin when making the incision around the ear lobe in a male patient, so that there will be a beard-free area where the ear lobe meets the facial skin."

According to statistics gathered by ASAPS, men accounted for 10.5% of the more than 100,000 facelifts performed in 1998.


The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world's leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body. ASAPS is comprised of over 2,600 Plastic Surgeons; Active Members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and nonsurgical aesthetic procedures. International Active Members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.


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