Men take pride in their appearance and strive to look and feel good about themselves. Dr. Megan and her team offer procedures tailored to the specific needs and aesthetics of her male patients.
WHAT IS GYNECOMASTIA ?
Gynecomastia is a condition where excess breast tissue and fat are present on the male chest, giving it a more feminine appearance. Often this begins in adolescence, cannot be corrected with diet or exercise alone, and is a huge source of insecurity in men. Gynecomastia can feel extremely limiting to men in terms of clothing and in situations such as the beach or the gym where it is common to go shirtless.
HOW DO YOU CORRECT GYNECOMASTIA?
Gynecomastia is corrected by performing a Male Breast Reduction. There are 3 distinct factors that need to be evaluated when deciding which procedure is best suited for each individual patient-- glandular tissue, fat, and the presence or absence of loose skin. When fat alone is present, liposuction is an easy surgical option for correction. Small incisions (3-4mm) are made in the skin through which fat is removed. Glandular breast tissue, however, cannot be removed through a liposuction cannula and must be surgically removed through a slightly larger incision that is camouflaged at the junction of the areola and the surrounding lighter skin. Most patients have a combination of gland and fat requiring a combination of these two procedures. Some patients have such a large volume of tissue that the chest skin is loose after the underlying tissue has been removed. If the amount of skin to be removed is small, the incision can be placed around the areola. If the degree of skin is large, however, this may require a large incision along the pectoralis major muscle and removal and replacement of the nipple and areola as a skin graft.
No matter which type of procedure is performed, utilizing liposuction to sculpt and contour the chest to create a masculine appearance is a key part of the correction of gynecomastia.
AM I A GOOD CANDIDATE?
The ideal candidates are in overall good health, and have a stable weight. Other causes of Gynecomastia such as steroid use, the use of certain medications or certain cancers are ruled out prior to proceeding with surgery.
All the variations of correction of gynecomastia can be safely performed in our State-of-the-Art Ambulatory Surgery Facility. The procedure time can range from 1-2 hours and require sedation or a general anesthetic. All incisions are closed using dissolvable sutures placed under the skin and, depending on the amount of tissue removed, a drain may be placed at the end of surgery. All patients will be dressed in surgical foam and a compression binder to help with swelling postoperatively. Patients are discharged home for their recovery.
If surgical drains are placed in surgery, they will be removed within the first week after surgery.
The foam and binder are to be worn for 1 week and patients are encouraged to continue compression therapy with a compression tank top for upwards of 2 months. Patients must refrain from heavy lifting for 4 weeks but can resume light activity around 2 weeks after surgery. Dr. Megan likes to take an individualized approach to fitness limitations/restrictions after surgery.
EYELID SURGERY/ BLEPHAROPLASTY
WHAT IS A BLEPHAROPLASTY/EYELID SURGERY?
The eyes are one of the most obvious places on both the male and female face where aging is visible. As we age, the thin skin of the upper and lower eyelids stretches and wrinkles, creating loose and sagging skin that makes us appear tired, the application of makeup difficult, and can even disrupt vision is severe. Excess fat deposits make the eyes appear “puffy” and can accentuate the appearance of dark circles under the eyes. Lastly, the lower eyelids become loose over time, giving the eyes a rounded, sad appearance. Conservative measures such as creams or injections do little to correct these issues. An Eyelift or Blepharoplasty is an outpatient surgical procedure that helps to restore a youthful and rested appearance to the face and eyes.
WHO IS A GOOD CANDIDATE?
Ideal candidates for a Blepharoplasty include both men and women who are healthy, non-smokers, and who exhibit the signs of eye aging as described above. Patients may require an examination by an Opthomologist prior to surgery.
WHAT IS A TEAR TROUGH DEFORMITY?
A tear trough deformity is a term used to describe the hollow appearance of the medial lower eyelid, where the lower eyelid meets the nose and cheek. It becomes prominent in some individuals for a number of reasons including protruding fat in the lower lids and thinning of skin in the area. Tear troughs can be treated non-surgically with fillers depending on their depth. During a Blepharoplasty, Dr. Megan can address the tear troughs through a number of mechanisms-- direct removal of excess fat in the lower lids, releasing any adherent retaining ligaments making the lid/cheek junction more apparent, and adding fat to the thinned, hollow area.
During the initial patient consultation, Dr. Megan will carefully evaluate the perio-orbital area to assess all of the structures (upper and lower lids, eyelid skin, protruding fat, tear trough deformity) which will require correction. All variations of a Blepharoplasty surgery can be safely done as an outpatient surgery but will require varying levels of anesthesia depending on which areas will require correction. In the upper eyelids, the incision is camouflaged in the natural eyelid crease approximately 1cm above the lash line. In the lower eyelids, fat is removed through an incision on the inside of the eyelid and skin excision is done with an incision 1-2 mm below the lash line to hide it.
Before surgery the patient is meticulously marked while awake and in the sitting position to ensure that the precise amount of skin will be removed. Once in the operating room, anesthesia is given by our outstanding team of Anesthesia providers. Protective eye shields are placed over the eyes to avoid inadvertent damage. A local anesthetic is infiltrated in all areas of skin to be removed. A fine scalpel is then used to remove the redundant skin as previously marked. Care is taken to ensure symmetry between the sides. Excess fat of the upper lids can be removed through the preexisting incision. If correction of the tear trough deformity is needed in the lower lids, this portion of the procedure is performed first through an incision on the inner aspect of the lower eyelid. Through this incision, excess and protruding fat can be removed or rearranged. After this step, any extra skin on the lower lids is directly removed.
Lastly, if it was determined preoperatively that tightening of the lower lids was also necessary, a permanent suture is used to anchor the lower lid to the surrounding bone. All external incisions are closed with a non-dissolvable suture that will be removed at one week. Once the procedure has concluded, eye shields are removed and ice packs are placed on the eyes. The patient will then be discharged home to recover.
Any surgical procedure on the face can be difficult for patients because of how visible the recovery is. To help prevent swelling, patients will apply ice packs and elevate the head for the first week after surgery. Eye drops are prescribed to help with any swelling of the tissues around the eyes. Eyes may feel irritated and dry as the swelling progresses. Swelling generally peaks around 3-4 days after surgery and will rapidly improve after that. Sutures will be removed at one week post-op in the office. We ask that patients keep the incisions moisturized for the first couple of weeks after surgery to help facilitate the healing process. Patients should avoid eye makeup for at least 2 weeks after surgery. Many patients take 1-2 weeks off work depending on how comfortable they are returning to work with such a visible recovery
WHAT IS LIPOSUCTION?
Liposuction is a surgical procedure for both Men and Women which permanently removes fat from areas such as the neck, arms, abdomen and thighs. It is also a tool that is used to “sculpt” certain areas such as the chest or abdomen to help enhance the underlying musculature. It is an outpatient procedure that can be done with varying levels of anesthesia depending on the number and location of the areas performed. Though the fat is permanently removed, maintaining results with a healthy diet and exercise routine postoperatively is key to long lasting results.
AM I A GOOD CANDIDATE?
The best candidates for liposuction are in overall good health, maintain a healthy and stable weight, and are motivated to maintain their results after surgery. Because liposuction alone will not tighten loose skin, ideal candidates do not have significant skin laxity. If there is significant skin laxity present, then combining liposuction with a skin excision procedure such as a Tummy Tuck is most appropriate.
During the procedure, multiple small incisions (3 to 4 mm) are created within camouflaged areas such as the groin creases or belly button. First, a Tumescent solution is injected into the areas. The Tumescent solution is a combination of Saline, Lidocaine and Epinephrine to help facilitate fat removal, decrease bleeding and provide postoperative pain control. After this step, small liposuction cannulas are inserted through the incisions in order to remove the fat. It is important to continually monitor the skin for uniform thickness and overall contour. Once the optimal contour has been achieved, the incisions are closed with a simple, dissolvable suture. Patients are placed in a compression garment after surgery which they will wear for upwards of two months to achieve the best surgical results. Results from liposuction take time and patience is critical. Dr. Megan generally tells her patients that five or six months is needed in order to see final results.
After surgery has been completed and the patient has been placed in a compression garment, they are then discharged home for recovery. We encourage all our patients to be up and moving around after surgery in order to help mobilize fluid and prevent blood clots in the legs. Patients will be provided with compression stockings. Patients remain in their postoperative compression garments until the first postoperative visit. The first 2-3 days after surgery patients will notice drainage from their incisions sites-- this is normal and is due to the tumescent solution that was added to the tissue prior to fat removal. Patients generally require pain medication for the first couple of days after surgery and the average time off work is approximately one week.
WHEN WILL I SEE MY RESULTS?
Final results after liposuction can take upwards of 5 to 6 months. The process of removing fat creates lots of swelling.. Even more, when we are performing fine, detailed Lipo Sculpting, we must have even more patience to await our results as even a couple of millimeters of swelling will temporarily alter the final contour. Result maintenance with diet exercise and overall patient lifestyle is critical to maintaining liposuction results. While the fat cells removed during liposuction will never grow back, the fat cells that remain can get bigger.
The structure of the jawline is a key feature to a masculine face. A weak or poorly projected chin can often be a source of insecurity for men. Jawline Augmentation with either fillers or an implant can be a great option to help build projection and strength to the chin and lower face, to help bring harmony the face, and to boost a sense of self-confidence in patients.
Fillers can be a great way to temporarily add volume to the lower face and jaw line. They are injected in the clinic with immediate results and minimal downtime. The downside of fillers is that they require maintenance in order to maintain results. Typically, fillers last anywhere between 9 to 18 months.
SURGICAL CHIN AUGMENTATION:
An alternative way to increase projection of the chin and add structure to the jawline is the surgical placement of a silicone chin implant. This is done through a small 2cm incision on the undersurface of the chin in the submental crease. The implant is placed in a pocket just above the bone, and it is secured to the bone to avoid malposition or migration. The incision is closed with dissolvable stitches. Pain and discomfort is minimal following a Chin Augmentation. The patient may eat and drink like normal immediately after surgery
AM I A GOOD CANDIDATE?
Ideal candidates for Chin Implants should be in good overall health and non-smokers. Patients with a true under development of the mandible are poor candidates for Chin Augmentation alone and should seek Orthognathic consultation for correction.
OTOPLASTY (EAR PINNING)
WHAT IS AN OTOPLASTY?
Prominent, large or asymmetric ears can be a significant source of insecurity that is difficult for patients to camouflage. Women can often use longer hairstyles to cover the ears but men typically cannot. Ear Pinning (Otoplasty) is a surgical procedure done to permanently correct prominent, protruding ears. Ears are typically prominent when the cartilage fails to fold correctly. There may also be extra or redundant cartilage present. During an Otoplasty, the cartilage is reshaped and any extra tissue is removed.
AM I A GOOD CANDIDATE?
Good candidates for Ear Pinning are in good overall health and do not smoke. This procedure is often performed on Men, Women and on Children, as children often report significant self-esteem issues secondary to prominent ears from being teased by other children. It is important to determine surgical expectations preoperatively as some elements of prominent ears can be difficult to correct and possibly even recur after surgery. Patients must also understand that while Dr. Megan always strives for symmetry, true symmetry in the body is never possible.
An Otoplasty can safely be performed in an outpatient setting in our Ambulatory Surgery Center. Varying degrees of anesthesia can be used depending on the age and comfort level of the patient. The surgery itself can be performed in under 2 hours. A local anesthetic is first injected to help minimize bleeding. An incision is then made on the back of the ear, right where the ear meets the posterior scalp. Through that incision, the cartilage is exposed and marked where stitches will be placed to reshape it. Permanent, non-dissolving sutures are placed to fold and reshape the cartilage sequentially, with care taken to observe both ears simultaneously for symmetry. These same sutures are then used to pin the bowl of the ear to the posterior scalp if indicated for prominence. Lastly, excess cartilage can be removed and the ear lobe size reduced if needed. The incision is closed using a dissolvable suture and dressings are placed over the ears. A head band is placed to hold the ears in position. This will be worn until the first postoperative visit. The patient is discharged home to recover.
Patients will go home after surgery to recover and typically follow up 3-4 days after surgery. With an Otoplasty, patients generally report minimal pain. Patients will be responsible for obtaining their own athletic headband to be worn after the initial dressings are removed during the first visit. A headband will be worn at all times for the first week and at night for the next two weeks to protect the ears while they are healing.
As we age, gravity takes hold of many features of the face and the eyebrows are no exception. As the brow lowers, it gives a tired and even angry appearance to the face. An Eyebrow Lift is a popular cosmetic procedure which helps to elevate the eyebrows to a more youthful position and restore a refreshed look to the eyes and face. This procedure is often combined with injectable wrinkle relaxers, fillers, or done in conjunction with other rejuvenating procedures such as an Eyelid lift (Blepharoplasty) or a Facelift. The ideal position and shape of the eyebrows has subtle but distinct differences between men and women that must be taken into consideration when devising a surgical plan.
AM I A GOOD CANDIDATE:
A good candidate for a Brow Lift has the signs of peri-orbital aging including deep forehead wrinkles and a low brow. They are in good overall health and are non-smokers, and they desire a realistic and refreshed look to the face.
There are multiple types of Brow Lifts available depending on the individualized patient anatomy and goals. A thorough consultation and physical evaluation will help Dr. Megan develop an individualized surgical plan. Regardless of the type of Brow Lift performed, the incisions are always camoflouged within the hair, in pre-existing wrinkles, or in an upper eyelid incision.
Traditional Brow Lift: This procedure is best suited for patients who require significant elevation of the eyebrows, have significant forehead wrinkles to reduce, and/or need shortening/lengthening of the forehead height. The incision is placed either right at the hairline or a couple centimeters posterior to it. The forehead skin is elevated to gain access to the eyebrows, the wrinkles of the forehead are smoothed, the brows are internally tacked to a more youthful position, and any redundant skin is excised.
Endoscopic Brow Lift: This technique involves 3-5 short incisions placed just behind the hairline through which an endoscopic camera and tools can be placed to gain access to the eyebrows, elevate them and release wrinkles.
Direct Brow Lift: In patients who deep forehead wrinkles or well-defined eyebrows, an incision can be placed in the skin directly above the eyebrows to elevate the brows and remove excess skin.
Temporal Brow Lift: Some patients have isolated lateral brow decent and only require a small amount of outer lift to recreate a more youthful brow arch. For these patients, a single incision on either side of the scalp can be placed in the hair above the top of the ear.
Brow Pexy: This technique is performed through an upper eyelid Blepharoplasty incision in order to tack the brow into a higher position.
All Brow Lift procedures can be safely done in our outpatient Ambulatory Surgery Center. The length of procedure can vary depending on the type of procedure performed and whether there are other procedures being performed simultaneously. Patients will be discharged home to recover.
After a Brow Lift, patients will be sent home to recover. Patients may experience bruising and swelling for which ice and head elevation is recommended. All sutures are removed at one week from surgery.