Selfie-Esteem: Selfies may be leading to the rise in plastic surgery.
Original photography by Matthew Rettenmund
"I've never had any plastic surgery. Except I had an eye done once."
It could have been a conversation between Joan Blondell and Eve Arden in the late '60s, but it was a conversation between two middle-aged (if we live into our nineties) gay men in 2014. One of them was me.
I'd asked a pal of mine about cosmetic surgery and was surprised my friend didn't "count" the surgical correction of a drooping eyelid. Apparently, the lid could have obstructed his vision so was classified as something he needed. He told me it—however you'd classify it—had gone well and had never been something he regretted.
In anticipation of this post, I'd asked male acquaintances and Facebook friends for their experiences with plastic surgery, and had received a raft of responses, right in line with statistics that show men are catching up to women in this arena. As of 2012, about a million American men were opting for plastic surgery of some kind every year, including sharp increases in men seeking facelifts, lipo and breast reduction. That accounted for only 10% of procedures overall, but the numbers feel outdated already.
"I've had lots done!" one friend wrote me. "Nose job, 3 gynecomastia operations, lipo in chest and abdomen, regular botox and Radiesse injections in the face. Whew! It's a lot of work and money to try to look decent as one ages." Judging from his youthful Facebook visage, the money has been worth it. Aside from wearing compression vests for "weeks" after lipo, which he described as a bit of a pain, he told me, "I would definitely recommend these procedures to anyone who feels they need them."
I've had lots done!
Still another friend told me of having a nosejob to balance out his hair loss. It turned into two nosejobs when the first left his schnozz a bit too reminiscent of a shark's fin. He's happy with it now, but warned that his female friend's new nose had left her looking like a dog. Hyperbole? No. "I mean, like a dog who should be eating Alpo out of a bowl," he clarified, suggesting her nose had taken on a canine appearance. She, too, had had it fixed, and was now happy. Both he and his friend felt they needed the work done, and both had eventually wound up with the result they expected.
So, judging from statistics and my unscientific poll, the number of people who feel they need plastic surgery seems to be skyrocketing...the most interesting word in that sentence being "need."
I've been obsessed with plastic surgery since that episode of Quincy and since watching Bruce Jenner go from being a smokin' hot dude to an okay-looking lady starting 25 years ago (though perhaps that was the desired effect on Bruce's part, which does make me feel happy). When Madonna went all the way in 2008, my obsession ticked up from an 8 out of 10 to a perfect 10.
It was inevitable I would eventually wind up across a table from a plastic surgeon sooner or later.
I arrived at the offices of board-certified plastic surgeon (and author) Dr. Douglas Steinbrech around lunch time one weekday last month. I'd been offered interview access for a blog post, but had leveraged it into an interview and consultation. I may—or may not—be one of those men these days who feels he needs plastic surgery.
I was greeted by Joseph Baiamonte, whose role in Dr. Steinbrech's office is as a "patient advisor." It might seem a bit like using the same lawyer as the person you're buying an apartment from—a little autonomy goes a long way—but I found Joseph to be quite independent, and easy to talk to.
After some chit-chat, he asked me, "What would you have done, if you were going to have anything done?" And here comes the hard part. I like to project confidence, so admitting to feeling I have physical shortcomings when I'm so lucky in so many ways feels not only weak but shallow. But let's be honest—almost nobody is 100% satisfied with his body, especially these days, with so many perfect male specimens flooding social media and smiling out at us from unhelpful blogs like, say, BoyCulture.com.
"Nothing with my face," I replied. Let's start strong!
"I agree; you have no wrinkles and I would have guessed you were 10 to 15 years younger than you are," he offered.
"I just wanna suck out all of this—" I grasped my mid-section "—and have it pumped into this—" I reached back and grabbed the part of my body where an ass should be.
He didn't tell me I was crazy. But I wondered if I was crazy. See, my first run-in with lipo was in college. When I was 20 years old, I had a very close friend who was also from Michigan and who was also a stocky guy. Even though we were built very similarly, I considered him hot and beefy, and I considered myself a fat slob. He secretly had lipo, something I'd barely heard of then, over 20 years ago, and it had been paid for by a rich sugar daddy who liked the young body but agreed it could use some improvement.
"Matt, my penis turned yellow," my friend told me. The bruising had been severe from his knees to his nipples, all to take out some non-existent fat around his tummy. Ever since then, I'd been reluctant to consider having fat suctioned out of my body, almost as reluctant as I've been to stop eating poorly and start exercising more.
But advances have been made in plastic surgery, and although I've cleaned up my act considerably, the ship has sailed on getting my 45-year-old torso into more than so-so shape. Skin doesn't snap into place and muscle doesn't dutifully grow, even with considerable effort, at this stage of the game.
So maybe I was crazy like a vain, but sensible, fox.
Before we moved on, Dr. Steinbrech popped his head in. He's a handsome guy of an indeterminate, not very advanced, age, and his dad definitely taught him how to shake a hand. He looks as good in person as his credentials look on virtual paper. With almost no preamble, he offered me a chance to watch a male patient having under-eye injections of Restylane, a popular filler. How could I refuse? We went back to the room where procedures are done to find a handsome, silver-haired gentleman reclining in a tall chair, marker all over his face.
It surprised me that the patient would allow a random blogger to see him in such a vulnerable position.
"Gay guys, they always wanna look great," Dr. Steinbrech told me. "They're a bit more courageous about talking about it. There isn't the same stigma that there used to be. Just because they're courageous about being gay, they're also courageous about talking about other things—like plastic surgery."
Cutting into that theory a bit, the gent before us turned to me and confirmed, "You won't use my name, will you?"
Plastic surgery is the worst-kept secret in Manhattan among women and men of a certain age and financial profile, but it is still a secret kept. I promised, as Dr. Steinbrech deposited injectibles into the wrinkles under his patient's eyes. The patient winced, but didn't betray any unbearable pain, then told me he had a friend who'd gone in (to another doctor) for a facelift and it had wound up looking too obvious, which was why he was content to battle the aging process in dribs and drabs. It looked to be working—he looked rugged and handsome, not weathered and, of paramount imortance, not "done."
"A lot of people come to me from other M.D.s who want their previous work corrected because it was uneven or overdone or underdone or didn't heal correctly," Dr. Steinbrech explained. "The goal is to look natural."
When we walked away, Dr. Steinbrech described the patient I'd just met as half-model, half-CEO, which led to him telling me about the types of men frequenting his practice these days. They break down into four profiles, which are outlined on his Web site:
(1) Male Model
Already in the upper 5% of the population, looks-wise, the male model seeks tweaks to gain a competitive edge—jaw augmentation, pec and glute enhancement, high-definition ab sculpting.
Not terribly different from the first type, the bodybuilder, too, would be coming in for mostly the same types of procedures, though gynecomastia would be more common since steroid use helps men sprout moobs as well as muscles. Bodybuilders would, of course, be more likely to want surgical intervention on parts of their bodies unreachable by exercise.
(3) Athletic Dad
This guy is seeking to look young and hot as long as possible now that our shelf lives have been extended. Lipo to combat middle-age spread and light face work (like an eyejob) rule the day for dad.
This guy needs to keep up with the young bucks around the office, so facial rejuvenation, a neck lift as well as some of the same, most common procedures younger men seek (lipo to bring out the abs) apply.
Men fitting into one of these four types, in particular gay men, have been flooding Dr. Steinbrech's practice.
It's 60% women, 40% men, and of the men, probably 60 to 70% are gay.
"When I started my practice," he told me, "it was probably 80% women, 20% men. Now, it's 60% women, 40% men, and of the men, probably 60 to 70% are gay."
Openly gay himself, Dr. Steinbrech hopes to be to go-to surgeon for the gay community in NYC.
It was my turn to get a little more hands-on; Joseph escorted me to a private room where I stripped nude and donned a tiny, paper version of a g-string. I'm sure it would be quite hot in a roleplay experience, but the real thing left me feeling a bit exposed. The high cut of the disposible mock-strap did allow for maximum bulging, a technology Andrew Christian may want to investigate.
Joseph played amateur photographer, posing me against the wall for photos from the front, side and back. Bad flashbacks to my Snatched poses.
At this point, Dr. Steinbrech entered and looked me up and down. The first thing out of his mouth was, "You need pec implants and lipo."
I don't want it to sound like I thought the doctor was being callous; to be honest, I was far more offended when a dear friend of mine recently surprised me during a walk to an event by confirming that I have no ass, even after I'd confessed how much it bothers me (read into my obsession with other men's asses as you like). Dr. Steinbrech was there to, ahem, assess my body, so it didn't come off as rude. But there was that word again—"need."
I was a little defensive about my chest. He pointed out that my chest is lower than it once was, but I think since I'm 45 and am just thrilled not to be morbidly obese anymore, the fact that I do not have man-boobs makes me feel fairly confident about things up top. The doctor's comment has led to some moments reminiscent of the one good scene from the 2000 Madonna bomb The Next Best Thing, in which her character holds her breasts up high and says, "1989..." before letting them drop and saying, "1999." Germane to the discussion is the fact that were Madonna to recreate this scene today, her 55-year-old breasts would actually be higher than her 41-year-old breasts were.
Dr. Steinbrech is high on pec implants, and for several very good reasons. For one, they're among the top procedures requested by his gay male patients, along with high-definition lipo (to make those already-existing abs pop). Compared to other common procedures, pec implants are less likely to lead to complications and infection (the overall infection rate of procedures at Dr. Steinbrech's practice is under 3%) and lead to easily quantifiable results. They're not as risky as female boob jobs because the implants, while pliable, are solid. The only major concern is getting them aligned correctly and choosing a size that will enhance a man's chest without looking silly. There is a small chance of a loss of nipple sensitivity—but even a small chance scares the hell out of me because that is one of my most cherished physical gifts: Hard-wired nipples. (Blush.)
In 45 minutes, I can give you what you've been working on for 45 minutes every week for the past 10 years.
"Some implants work much better than others," Dr. Steinbrech told me. "Pec implants are amazing, glute implants are good...it's a little trickier for calf implants because the incision is harder to hide. As long as people know that and are okay with that, or if they'll wear shorts that hide it anyway, then I'll do it. But some procedures are a home run and some are not.
"For the pecs, it's easy to get shoulders and arms [through working out] but slow for the chest. I can just slide them in. In 45 minutes, I can give you what you've been working on for 45 minutes every week for the past 10 years. When you pop those babies in, people immediately look at your chest and they're like, 'That guy's hot.'
"Pec implants are a home run."
Perhaps, but he read on my face and from my questioning that I wasn't keen on accepting implants into my tittays, so the doctor gallantly did not try to upsell me.
Moving on to the rest of me, Dr. Steinbrech noted that my previous weight loss had left my skin pretty loose (I've had more than one masseur brightly ask me if I'd lost weight recently, oblivious to what a non-compliment it is), saying that this was a plus if I decided to have lipo with some of the fat relocated to my buttocks. He related that in some cases, men have tiny butts but no space to work with, so can only expand so far, perhaps not far enough for fat or implants to make a worthwhile difference.
I asked if I would instead be a candidate for a tummy tuck, inspired by having seen an interview with a 28-year-old gym stud who'd posed for L.A.'s gay magazine Frontiers and who had, impossibly, had one. Dr. Steinbrech told me those are really for people who've lost upwards of 70 pounds (I'm at 50 from my peak 12 or more years ago), or post-pregnancy women (his "mommy makeover" would be a great article for another blogger), but he couldn't help bragging that he makes his patients' stomachs "as tight as a sailor's bunk" when he does do the tuck.
I wondered aloud how satisfied people are after getting work done. What a terrifying idea, to go under the knife, go through painful healing, then look...off. Even by a little. Dr. Steinbrech told me the lipo would be 80% healed in two weeks, one could return to work within two days, to the gym in two weeks and to the beach in three weeks. Sounded pretty satisfying.
"It depends for any procedure, but based on your tissues and based on the incisions, I can gauge what kind of satisfaction and the level of improvement I can get.
"Your percent improvement on pecs would be 98 to 100%. Back here [pointing to my back fat], it's gonna be more like 80 to 90%, and that's because I'm limited by the skin you have from the weight you lost. For your tummy, it's gonna be 85 to 90% improvement. For your butt, it's gonna be 95% improvement."
Those numbers sounded good, even if Joseph had warned me that as much as 40% of my new butt would have deflated (the fat dissipating back into my body) after about two years. Still, I could sport a decent can until age 50.
The rest of my visit was clothed. I sat with Joseph and then with Dr. Steinbrech and viewed an animation showing my before photos morphing into what I might expect to look like with less fat around my mid-section and more fat in my ass. Watching my body cave in and expand in all the right places was disturbingly satisfying, like popping a zit. I was subconsiously holding my chest under my crossed arms as I watched.
We talked briefly about hair transplants (my own hair is mighty fine, in the bad way, so I've been taking pre-emptive Propecia and massaging Rogaine into my scalp for a few years). Dr. Steinbrech works with a hair guy who's based in Miami, but who flies his team into NYC once a month to take care of a waiting list of anything-but-bald! patients.
Both Joseph and Dr. Steinbrech were highly complimentary about my lack of wrinkles for my age, but in the interest of covering all the bases, I did ask about facial procedures beyond the injectibles being enjoyed/endured by the older man I'd met.
"Everyone wants a Tom Cruise jaw," Dr. Steinbrech told me. "If you look at old pictures of Tom Cruise, Tom Cruise didn't have a Tom Cruise jaw. Now, he's all chiseled." (Dr. Steinbrech's Web site is offering a free Botox treatment to select top guns.)
Cruise is actually a terrific celebrity example of how any man might want to look after having procedures done. If Cruise has had work done, in spite of his flat denial, I would say his plastic surgery is as subtle as his couch-jumping is not.
"Everybody knows certain overdone celebrity men have had a facelift," Dr. Steinbrech said, listing as one example a famous reality star whose name he prefers I don't mention. "My whole philosophy is to make it look like it isn't a facelift. Some surgeons put their foot on the table and go like this—" The doctor made a sloppy pulling gesture for effect. "I know people who want it 'tighter, tighter, tighter,' I know surgeons who'll pull it so tight a crease will form at their eye. It's a no-brainer. Everyone can identify bad or overdone plastic surgery. The secret is that there's a lot of good plastic surgery that people don't see or notice. If I put a little filler in the cheekbone and along the jawline and chin, it turns you into a rockstar. It's a male-model makeover."
My whole philosophy is to make it look like it isn't a facelift.
I think what makes people leery of plastic surgery is that we've all seen so many horrendous examples of what it looks like when it goes wrong. It would be uncharitable to list all the public figures with bad plastic surgery...uncharitable, but not difficult. Interestingly, the doctor agrees.
"It's like 'I see dead people,'" he says when I ask if he sees as much bad plastic surgery as I think I do. "But while I do see really bad plastic surgery that makes me cringe, I also see really good plastic surgery." I think the latter is what most of us laymen aren't so sure about. I've certainly had raised-voice arguments with people over celebrities who look too suspiciously good into their sixties and seventies to not have had work, and how many times have we all read a Facebook post declaring that someone like [fill in the blank with an obviously tweaked star] is overdoing it while [fill in the blank with a less obviously tweaked but still obviously tweaked star] is "aging gracefully."
I found the doctor's conversation about plastic surgery to be incredibly reassuring. If I were a guaranteed patient, I'd have been writing a check for my deposit. Why? Because he is confident, seems to have a realistic outlook on the pitfalls of going too far and has desirable personal taste. There is a certain famous facialist in Manhattan whose appearance is downright otherworldly—it's a wonder anyone would pay the person sporting that face to tinker with their own.
"I want my men to look like the Marlboro guy—I think wrinkles are sexy. Not too many, or not too deep, but I think a little bit of a wrinkle here or there is so sexy," Dr. Steinbrech said. Who would disagree with that? "And if someone comes in and wants not a single wrinkle, that would be a little bit odd-looking. If someone wants it that tight, I encourage them not to because it ends up a little too 'done'-looking or feminized. It looks like bad plastic surgery." He doesn't want to give crazies whatever they want because he takes pride in his work. "I'd say no rather than putting my name on it. Otherwise, people will say, 'Who did that?' but they sometimes want to know so they can warn their friends."
Speaking of not giving every patient what they want if the expectations are out of sync with reality, there are some surgeries the doctor avoids.
"Penile things. Those surgeries have a higher risk portfolio and a higher complication portfolio." I have been using the phrases "risk portfolio" and "complication portfolio" ever since. "I'm not saying I definitely won't do it, but I'm saying I make sure that people know those things."
And I'm not saying that I definitely won't do any of the procedures about which I inquired, either.
As we wound down our two-hour tour of what it would be like if I were a person who had had plastic surgery, Dr. Steinbrech further honed in on why I think he would be a surgeon I would trust. He told me he has a better-looking brother in Hollywood who had been an actor, one so handsome and firm of jaw he could have been Aaron Eckhart's stand-in.
"I like to make everyone look like their twin brother out in Hollywood," he explained. "The reason why I say 'twin' is I don't want you to look like a different person, I want you to look like the best version of you."
I want you to look like the best version of you.
I suppose that, along with finding a solid doctor and working out the financial consideration—my scaled-down middle (unless I opt for the criminally underpublicized CoolSculpting, which Dr. Steinbrech offers and has experienced himself) and junked-up trunk would cost about 20 grand—the prospect of cosmetic surgery comes down to that pesky word: need.
Do I need it?
I'll keep you posted on the answer to that question, but if you have already answered that question for yourself and the answer is that yes, you need it, I think a doctor who wants you to look like the better version of you is a good place to start.