Cosmetic surgery (plastic surgery) for men has become more popular for men recently, probably motivated by increasing awareness of the importance of male attractiveness. However, there still are many bogus ideas about it floating around (e.g., only bad results get much attention) and many men who do not understand how or if they should proceed with cosmetic surgery. If only male cosmetic surgery were easy to do well, by just about any cosmetic surgeon. Most doctors who do cosmetic procedures are knowledgeable about aesthetics in certain body parts, but are not doctors of total physical attractiveness, probably will not help devise a strategy of facial attractiveness involving all the relevant areas, and cannot necessarily say how much better a particular procedure will make someone look. Furthermore, doctors are busy and would rather avoid awkward discussions about attractiveness. Whether a doctor wants do a mostly cosmetic procedure then mostly is about how easy and rewarding for the doctor it is, how medically risky it is to the patient, and whether the patient is likely to be happy. The actual expected benefit of undergoing cosmetic surgery is part of what this service advises on. But only if supplied with pictures. Nonetheless, some advice can be given about surgery re problems that, unbeknownst to some, often significantly lower attractiveness and when issues probably should not be addressed surgically. This article will focus on four above-the-neck procedures....
Rhinoplasty (nose job)
Many men would like a different nose. However, the male nose does not generate sexual attraction. It only diminishes it (to most) if far from the ideal and then is a distraction from more sexual parts of the face. That said, per research, rhinoplasty that meets expectations reliably improves self-image and self-confidence for someone lacking in it due to unhappiness with the nose. If one has been subjected to teasing or negative comments about the nose (and facially little has changed since), rhinoplasty can significantly help psychologically. Sometimes the nose becomes a fixation, as in body dysmorphia, too easy to see in a mirror with little relation to the rest of the self and how the world sees things. If a doctor rejects a patient for that reason, it probably is time to accept the nose's imperfections, perhaps with therapy. Doctors seldom turn down correctable significant aesthetic problems. Doctors who do rhinoplasty generally have high standards about what a nose should look like and quickly find things wrong with a patient's nose. A man seeking a nose job should be careful and carefully communicate what his overall goal is (which might be unrealistic), what sections to modify and what not to do.
Even with all that, things can go wrong. Less than 60 percent of men are satisfied after rhinoplasty, according to one study.
A nose that is noticeably crooked, hooked, or asymmetrical or has a large hump, large nostrils, or a big bulbous tip is a serious candidate for a rhinoplasty.
A very droopy tip (nasal tip ptosis) can make someone look older in a bad way and even cause breathing problems. Also, droop is more noticeable and unappealing on a nose that projects much, e.g., the Gonzo Muppets character. (Just doing the tip is called tip rhinoplasty, as opposed to full rhinoplasty.) A droopy nose with thin lips is a distractingly unattractive combination. There is some chance that a droopy tip will droop more over time; a doctor might be able to give a prognosis based on his or her assessment of the individual.
If a nose looks different long after being broken, it almost definitely should be surgically repaired, if only for health.
One should get a broken nose examined and treated as soon as possible; it is easier to fix then and very likely to be covered by insurance then.
The base of the nose (including the nostrils) should be clearly narrower than the closed mouth and chin, or else it very likely will decrease attractiveness and in turn be a reasonable candidate for rhinoplasty. Of course it is sensible to choose surgery on a nose that is simply quite large (reduction rhinoplasty), though structural stability and ability to breathe limit how much smaller it should be made. If it is only slightly large, longer hair or probably (and more drastically) enlargement of the lower face are wiser options. Overall reduction of size that on its own is passable might be worth addressing while correcting other nasal problems. Various problems, including allergies and sensitivities, can swell the nose. That should be treated before rhinoplasty. Also, when there is a crooked nose and poor breathing, probably surgery should be done; that is classified as functional rhinoplasty.
A crooked nose often means both nasal bones and the septum need to be operated on, which is a more unpleasant procedure that makes recovery tougher and has an elevated risk of disappointment.
Adequate breathing with a nose that is hardly crooked? Surgery just for that might not make it look better.
Nostrils showing too much often does lower attractiveness, but it can be a difficult problem to treat. The usual reason is a short nose or the bottom portion is rotated upward. Or as a result of rhinoplasty gone wrong.
A long mid-face is one of the more unattractive facial configurations commonly found in people. When that includes nasal height and the only treatment is rhinoplasty, there is little chance of a significant improvement and if not done well surgery can make the nostrils show too much. Various hair cover-ups might instead be helpful....
Most initial rhinoplasties should use the closed method, not the open method (which is more likely to cause a visible scar).
Now, the scary part...
The many not-so-rare long-term risks of rhinoplasty include damage to the septum (which can cause breathing problems), skin damage (including skin death), a pinched nasal tip (again, poor breathing possibility), a beak-like tip due to scar tissue, uneven nostrils, and nostrils that show too much. Another possibility is aggressive rhinoplasty collapsing the structure and leading to more surgery. Too small is a common complaint by men. Many doctors seem to literally operate nasally with a smaller is better mentality. A small nose is feminine. Also, on a man, a very narrow nose looks strange. To thin a nose can make sense in some situations, including narrow intraocular distance (distance between the eyes) and a small mouth. An upturned tip is feminine, as is a sloping bridge. Do-not-do-that should be established beforehand.
A man cannot distract from a poor result with cosmetics (assuming he cares about gender norms) and probably not much with hair.
With almost any rhinoplasty gone wrong, one often must wait more than a year before repair can be attempted. Furthermore, rhinoplasty will not re-done for free or highly discounted if only the patient is dissatisfied. On top of that, due to scar tissue for example, revision usually is more technically difficult and in turn one should go to a doctor who often fixes the work of other surgeons.
Lengthy experience in rhinoplasty is a must, but selection calls for more than that. Some doctors who do rhinoplasty have little training as nasal specialists. Ear-nose-throat training should be sought in a rhinoplasty surgeon, in part to identify and if necessary surgically treat any non-cosmetic problems, which many people do not realize they have.
A septoplasty can be done at the same time if it is medically advisable, leading to better breathing and sometimes less reoccurring swelling and pain from nasal blockage. (The combination is called a septorhinoplasty.) Sometimes it can convincingly be cited to hide the cosmetic procedure. Various other significant nasal problems that can limit breathing, lead to infections, and even affect speech can be surgically corrected at the same time as rhinoplasty.
Ignoring a portion that insurance might pay for functional problems, one should expect to pay at least $5000 for a rhinoplasty and possibly much more. No, one should not use medical tourism for rhinoplasty. A relatively cheap rhinoplasty almost always will end badly. Many cosmetic surgeons consider a rhinoplasty the technically most difficult common procedure in the field.
Rhinoplasty can be quite painful and generally causes significant discomfort for days.
After surgery, there will be much special nasal upkeep required and also many activity restrictions for weeks or more. For months, it will be important to avoid contact sports and unprotected sun exposure (though most people should limit that anyway). If the nasal bridge has been operated upon, even briefly wearing glasses is not okay for weeks at least, to avoid deforming the area.
With most rhinoplasties, after a week or two, one should look normal in public. After a reduction rhinoplasty, skin might be loose on the nose for months, but almost always it eventually will shrink down. Following a full rhinoplasty, the nose itself will take months to shrink down. That actually makes it easier to hide that the nose was operated on.
Chin and more
Microgenia is the technical name for a disproportionately small chin, which is a common aesthetic flaw in men. In almost all cases, it is very correctable with a genioplasty (mentoplasty) or chin implant. That said...
To most women, an objectively good chin does not generate much attraction and that ideal is not huge. Someone without a notable chin problem should only consider an operation there to partly compensate for loose skin (e.g., double-chin), a jaw deformity that does not quite qualify for surgery, or a general lack of facial masculinity. If social confidence happens to be lacking due to self-consciousness over the chin, research indicates that surgery often helps.
If a chin hardly attracts sexually, why is a weak lower face a notable problem?
A small chin or recessed jaw can make a nose look too large and therefore throw off the balance of the midface (proportion is an important part of attractiveness).
A small jaw has many warning signs, all of which are arguably unappealing: small mouth, crowded or naturally crooked teeth, a particularly gummy smile, and nasal/sinus problems for much of childhood and early adulthood (often a contributing factor in poor jaw development). More signs are described in more detail below.
An obvious overbite (malocclusion) usually is present with a small lower jaw (micrognathia) or rotated, recessed lower jaw (retrognathia), and that overbite itself will be seen as unattractive.
In most cases, an oval face shape indicates a lower jaw that has not optimally developed.
A small mouth and lower face often says sad demeanor.
If the mouth sometimes automatically hangs open when not eating or speaking, that is not a confident look and usually means retrognathia.
When significant bimaxillary protrusion (typified by forward-slanted upper teeth) is present with a weak-looking lower jaw, profile attractiveness is significantly lowered and treatment is more complex (with teeth extraction as a worse option than it might seem to be).
A soft lower face can make a clothed slim, fit person seem to lack muscle.
The chin and lower jaw help signal sexual maturity in men.
A weak lower third (jaw and chin) usually contributes to a babyface, which in young men often leads to less-than-desirable treatment professionally and romantically.
Premature aging in the middle portion of the face around and below the chin often means the chin is undersized, though sometimes a small jaw deserves some blame.
An inherently quite unattractive neck-less look from the side is the combination of loose skin with a short, weak jaw and unimpressive chin.
Sometimes a person will think his problem is a weak chin, when it is actually that and a recessed lower jaw (mandible) (The maxilla is the upper jaw.)
Being a masculine feature, a well-centered, distinct cleft usually makes a chin look good enough, unless for example the chin is quite recessed.
A short jaw and small chin often go together, due to general underdevelopment of the lower face.
Treating the Chin
First of all, fillers are to be avoided. Misplacement is too likely, results (bad or good) fade and can leave stretched-out skin, and the temporary size increase is very subtle.
Surgeons who prefer chin implants might not have the skills to be eager to do genioplasty. One should go to a maxillofacial (oral) surgeon for chin surgery. Or, since most oral surgeons avoid chin implants, a cosmetic surgeon who regularly does facial implants.
The big risk of a chin implant is eventual erosion of the chin bone beneath it and the visual impact thereof.
Genioplasty (an operation that involves cutting the chin bone to move and/or enlarge it) has fewer risks than using an implant; its biggest likely complication is nerve damage, usually temporary.
A chin implant will cost several thousand dollars, and typically a genioplasty will cost a few thousand more than that. Chin surgery is done in a surgical setting and should not require an overnight stay. A sliding genioplasty that moves that the chin forward significantly can improve sleep apnea, but it is very unlikely for insurance to cover what it is primarily a cosmetic surgery.
A square chin is the best shape, though it does not fit every face. Giving an oval face a broad, square chin generally will be an improvement if the face is not very boyish and body frame not narrow, but less so if it makes the face shape oblong.
A very tall chin can be unattractive. The mandible should be clearly wider than the chin is high.
Some chin height and width can be added with genioplasty, sometimes by grafting bone, which would come from another part of the body and make the procedure and recovery slightly more difficult.
For much of an increase in width, a chin implant tends to be the better choice, at least in the short term.
A chin made too big can be fixed, but skin might be left permanently loose.
A large chin might stretch out the skin so much that it develops lines faster.
Seldom should a large chin implant be used to 'fix' a small chin. The latter usually is part of a boyish face, and boyish mixed with hypermasculine is odd, like a mix of Bieber and Schwarzenegger.
A chin implant atop a weak lower jaw can worsen folds of loose skin.
Furthermore, a chin implant on a fleshy face with a weak jaw can stick out like a sore thumb.
A man with thin lips probably should not try to upgrade to a big chin, for it makes a hypermasculine combination, and many women are wary of hypermasculinity.
One should avoid getting his chin made so big that it turns into the focal point of the face (the Jay Leno effect).
The ideal height of the chin should take into account neck length. For example, a tall chin can camouflage a giraffe neck.
Ideal male chin height should be about twice the distance from upper lip to the base of the nose, assuming a normal philtrum length.
A chin should not be noticeably wider than it is high.
A short chin can cause problems with facial harmony. Genioplasty can make a chin look longer, though an implant can add more height.
Chin implants can be custom-sized, and standard ones can be shaved during the procedure.
An augmented chin should extend about as far as the lips and not clearly farther.
While a cleft chin can be created with surgery, it usually will not look right.
A chin implant hardly affects a natural cleft.
In most cases, increased chin projection from a genioplasty or implant will only improve the jaw line slightly.
Unless the chin size or position is changed quite a bit or there was much loose skin, the difference from the front view (after surgery) will be subtle.
There is surgery to slide the chin forward then put an implant in front of it, but in that case jaw surgery probably should replace one of those procedures.
While chin surgery seldom is particularly painful, a chin implant procedure likely will hurt more than genioplasty. Any type of chin surgery likely will have at least few days of eating restrictions and longer activity restrictions, plus many special care requirements. The recovery from genioplasty will be longer (though the bone itself will take longer). For weeks or more, the smile might look somewhat different. After a few weeks, almost all activities will be permitted. It typically takes about 10 days to look normal following chin surgery, though to strangers the swollen chin might simply seem like a big chin. One will be less inclined to be seen if the doctor requires wearing a chin strap for a week, which some do.
A chin implant will only feel weird if there is a significant error in size, shape, or placement.
Infection is unlikely, but if it happens with an implant, that might need to be temporarily removed.
There is a modest chance that the implant will shift at any time in the future. If it does, that can perpetually affect the smile.
If there is no complication from surgery, there is unlikely to ever be a reason to remove or replace a chin implant, except for wanting to look different again. Replacement usually can be done during a removal procedure, and it is similar to the initial implantation. If smaller is decided as better, it might be possible to then shave down the original implant.
Chin surgery and rhinoplasty can be done at the same time; that might be the best way if a maximum of one procedure affects projection and the medical team has expertise in both areas.
Treating the Jaw
As with perhaps all other types of significant cosmetic surgeries, jaw surgery results are never exactly what was expected, even with agreement ahead of time on many details and computer simulations. That said, the maxillomandibular advancement version of orthognathic surgery (especially if it includes jaw implants) probably is the surgery most likely to make some men significantly better-looking. Not surprisingly, that often comes with more social confidence, according to research. A good jawline - long, sharply defined with a moderate angle - can generate sexual attraction. A larger, more attractive (less gummy) smile can make someone look better.
A strong lower jaw helps balance out a large nose.
A square jaw is almost expected from a blonde-haired man, and changing toward that is recommended.
Also, jaw augmentation can lessen unattractive loose skin.
However, if the jaw has grown quite downward, post-surgical improvement to the point of having an attractive side profile is unlikely.
Sometimes afterwards the lower jaw might still look slightly recessed, and in a small percentage of cases the mandible gradually will retract slightly after surgery.
Still, compared to other cosmetic procedures, pure jaw surgery (no implants) is one of the few where the result is almost guaranteed to be at least an objective, subtle aesthetic improvement.
Choosing if or how to treat lower-face developmental problems sometimes is not easy.
The biggest decision-maker is this: jaw alignment affects health, and health comes first.
Breathing-related problems, such as sleep apnea and snoring, often are due to small jaw size.
Also, TMJ often goes with aesthetic jaw problems, and jaw surgery more often than not lessens TMJ pain and any associated headaches in the long run.
Then there are the aesthetic guidelines that can help a man decide which procedure(s) to choose....
A long face (which typically includes a narrow jaw) is widely considered unattractive in and of itself. Moving a jaw forward without adding much width will hardly improve attractiveness. Implants likely will be needed.
Though men might be inclined to idolize it, a wide lower jaw with a strong jawline is too masculine to some women.
A very steep, strong jawline will appear unattractive to some people.
Better aging will happen with jaws that are the proper size and in proper alignment. Namely less sagging. Also, teeth will look and work better longer if the jaws are positioned and sized ideally
Chin surgery can be done before jaw advancement, if one does not want to wait. Chin and jaw surgery also can be done together. In any case, it is best to have the same surgeon correct both the chin and the jaw.
A jaw surgery done with genioplasty, according to research, is more satisfying than that chin surgery alone.
Upper and lower jaw surgery should be agreed upon if recommended (doctors are supposed to use specific criteria to determine medical necessity) . One is very unlikely to get an attractive-looking jaw if the choice is to only get lower-jaw surgery when dual is an option. Also, there is basically no chance upper jaw surgery will be done separately, after lower jaw advancement.
Typically the upper jaw surgery will involve widening it (and the mouth, which can make the smile look better after the associated dental work is finished).
Upper jaw surgery often will affect other components of the face, including the cheekbones and nose. It can make a nose look wider.
Upper jaw surgery probably will not be considered unless dental crowding has been a problem.
Consultation for jaw surgery can cost several hundred dollars, if special x-rays are taken. (They are to be expected at some point before surgery.)
By the way, facial fat removal can be done during jaw surgery.
For a few reasons, including possible continuing growth, jaw implants generally should not be placed until at least age 21.
Jaw implants can lead to a fat-looking face with moderate weight gain, especially if the mouth is small.
Jaw implants can be done during jaw advancement surgery. Advancement itself seldom widens the jaw much.
There are custom-sized jaw implants, which can improve jaw angles and correct asymmetry (an unattractive trait if obvious).
Custom implants of any kind cost about twice as much as prefabricated implants.
Only large jaw implants on someone with low body fat are likely to create a strong jawline, and they will not be appropriate for some patients, such as narrow-necked ones. Michael Phelps is a famous example of someone who likely would look much better with large jaw implants.
For most men, the lower jaw will look more attractive if implants lower the angle of the jaw by adding height there. Much jawbone near the ear is a very male trait.
In most cases, jaw advancement will only improve the jaw line slightly when no implants (or fillers) are involved. Retrognathia is unlikely to be correctable near 95 degrees, and also many tall men would look too heavy in the lower face with a 95 degree gonial angle.
There is at least one style of implants that wraps around the entire lower face, but the change likely would be too dramatic and the implant difficult to replace or revise.
The two notable additional risks with jaw implants are asymmetry (due to poor placement) and of them shifting, which can be fixed later.
If infection were to happen, which is neither likely nor extremely unlikely, at least the infected implant would need to be temporarily removed, in a fairly major surgery.
Jaw implants are not commonly done by most orthognathic surgeons; one should seek out an expert for that.
Tempting reasons to get the nose improved during jaw surgery are money-saving, hiding the rhinoplasty, convenience, and some inpatient aftercare for a rhinoplasty, but cosmetically it is not advisable in most cases. Basically rhinoplasty with jaw advancement can create surprises, sometimes unpleasant. Strictly speaking only straightening the nose is reasonably sure to not affect how the nose and jaw look relative to each other (assuming no initial significant jaw asymmetry). Also, there is a limit to total safe operating time, and rhinoplasty is best done slowly to achieve near-perfection.
Jaw surgery likely first will require many months of orthodontic treatment (meaning braces). That might be partially covered by dental insurance. Braces almost surely would need to remain for months after surgery.
A few bottom teeth likely will need to be removed in order to do jaw advancement surgery (in other words, extra pain and cost). Probably it will be done at an earlier time.
Jaw advancement occasionally can leave a noticeable deformity in the area of the incision, which jaw implants can mask.
There will be a few weeks of significant swelling and limited mouth opening from implants.
Jaw advancement is medically a major procedure sometimes involving a hospital stay, and a small percentage of patients will have significant complications that require urgent treatment. Also, there can be some long-term loss of sensation that occasionally is permanent, more likely with double jaw surgery.
There easily can be a few weeks of swelling and numbness in the chin area from lower jaw advancement. Upper jaw surgery does not add much to the swelling.
Jaw surgery typically is not particularly painful.
The jaw surgery recovery period usually includes more restrictions than chin surgery, with a liquid diet that turns into soft foods and maybe not hard food for a few months.
Unobstructed nasal breathing and proper swallowing (often missing in jaw development problems) will make the entire jaw surgery process go better
Hair loss is confirmed by research to be psychologically damaging to many men. While non-surgical treatment generally is at least moderately effective at maintaining hair, anecdotally at least restoration can restore happiness and increase interpersonal success and is the one common purely cosmetic procedure for men that often does that. It is especially helpful to light-skinned men weak in the lower-third of the face. If the results are satisfying. Fears of otherwise contribute to some people hoping they look okay bald, but research indicates that virtually everyone looks worse that way. A hair restoration surgeon is not going to tell someone whether or not he can pull off a shaved look (instead of a transplant), and most others are not going to answer that question both honestly and thoughtfully.
Modern hair transplantation is very unlikely to look pluggy (which commonly occurred decades ago). If using the newer, virtually scarless method, there is even less chance a transplant will make someone look worse than not undergoing the procedure. Scalp reductions, which are to blame for some hair disasters, are almost never done anymore on men. (Meanwhile, medications rarely regrow much hair, and no non-surgical end to hair loss is expected to be available any time in the near future.)
Then why do the modern transplant results sometimes look bad?
Hairline location and density are very important. Many hair transplants look unnatural because the hairline is made strong while being too high or too low. The latter sometimes looks okay initially on young patients, but as people age, usually the hairline moves up along with other facial changes. And the native hair behind it is likely to thin.
Sometimes there is too much hair loss to treat with standard procedures in a way that will look normal (often Norwood 5 on the hair loss scale). Not all doctors are ethical enough to say that. Some doctors do have special techniques, such as body hair transplantation or very invasive tricks, that can squeeze out more hair to use. Also, one partially camouflaging technique that is practical for many men over 40 for whom hairline lowering needs to be limited is to moderately lengthen a reasonably intact forelock (basically a broader version of a widow's peak) or create a small one. The forelock will not need to be made or kept particularly dense.
It is a bad idea to get a hair transplant (session) during a period of rapid hair loss or poor scalp health.
Transplanted hair should last forever, though people should keep in mind that all hairs tend to thin in width as one enters the senior years, which can lead to see-through hair if density is marginal. A new hairline usually looks best, for the long run, not rounded and a little chewed on. For a man under 35 or so, it is better not to fully restore the hairline, lest the hair behind it become noticeably sparse. Many doctors will resist full restoration in such cases. If the hairline is going to be made full-looking, that should be done gradually, in part to correct anything that looks amiss (gaps between thick hairs) instead of trying to later undo a full-fledged unnatural look.
Significant transplantation to the hairline should not be done if a bald spot in back is not being addressed.
Usually an attempt to fill in a sizable bald spot at the crown is a bad idea, due to the sheer amount of grafts that would require, which might be needed elsewhere later. See-through when wet is a more sensible goal. Almost never should a man with male-pattern baldness have hair transplanted to his crown before age 30.
Sticking to small transplants (under 1000 grafts), after the few days following surgery, it is unlikely a casual observer will ever notice that work has been done. Especially if the hairstyle is changed soon before or during the regrowth period. Ability to touch and move the hair will be limited for several days after the procedure, it must be said.
Occasionally transplants fail, sometimes for reasons unknown. In terms of hair supply, that means a large transplant can be a disaster.
Frontal transplantation usually requires more work over the years, because medication typically is of limited effectiveness in halting loss in that part of the scalp.
Note: A small percentage of men are candidates for hairline advancement in place of much restoration. Improvement will be immediate, and usually pain surprisingly is not very much. However, it will involve a high price (likely $7000 or more), a scar (typically somewhat hidden by hair), virtually guaranteed facial swelling for at least a few days, temporary forehead numbness, a risk of shock loss, and higher risk of infection than a transplant, and it likely will prompt a small transplant in front of it later to make the hairline look more natural or hide any more thinning that has occurred. In a small percentage of cases, results will immediately or later look terrible and be very costly to make better. Candidates will have much frontal loss with otherwise an almost full, long-stable head of hair, a scalp that is not already pulled tightly, and a history of not scarring badly. Usually it is done as an outpatient surgery, basically a hospital setting (around many other people). Also, not many doctors do forehead reduction surgeries. It is a procedure that calls for much more guidance than a paragraph can provide.
If one does not keep up with transplants, the hair might begin to look unnatural and might even need to be cut very short to hide that.
Despite what ads imply, in basically no cases will hair look better just a few weeks after a transplant. Several months is the usual minimum. Any previously bare areas in front might look strange as hair grows in and temporarily require cover-ups.
Density in an area that once was bare or very thin is unlikely to ever be good (look normal when wet) and usually will require multiple procedures to look passable. There is a limit on how densely hair can be packed (just below normal original density for most men), and also a procedure can knock out sometimes permanently dying hairs in the area (shock loss), more so when density is maximized. Also, the incisions for new hairs can lead to healthy hairs being cut. There is potential for hair temporarily to look much worse after a transplant.
A man whose natural hair is very dense likely will end up wanting more and more procedures to restore that look, though it might be impossible.
The further from reaching age 30, the much greater the chance that multiple procedures will need to be done to prevent a very strange-looking head of hair.
Generally a man should not have a transplant before age 25, for either the hair loss is already looking too severe or the long-term prognosis is too hard to predict. Also, 2000 grafts is about the maximum number in total that ought to be transplanted to an average patient while still in his twenties.
Thin hair throughout the top of the scalp or in the back of the head often makes someone a poor candidate for surgery.
The more contrast between hair and scalp color, the more important it is that the individual hairs be thick or plentiful to provide supply for transplants .
Almost everyone who has not already used the FUT (strip) method, which involves cutting and therefore scarring the scalp, should use the FUE method. Though it is more expensive and is not quite as efficient in the amount of hair available to transplant. The FUT scar on back of head will be obvious with shaved head or very short hair (or to a barber or maybe a romantic partner), unless hair is later transplanted into it to hide it. With FUE, usually the worst visible result in the back of the head is tiny dots when shaved, which not everyone develops, though with too many or large procedures, the entire area might look thin at least temporarily. That or shock loss in the donor area, which will be temporary. Almost everyone with medium or thick hair seeking to perfect the hairline should use FUE for that. It allows for placement of fine hairs usually found there.
Transplant surgeons who do manual FUE generally are perfectionists and therefore less likely to botch patients. (Robot-assisted FUE hints at poor motives and is less likely to produce a good result.)
Also, poor wound healing or poor laxity is a strong argument for avoiding the (FUT) strip method.
For various reasons, it is harder to achieve a pleasing result when transplanting ethnically African hair, and such a patient should seek out a doctor with a strong track record in that.
Very curly hair can make it hard to disguise a transplant if not done well.
Usually a person has to wait at least a year between transplants.
There is some online chatter that all hair transplants require shaving the head (before or on the day of the procedure), but that is inaccurate. Small sessions do not necessarily require shaving, and in most cases, only partial shaving of the donor area is required and can be camouflaged by hair. Some doctors prefer short hair over shaving. Each doctor has his or her own policy, though. It might be difficult to find a doctor to do FUE who does not require the hair in back to be cut very short or shaved. With FUT, having short hair throughout the back of the head might make the sutures or staples visible until they are gone.
A transplant usually is done in a doctor's office and probably will take at least 3 hours.
A hair transplant typically is not done at the same time as any other non-hair procedures. Some doctors will do rhinoplasty at the same time, but that should only be considered if the doctors involved are highly skilled at both procedures. Pain is to be expected during and shortly after transplant surgery. It is very mild with the FUE method, but with FUT can be present to a bothersome degree in the back of head for a few weeks. Bleeding can occur for up to 2 weeks, regardless of surgical method. Facial swelling can happen after frontal transplantation and will take a few days to subside. For those reasons (and because hat-wearing can harm transplant results), one will not want to be seen unnecessarily for several days at least after surgery. Sun exposure will need to be restricted for a while, and there will be some exercise and activity limitations with FUT that will dwindle away after a few weeks .
Most of the better surgeons use a densitometer to check for miniaturization (that individual hairs are thinning). A few also measure hair bulk.
A reputable doctor usually will almost require a man with genetic balding to be on a prescription DHT blocker (e.g., Propecia) for at least a year before a transplant. Similarly, one will be expected to continue taking medication afterwards in most cases.
For a hair transplant surgeon to be good at his or her job, years of experience at doing almost nothing but hair transplants is a virtual requirement. Too many doctors offering hair transplant do not meet that criteria.
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