Be under no illusion, says the genial and good-looking Dr Andrew Khoo: men request all the procedures that women do… and then some. Here he spills the beauty beans to Verne Maree.
A good 25 percent of his patients are male, Dr Khoo confirms. And why not? Men are driven by the same desire as women to look younger and more attractive. What’s more, they face similar career-related pressures to appear youthful, energetic and charismatic. Both socially and in business, looks do count.
What kind of man comes to you for treatment?
They’re a mixture of Singaporeans and expats, plus men who come to me from elsewhere in the region. Some are accompanied by a wife who is already a patient and wants to know if I can do something for her husband’s eyebags, for example. Most come on their own, however, having found me on the internet or by word of mouth.
What’s different about treating men?
Firstly, discretion is extremely important; many men won’t even tell their partners about it. Although cosmetic enhancement is becoming less taboo, it’s still a sensitive subject, especially for men.
Secondly – and at the risk of sounding chauvinistic – many men have less time to spare, so they’re more averse to treatments that require a lot of downtime. They prefer non-invasive or minimally invasive options, or invasive ones that promise quick recovery.
Which are your most popular non-invasive or minimally invasive treatments?
Botox and fillers: Botox to smooth out dynamic lines associated with smiling and frowning, mostly around the eyes, on the forehead, and in the glabella, between the eyebrows; and fillers for nasolabial lines and the eye area. A good 25 percent of his patients are male, he confirms. Next most popular are laser treatments to even out the complexion, and radiofrequency procedures such as Thermage to tighten the skin.
What about acne scarring?
It’s largely younger men who come to me for acne scarring, with a mixture of fine scars and broad scars. For the fine scars, we use a mixture of Erbium laser, which is like a fine sandpapering, and Matrix IR, which stimulates collagen growth; they work synergistically to achieve a very good effect. Bigger depressions can then be filled in with a method called subcision.
I’m a big fan of the skin-firming and tightening effects of Thermage. Is it effective on men?
Having virtually no downtime, Thermage is very popular; and it’s highly effective on the right candidate. Proper selection is all-important, though, as it works much better on the thinner, lighter skin that Caucasians tend to have; it is less successful on thick, heavy and more sebaceous skin. Thermage’s tightening effect is basically mechanical: it’s easier to lift and tighten fine, thin skin like yours than it is with strong, heavy skin.
What’s more, Thermage is not inexpensive, so it’s not worth doing it to achieve only a marginal result. If a patient needs a thread-lift or a facelift to get a real result, but can’t afford the downtime now, I will advise him to plan ahead and schedule it to coincide with a lull period or a holiday.
Do you think those expensive little bottles of anti-eyebag stuff that they sell on aeroplanes actually work?
Many of those eye gels merely have an astringent effect that may improve minor eyebags. Where there is still a reasonable level of skin tone, we can achieve good results with laser tightening treatments, or with Thermage.
But in cases where the skin is loose and stretched from too many late nights, too much rubbing of the eyes or years of UV exposure, the answer is blepharoplasty (eyelid surgery).
What does blepharoplasty entail?
There are two types: in the first we don’t make an incision on the outside of the eye; in the second we do.
With isolated fat deposits and fairly good skin tone, we can do the simpler transconjunctival surgery to remove under-eye fat; the skin simply springs back and there’s no external scar. Eight out of ten patients, though, require an external open lower blepharoplasty: removal or redistribution of fat, tightening of the skin and sometimes tightening of the lower lid.
Which type is required can easily be assessed with the spring-back test: pulling the lower lid gently and releasing it to see how readily it springs back. If it takes more than a second or two, you need the more complex blepharoplasty with lid-tightening. We tighten the lid by bringing it back to its original youthful position, and attaching it with a stitch to the eye socket bone.
As for downtime, you could go back to the office within seven to 10 days, after the tiny stitches have been removed, but there might still be some swelling and possibly some bruising. Two weeks’ downtime is the norm.
Apart from blepharoplasty, which are the most popular of the more invasive procedures?
Next most popular is Vaser liposuction of the abdomen and flanks; unlike women, men seldom accumulate fat in the buttock and thigh area.
Then comes Vaser liposuction to remove unsightly deposits of fat from the chest, a condition known as gynaecomastia. It may be necessary to take out some central breast tissue from just under the areola, too, so that the nipples don’t stick out. Excess breast tissue is more common in Indian men, probably due to a diet high in soya, which contains bio-estrogens. I also see it in some Caucasian men, often Americans, who took body-building substances in their youth, and then stopped exercising and put on weight.
Jowl liposuction is another popular procedure. It involves sucking away the fat from a diamond-shaped area stretching from the chin to the Adam’s apple, and is often combined with face-lifting procedures. I may or may not add in an endotine ribbon, which gives superb definition to the jaw-line.
The downtime for jowl liposuction comes mainly from having to wear a chin support – much like a balaclava – for two weeks after the operation; this is not comfortable and makes it obvious what you’ve had done. Actually, most patients don’t manage to wear it for the full fortnight; they wear it for a week, and then they cheat.
I can understand, then, why people would prefer to fly off to recover in another country.
Exactly. My most recent patient, a local banker, asked me to shorten his stitches as he was jetting off to an exotic European location for a couple of weeks– not anonymously, though: he was going with a few good friends!
The Aesthetic & Reconstructive Centre is at 3 Mount Elizabeth, #13-08 Mount Elizabeth Medical Centre.
6733 3712 | andrewkhoo.com
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